Exploring the Impact of Clinical Diagnosis on Health and Education Outcomes for Children Receiving SEN support for Autism: an analysis of ECHILD
“It is only through dialogue with those who are affected that we can hope to make sense of the challenges people face.”
This study is being led by Dr Xingna Zhang (University of Liverpool) and is funded by ADR UK and ESRC. The study started in September 2024 and aims to finish in December 2026.
This project was reviewed and approved through ECHILD's data access process. Learn how ECHILD data is kept safe.
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How do clinical autism diagnosis and special educational needs (SEN) support interact to influence children’s health and education outcomes, and how do these patterns vary by socioeconomic background and ethnicity?
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Children and young people can face long waits for autism assessment, placing pressure on services and raising questions about how diagnosis relates to access to support. Findings from the study will be used to inform how CAMHS and SEN support might be improved to reduce inequalities in health and education outcomes.
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The study uses linked ECHILD health and education data in three connected work packages, following eligible children from 2016 to 2022 and using statistical analyses to examine diagnosis, SEN support and later outcomes. It also engages clinicians, local services, and autistic children and young people to help interpret the research and identify potential improvements to support.
Find out more
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Why does this matter?
Diagnosed autism is becoming more common among children and young people, while waits for assessment remain long, making it important to understand what additional value a clinical diagnosis may provide alongside needs-based support.
What do we want to find out?
The project aims to identify factors associated with receiving an autism diagnosis after referral to Child and Adolescent Mental Health Services (CAMHS), examine how diagnosis and SEN support relate to later educational attainment and mental health service use, and assess whether these relationships differ by socioeconomic background and ethnicity.
What we will do
This project has three connected work packages. It will use linked ECHILD data to identify eligible children and follow them from 2016 to 2022, examining factors associated with receiving an autism diagnosis. It will then investigate how diagnosis and SEN support relate to educational attainment and mental health service use, including differences by ethnicity and socioeconomic background. The project also engages clinicians, local health and education services, and autistic children and young people to help interpret findings and identify ways to reduce inequalities.
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Background and aims
Autistic Spectrum Disorder (ASD) is a lifelong developmental disability affecting communication and interaction. Against a background of increasing diagnoses and pressure on autism assessment services, this project aims to evaluate underdiagnosis and inequalities in receiving SEN support, and to examine how clinical diagnosis and SEN support relate to health and education outcomes for children in England. It also aims to assess whether these relationships vary by socioeconomic background and ethnicity.
Methods and analysis
The project comprises three connected work packages combining linked-data analysis with stakeholder engagement. The first work package plans to construct a cohort of children without an ASD diagnosis in 2016 and follow them to 2022; within a time-to-event framework, age at diagnosis is treated as the time indicator and ASD diagnosis as the event, with a mixed-effects Cox survival model planned to examine predictors including individual, school/class, socioeconomic and geographic factors. The second work package will examine how ASD diagnosis and SEN support relate to educational attainment and mental health service use, including variation by ethnicity and socioeconomic background. The third work package works with health and education services and autism communities to understand system processes, identify gaps, and inform potential improvements.
ECHILD data used
HES: Mental Health Services Data Set (2015/16-2021/22) and Accident & Emergency (2015-2019)
NPD: Early Years Census, EYFSP, Absences, Exclusions, Alternative Provision Census and Placement, Key Stages 1 and 2, Children Looked After and Children in Need Census (2015/16-2021/22)
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