Some autistic children not properly diagnosed, says expert

Julia Medew

Some children showing signs of autism are left undiagnosed under new guidelines for autism spectrum disorders. Others are told they have ''social communication disorder'', a new condition that does not attract government funding for therapy, a leading psychologist says.

Eight months after the latest diagnostic manual of mental disorders came into effect, Vicki Gibbs, a clinical psychologist with Australia's largest non-profit, autism service provider, Autism Spectrum Australia (Aspect), said a small number of children who would have previously been diagnosed with autism were now either left without a diagnosis or classified as having ''social communication disorder''.

She said this meant they missed out on federal government funding of up to $12,000 for those diagnosed with autism spectrum disorders before the age of six.

According to the latest manual those with the disorder have persistent difficulty with verbal and non-verbal communication that cannot be explained by low cognitive ability. Symptoms include difficulty with spoken and written language and inappropriate responses in conversation.

Ms Gibbs said children with SCD may not pick up on social cues such as people getting bored of what they are saying or understand idioms such as "pull your socks up".

But, she said, under the new diagnostic guidelines, they will not exhibit restrictive or repetitive behaviours associated with autism such as obsessions or sensory difficulties.

While previous studies have estimated 10 to 50 per cent of children diagnosed with autism under the previous manual may not be diagnosed with it under the new one, Ms Gibbs said, her service which assesses about 350 children a year, had seen about 10 examples of this so far. This meant the children would miss out on funding for care which they still needed.

''A child with social communication disorder still needs intervention, they are still going to have great difficulty getting on with other people and having relationships, so in many ways they still need a lot of the same therapies we give to kids with autism spectrum disorder, such as social skills training, conversation training and reading people's expressions,'' she said.

Ms Gibbs said although she diagnosed people according to the manual, some clinicians might diagnose autism when children did not meet all the criteria because they would get funding for care.

''I think there's been a bit of that going on. It definitely does influence decision-making, it's just human nature,'' she said.

A spokeswoman for the federal Department of Social Services would not comment on what assistance would be provided to people diagnosed with SCD, but Fairfax Media understands the government has agreed to review cases in the next year in preparation for a policy response.

A new overview of autism spectrum disorders published by Murdoch Childrens Research Institute says the causes are unclear. However, some high-risk genes have been found and researchers have linked the disorders to rising maternal age, improved survival rates of premature babies and exposure to antidepressant drugs.