Saudi Arabian evidence-based clinical practice guideline for the management of children with autism spectrum disorder: A national guideline adaptation using the KSU-modified-ADAPTE methodology

Shuliweeh Alenezi, Fahad Bashiri, Amel Alawami, Ayman Alhazmi, Somayyah Aladamawai, Faisal Alnemary, Yasser Alqahtani, Maysaa Buraik, Saleh AlSuwailem, Shahad Akhalifah, Saleh Al-Salehi, Yasser Amer
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Abstract

Introduction

Autism spectrum disorder (ASD) is one of the national mental health priorities that has manifested a wide variability in practice in the Kingdom of Saudi Arabia (KSA). This work aimed to adapt evidence-based clinical practice guidelines (CPGs) for ASD to synthesize the first national CPG for the management of children with ASD in KSA.

Methods

The CPG adaptation group comprised multidisciplinary expert clinicians and a CPG methodologist following the KSU‑Modified‑ADAPTE methodology. The last search date for source evidence-based guidelines was March 2022.

Recommendations

Three main categories of recommendations were included: (i) prevention and early identification, coding, psychometric tools, telehealth, risk factors and referral criteria, (ii) diagnosis, differential diagnosis, investigations and family support, (iii) interventions with problem minimization and avoidance, treatment goals, physical wellbeing, nonpharmacological interventions, sensory integration, parent-mediated interventions, cognitive behavioural therapy, pharmacological interventions, psycho-education of the family, special cases or comorbidities, sleep management, gastrointestinal and feeding interventions, the transition of care from paediatrics to adulthood. CPG implementation tools included a baseline assessment tool, clinical scenarios, pathways, quality measures, referral forms, screening tools and useful online resources. The adapted CPG presents practical, evidence‑based guidance with implementation tools for managing children with ASD in KSA. The project illustrated the applicability of the KSU‑modified‑ADAPTE and highlighted the importance of collaboration between clinicians and methodologists for adapting national CPGs.

沙特阿拉伯自闭症谱系障碍儿童管理循证临床实践指南:采用 KSU 改良-ADAPTE 方法对国家指南进行调整
引言 自闭症谱系障碍(ASD)是国家精神健康优先事项之一,在沙特阿拉伯王国(KSA)的实践中表现出很大的差异。这项工作旨在改编以证据为基础的自闭症临床实践指南 (CPG),以合成第一份针对沙特阿拉伯自闭症儿童管理的国家级 CPG。 方法 CPG 改编小组由多学科临床专家和 CPG 方法论专家组成,采用 KSU-Modified-ADAPTE方法。循证指南来源的最后搜索日期为 2022 年 3 月。 建议 包括三大类建议:(i) 预防和早期识别、编码、心理测量工具、远程保健、风险因素和转诊标准;(ii) 诊断、鉴别诊断、调查和家庭支持;(iii) 干预,包括问题最小化和避免、治疗目标、身体健康、非药物干预、感觉统合、家长干预、认知行为疗法、药物干预、家庭心理教育、特殊病例或合并症、睡眠管理、肠胃和喂养干预、从儿科到成年期的护理过渡。CPG 实施工具包括基线评估工具、临床情景、路径、质量措施、转诊表、筛查工具和有用的在线资源。改编后的 CPG 为管理 KSA 的 ASD 儿童提供了实用的循证指导和实施工具。该项目说明了 KSU 修订版--ADAPTE 的适用性,并强调了临床医生和方法论专家在改编国家 CPG 方面开展合作的重要性。
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