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The International Consortium for Health Outcomes Measurement (ICHOM) has launched a standardized Autism Spectrum Disorder Standard Set (ASDSS). The rollout of this set marks a step toward promoting data quality and availability across the industry. The ASDSS will strengthen autism care and provide a cohesive set of standards that ICHOM will implement globally.

ICHOM experts worked together with leading researchers, psychologists, behavioral analysts, and service user representatives from across Europe, the Americas and Asia to identify standards that will positively impact the quality of life for autistic individuals, while driving value-based health care globally.

The ASDSS is the first international standard for measuring treatment outcomes for autism spectrum disorders of children and adults over 18 months old.

The ASDSS has two similar tracks for implementation in countries that use specific tools in existing reimbursement models and for those without. Both tracks will measure the same outcomes and they will be risk adjusted with the same factors, however:

  • Track A recommends tools with cost associated with them to match existing tools in the current reimbursement models; and

  • Track B recommends tools that are free or have a low cost.

The Autism Spectrum Disorder Standard Set

The ASDSS provides a set of recommendations for how treatment outcomes should be measured in clinical practice. It recommends measuring nine health outcomes covering four domains.

The nine health outcomes include:

  • Restricted and Repetitive Behaviors
  • Social Communication
  • Daily Functioning
  • Leisure
  • Quality of Life
  • Family Functioning
  • Emotional Regulation
  • Anxiety
  • Sleep Issues

For this purpose, it recommends a set of patient- and clinician-reported outcome measures. To help ensure the ASDSS is effective across different intervention contexts, the working group also recommends 15 risk adjustment factors, to be collected along with the outcomes, as well as timepoints for measurement.

Measuring, reporting and comparing these outcomes can help identify best practices for autism spectrum disorder, ultimately generating increased value and outcomes for service users. The selected outcome measures are available in several languages, allowing the ASDSS to have increased adoption across various countries.

Consumer Review Period

The working group’s recommendations were validated during an open review period by a large group of external stakeholders from around the world. Over 85% of behavior analysts, psychiatrists, psychologists, occupational therapists and researchers approved the recommended outcomes and over 75% of the stakeholders agreed with the recommended measures. Finally, over 85% of the external stakeholders agreed that these outcomes and measures in Track A were feasible to collect in clinical practice.

The Future of ASDSS

From its inception, ICHOM has made the ASDSS an open source. Now that this recommendation is finalized, the real work can begin, ushering in value-based autism care. It will be invaluable to learn from implementation pilots that may emerge across the globe and inform future iterations of this global set of standards.

This collaboration was facilitated by ICHOM and the independent project was made possible by generous contributions from the following organizations: Hopebridge, United States; InBloom Autism Services, United States; Trumpet Behavioral Health, United States; Learn Behavioral, United States; Center for Autism & Related Disorders (CARD), United States; Autism Learning Partners, United States; Centria Autism, United States. The ICHOM ASDSS sponsors are invested to ensure that the best care is provided in the autism spectrum disorder (ASD) space.

The sponsors recognize that the only way to test this is the creation of a standardized method of collecting outcomes in the ASD space that are agreed and meaningful to patients, can be deployed and, that are sensitive to improved intervention. The sponsors are also aware that in the past, ASD is typically not designed to be the space of collaboration, however they have found that this project is a model of collaboration and although this is the beginning of the process they are really looking forward to furthering this outcome set alongside other providers and organization to standardize outcome measurement.