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A recent review focusing on tools used in determining the diagnosis found that guidelines varied in their recommendations ( Canadian Agency for Drugs and Technology in Health, 2013). There have been numerous guidelines published with recommendations for diagnostic assessments for ASD, for governmental jurisdictions ( Dua, 2003 National Collaborating Centre for Women’s and Children’s Health, 2011) as well as for professional associations ( Filipek et al., 2000 Johnson et al., 2007). Clinical guidance documents play an important role in shaping these diagnostic assessment practices. The rise in the prevalence of autism spectrum disorders (ASD), now estimated at 1 in 68 ( Centre for Disease Control National Center on Birth Defects and Developmental Disabilities, 2014), has created an increased demand for ASD diagnostic assessments. Research is required to close the evidence gaps and inform high-quality clinical guidelines. The substantial variation likely stems from insufficient evidence supporting assessment practices. Multiple guidance documents exist for autism spectrum disorder diagnostic assessments, with varying quality and recommendations. There was little supporting evidence for team and personnel recommendations. The documents varied substantially in their recommended tools and personnel for diagnostic assessment. All documents either recommended multidisciplinary team assessment or stated it was ideal. The 11 documents demonstrated higher quality in Scope and Purpose (mean: 90.1, standard deviation: 7.4) and Clarity of Presentation (mean: 82.8, standard deviation: 9.4) and lower quality in Applicability (mean: 43.3, standard deviation: 23.8) and Rigor of Development (mean: 52, standard deviation: 21.9). A content analysis was conducted for recommended clinical personnel and psychometric tools. A quality appraisal was conducted by two appraisers using the Appraisal of Guidelines Research and Evaluation, second edition tool. The government search was limited to English-speaking, single-payer, publicly funded health systems.
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The objective was to perform a systematic review of professional association and government clinical guidance documents for autism spectrum disorder diagnostic assessment, analyzing their quality and content. Clinical guidance documents play an important role in ensuring access to high-quality autism spectrum disorder diagnostic assessment practices.