Analytisch schema en klinische uitgangsvragen

Deze geeft een overzicht van de oorspronkelijke Engelstalige uitgangs­vragen (primary review questions) en het bijbehorende analytische schema (analyticframework). Deze Britse uitgangsvragen zijn uiteindelijk verwerkt in de reviewprotocollen (A1-A2; B1-B3, C1-C6, D1-D2) en in de Neder­landse utigangsvragen (zie hoofdstuk 1, paragraaf 3), ofwel er is besloten ze in de volgende herziening van de Nederlandse richtlijn te behandelen (E1-E2, F1-F2).

Hier volgt het analytische schema (analytic framework) met de oorspron­kelijke Britse uitgangsvragen (primary review questions) voor het onder­zoek naar case identification (A1-A2), steun aan familie en naasten (D1-D2), naar organisatie en uitvoering van de zorg (E1-2) en ervaringen van patiënten en naasten (F1-F2). Verderop in deze bijlage (figuur B4.2) vindt u het analytische schema en voor het onderzoek naar behandeling (interventions) (C1-C6).

 

 

Case Identification

Hier volgen de oorspronkelijke Britse uitgangsvragen (primary review questions) voor het onderzoek naar case identification.

No.

Primary review questions

A1
  • What signs or symptoms should prompt any professional who comes into contact with an adult with possible autism to consider referral for further assessment?

A2 & A2a
  • What are the most effective methods/tools for case identification in adults with autism?
  • What amendments, if any, need to be made to the agreed methods for case identification to take into account individual variation [for example, gender, age, intellectual abilities (including cognitive strengths as well as difficultie], communication problems, developmental disorders, coexisting mental health disorders, physical problems including hyper/hypo-sensitivities, motor impair- ments, and visual and hearing impairments)?

 

Diagnosis and assessment

Hier volgen de oorspronkelijke Britse uitgangsvragen (primary review questions) voor het onderzoek naar diagnostiek en assessment.

No.

Primary review questions

B1
  • In adults with possible autism, what are the key components of, and the most effective structure for, a diagnostic assessment? To answer this question, consideration should be given to:
    • the nature and content of the clinical interview and observation (including an early developmental history where possible)
    • formal diagnostic methods/ psychological instruments (including risk assessment)
    • biological measures
    • the setting(s) in which the assessment takes place
    • who the informant needs to be (to provide a developmental history).

B2
  • When making a differential diagnosis of autism in adults, what amendments, if any, need to be made to the usual methods to make an:
    • assessment of autism itself in light of potential coexisting conditions?
    • assessment of the co-existing conditions (for example, common mental health disorders, ADHD, personality disorder, gender/identity disorders, eating disorders, Tourette syndrome, and drug/alcohol misuse)?

B3
  • What are the most effective methods for assessing an individual's needs (for example, their personal, social, occupational, educational, and housing needs) for adults with autism?

 

Interventions

Hier volgen het analytische schema en de uitgangsvragen (primary review questions) voor het onderzoek naar behandeling (interventions).

 

 

 

No.

Primary review question

C1
  • For adults with autism, what are the benefits and/or potential harms associated with different psychosocial interventions (for example, applied behavioural analysis, cognitive behavioural therapy, mentoring, social groups, and befrien- ding schemes)?

C2
  • For adults with autism, what is the effectiveness of vocational and supported employment programmes?

C3
  • For adults with autism, what is the effectiveness of educational interventions (including specialist programmes, or support within mainstream education)?

C4
  • For adults with autism, what is the effectiveness of biomedical interventions (for example, dietary interventions, sensory integration, pharmacotherapy, and physical-environmental adaptations)?

C5
  • For adults with autism, is the effectiveness of interventions moderated by:
  • the nature and severity of the condition?
  • the presence of coexisting conditions?
  • age?
  • the presence of sensory sensitivities (including pain thresholds)?
  • IQ?
  • language level?

C6
  • For adults with autism, what amendments, if any, need to be made to the current recommendations for psychosocial and pharmacological treatment (including the nature of drug interactions and side effects) for coexisting common mental health disorders?

 

Support for family and carers

Hier volgen de oorspronkelijke Britse uitgangsvragen (primary review questions) voor het onderzoek naar steun voor familie en naasten (support for family and carers).

No.

Primary review question

D1
  • What information and day-to-day support do families and carers need:
    • during the initial period of assessment and diagnosis?
    • when treatment and care is provided (for example, telephone helpline, information packs, advocates or respite care, interpreters and other language tools)?
    • during periods of crisis?

D2
  • What role can families and carers play in supporting the delivery of interven- tions for people with autism?

 

Organisation & delivery of care

Let op: deze vraag wordt in Nederland in de eerstevolgende update behandeld

Hier volgen de oorspronkelijke Britse uitgangsvragen (primary review questions) voor het onderzoek naar organisatie en uitvoering van de zorg (organisation & delivery of care).

No.

Primary review question

E1
  • What are the effective models for the delivery of care to people with autism including:
    • the structure and design of care pathways?
    • systems for the delivery of care (for example, case management)?
    • advocacy services?

E2
  • For adults with autism, what are the essential elements in the effective provi- sion of:
  • support services for the individual (including accessing and using services)?
  • day care?
  • residential care?

 

Experience of care

Let op: deze vraag wordt in Nederland in de eerstevolgende update behandeld

Hier volgen de oorspronkelijke Britse uitgangsvragen (primary review questions) voor het onderzoek naar ervaringen van patiënten en naasten (experience of care).

No.

Primary review questions

F1
  • For people with autism, what are their experiences of having autism, of access to services, and of treatment?

F2
  • For families, carers or significant others of people who have autism, what are their experiences of caring for people with autism, and what support is available for families, carers or significant others?