ASD Comprehensive Assessment — MRCPsych Paper B MCQ
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Correct answer: A — Integrate developmental history, direct interaction and observation, medical and physical assessment, differential diagnoses, coexisting conditions, and information from home and education.
Explanation lettering: B = shown as A · A = shown as B · D = shown as C · E = shown as D · C = shown as E
B is correct. NICE recommends a comprehensive autism diagnostic assessment drawing on parental and developmental history, the child’s experiences across home and education, direct interaction and observation, medical history, physical examination, differential diagnosis and systematic assessment of coexisting conditions. Information from all sources is integrated with clinical judgment. Autism-specific instruments such as ADOS-2 or ADI-R may help gather information, but neither is mandatory and no tool should determine the diagnosis alone; therefore A and C are incorrect. School or nursery observation may provide useful additional evidence, particularly when reports conflict with clinic observations, but is not sufficient alone, excluding D. Intellectual and language assessment should be tailored to the child’s profile. Genetic testing and EEG are indicated only in selected circumstances, not routinely, excluding E.
Reference: National Institute for Health and Care Excellence. Autism spectrum disorder in under 19s: recognition, referral and diagnosis (CG128), recommendations 1.5.5–1.5.11. 2011, updated 2017. https://www.nice.org.uk/guidance/cg128/chapter/recommendations