New Zealand Autism Spectrum Disorder Guideline

The NZ Autism Spectrum Disorder Guideline provides evidence-based information for people on the autism spectrum, their family and whanau, as well as health, disability and education professionals and social service agencies.  It includes information about good practice that is evidence-based and aims to improve the health, educational and social outcomes for people with ASD.

As part of the implementation of the Guideline, the Ministries of Health and Education established a living guideline process to regularly update the Guideline to reflect new evidence and changing user needs.

Since the living guideline process was established in 2009, Supplementary Papers have been published annually. These provide updates in areas of applied behaviour analysis, pharmacological interventions, supported employment, changes in diagnostic criteria in the DSM-5, gastrointestinal issues, social skills groups, and cognitive behaviour therapy.

The second edition (2016) of the Guideline incorporates the updates developed through the living guideline process. This means that all amendments to the Guideline recommendations, identified in the Supplementary Papers, are incorporated into the second edition.

The first edition of the Guideline was published in 2008.

See the Autism Spectrum Disorder Guideline section for links to further information and resources.

Key points of interest in the Guideline

For health professionals

Early identification of children with ASD is essential – it enables early intervention and is likely to lead to better function in later life.

• There is no cure for ASD.
• Parents’ concerns about their child’s development must be taken seriously.
• Pathways for people with ASD to access assessment need to be clearly identified. (The Guideline describes some of these pathways.)
• Multidisciplinary assessments through specialist ASD services are the best way to improve diagnosis.
• Robust information on effective assessment and diagnosis processes for different age groups is needed.
• Health professionals assessing people with ASD need to be aware of effective assessment tools and the role of cognitive assessment.

For the education sector

• A single approach or solution is unlikely to ever meet the needs of all learners with ASD. Educators need to choose approaches that fit the individual and their settings, and need to be skilled in providing a range of interventions
• Strategies need to be implemented right across home, early childhood education, school and community settings if we are to achieve successful outcomes for children and young people with ASD
• Most overseas educational intervention programmes are based on three broad approaches:
  • discrete trial training (DTT)
  • contemporary behavioural and developmental research findings
  • developmental (social pragmatic) approaches.
• Some programmes include elements of all three. No one approach has been shown to be more effective than another.
• Current special education practice in NZ emphasises participation and development, rather than ‘fixing’ the child.
• Teaching children with ASD in isolated settings away from other children is not best practice. Children and young people must be supported to use what they learn in more than one setting. The best way to achieve this is for parents, teachers and peers to work collaboratively.
• People providing services and support to children and young people with ASD must have a positive attitude, expertise in ASD, and the willingness to work in a team with the family.
• Young children with ASD should be appropriately engaged in goal-directed activities across a variety of home, educational and community settings, for 15–25 hours per week. This is a collective responsibility involving families, early childhood education services, early intervention services (including education support workers) and community services. It does not mean that specialist service providers have to be with the child for all of these hours – but they do need to support others to contribute in accordance with an agreed plan.
• Interventions should be monitored and evaluated on an ongoing basis. Changes should be made if there is no evidence of progress within a few months.
• The principles of positive behaviour support should be incorporated into educational interventions, with a focus on understanding the function of the child or young person’s behaviour.
• All transitions should be planned and new environments prepared carefully.