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CAMHS ASD screening questionnaire - question on the CHOICE Checklist

Tania

Hello there. My daughter (13) has been referred by CAMHS for ASD screening and one of the pre-screen questionnaires is the ASD CHOICE Checklist. I can see that the source of this checklist is Simon Baron-Cohen's 2008 Autism And Asperger Syndrome book and I'm concerned that his views have since been very challenged in terms of their bias towards diagnosis in boys/men and lack of applicability to the way that autism in teen girls can present. I have related concerns about the School questionnaire (Autism Spectrum Screening Questionnaire - 27 questions) that accompanies it, which also seems to be seeking quite extreme and expressive demonstrations of autistic traits, e.g. "is regarded as an ‘eccentric professor’ by the other children" whereas my understanding is that girls are relatively good at masking their natural instincts on this front.

Am I right to be concerned or does the community here have reasonable faith in the CAMHS/NHS process of diagnosis for girls today? Thank you so much.

  • in reply to Martin

    Thank you, this is my concern too.

  • in reply to Ann :)

    Thank you. It's strange, it's not as if I'm "willing her" to be autistic, but it would be helpful if there was a diagnosis that made her treatment path a little more clear. If the NHS result is 'borderline' or the girl aspect feels like it's being under acknowledged, then I may be able to try a private route for a second opinion.

  • in reply to Martin

    Yes, I think some clinicians are becoming more aware but this seems to be more of an exception rather than the norm. I was actually sent the pre-screening questionaires for diagnosis in Luxembourg (though I ended up not being assessed there due to moving abroad), and they included an additional questionaire specifically for girls, which I thought was positive. What was less positive was that most of the questions on all their questionaires were geared towards toddlers or school age children so it was quite hard to fill out. 

    Hopefully you will come accross a well informed clinician. It might help to make a list of any traits you spot so that you can use this as evidence later if necessary. I hope it goes smoothly. I don't have experience with the NHS diagnosis process unfortunately as I was diagnosed privately (due to my frequent moves between different countries). I did have a very good experience with my private diagnosis in the UK, which involved an in-depth pre-screening assessment with someone experienced in working with autistic individuals (which took about 3 hours), followed by a second assessment by a psychiatrist that also works for the NHS. 

  • Not all the questions are looking for extreme traits. My daughter scored highly and she doesn’t present like a typical male, and coupled with the assessment, she didn’t get a diagnosis. Just try to remain positive for now.

  • I think that the diagnosis of girls is a problem and that very many tests (AQ10, AQ50 and RAADS-R) and questionnaires still contain outdated and stereotypical thinking on how autism presents and are biased towards male presentation and away from female presentation. Some clinicians, some, are 'on board' and make allowances for this bias, but until the basic tools for diagnosis are officially updated I have little confidence that all clinicians are fully aware enough to make reliable diagnoses for females.

  • in reply to NAS73797

    Thank you for such a quick response.

  • i think everythings taken into account, professionals see and diagnose all sorts of childhood issues and are good at spotting the subtle differences, theres usually a group of professionals that all discuss and diagnose. recently my son started hallucinating when stressed, they just assessed and come to the agreement that its related to his sleep issues. also i have never asked about the questions on the forms but the doctors might use them as a base guide for questions and reference ?  if your unsure of the form get the doc to help fill it in during your next appointment