Towards system redesign: An exploratory analysis of neurodivergent traits in a childhood population referred for autism assessment

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Lang, J., Wylie, G., Haig, C., Gillberg, C., & Minnis, H. (2024). Towards system redesign: An exploratory analysis of neurodivergent traits in a childhood population referred for autism assessment. PLOS ONE, 19(1), e0296077. https://doi.org/10.1371/journal.pone.0296077

Publication date: 10 Jan 2024 Added to AutiHub: 18 Sep 2026 Type: Article Article language: English
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Authors

Publication authors
5
Publication authors identified as autistic
1 / 5 (20.0%)
  1. Jason Lang *
  2. Georgia Wylie
  3. Caroline Haig
  4. Christopher Gillberg
  5. Helen Minnis

Abstract

Background Children’s health services in many countries are moving from single condition diagnostic silo assessments to considering neurodevelopment in a more holistic sense. There has been increasing recognition of the importance of clinical overlap and co-occurrence of different neurotypes when assessing neurodivergent children. Using a cross-sectional service evaluation design, we investigated the overlap of neurodivergences in a cohort of children referred for autism assessment, focusing on motor, learning, and attention/activity level domains. We aimed to determine what proportion of children in a cohort referred for an autism assessment showed traits of additional neurodivergences, and what proportion were further investigated. Methods We evaluated anonymised medical records of children aged between two and 17 years referred for autism assessment. We used validated questionnaires to assess for neurodivergent traits. A weighted scoring system was developed to determine traits in each neurodevelopmental domain and a score above the median was considered to indicate a neurodivergent trait. Evidence of further investigations were recorded. We then examined the relationships between autism traits and traits of additional neurodivergence. Results 114 participants were included for evaluation. 62.3% (n = 71) had completed questionnaires for analysis. Of these, 71.8% (n = 51) scored greater than the median for at least one additional neurotype, indicating the presence of other neurodivergent traits, and 88.7% (n = 64) attracted a diagnosis of autism. Only 26.3% of children with evidence of additional neurotypes were further investigated beyond their autism assessment. Conclusions Our results demonstrate the extensive overlap between additional neurodivergent traits in a population of children referred with suspected autism and show that only a small proportion were further investigated. The use of standardised questionnaires to uncover additional neurodivergences may have utility in improving the holistic nature of neurodevelopmental assessments.

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Cited references
60
With a DOI
47
Without a DOI, from raw bibliography text
13
3 / 60 (5.0%) cited references include at least one author identified as autistic.
References with data to complete
9 / 60 (15.0%)
References with detected author names
51 / 60 (85.0%)
Without detected author names
9
Without a structured title
9
Without a stable identifier
11
References with raw author names still to review
9
References with external metadata lookup issues
0
These indicators apply to cited references displayed on this page, after technical duplicates have been merged. A reference without a DOI can still support author statistics when a title and author names are available.
Author names detected in the cited bibliography
228
From DOI or external metadata
228
From validated raw bibliography text
0
Raw names already validated
0
Raw names still to review
18
43 / 228 (18.9%) names are linked to an author already present in AutiHub. 185 / 228 (81.1%) names are not yet linked.
Names linked to a person identified as autistic
4 / 228 (1.8%)
Calculated across all author names detected in the cited bibliography. Among names linked to an author already present in AutiHub: 4 / 43 (9.3%). Distinct people identified as autistic: 4 / 212 (1.9%).
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