Hull York Medical School and Dept Health Sciences, University of York, York, UK,

Institute of Psychological Sciences, University of Leeds, Leeds, UK,

Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK,

Leeds Institute for Health Sciences, University of Leeds, Leeds, UK,

Child and Adolescent Mental Health Service, Bradford District Care NHS Foundation Trust, Saltaire, UK,

Child Oriented Mental Health Intervention Centre, Leeds and York Partnership NHS Foundation Trust, York, UK,

Corresponding author.

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We demonstrate the feasibility of linking education and health data. Performance on teacher ratings taken universally in school reception class can flag children at risk of ASDs. Further research is warranted to explore the utility of EYFSP as an initial screening tool for ASD in early school years.

This study demonstrated the feasibility of linking education and health data using ASDs as an exemplar. A total of 8,935 children had linked primary care and education data with 20.7% scoring <25 on the total EYFSP and 15.2% scoring <10 on a EYFSP subscore proposed by an expert panel prospectively. The rate of diagnosis of ASDs at follow-up was just under 1% (84 children), children scoring <25 on the total EYFSP had a 4.1% chance of ASD compared with 0.15% of the remaining children. Using the prospectively designed subscore, this difference was greater (6.4% and 0.12%, respectively).

We linked the EYFSP score at the end of reception year with subsequent diagnosis of an ASD, using all ASD general practitioner Read codes. We used the total EYFSP score and a subscore consisting of five key items in the EYFSP, prospectively identified using a panel of early years autism experts.

The Born in Bradford longitudinal cohort of 13, 857 children.

We set out to test whether the early years foundation stage profile (EYFSP) score derived from 17 items assessed by teachers at the end of reception school year had any association with autism spectrum disorder (ASD) diagnosis in subsequent years. This study tested the feasibility of successfully linking education and health data.

Abstract

To date, there is limited evidence that screening for autism spectrum disorders in the first 6 years of life is cost-effective.

Linking these data has the potential to decrease costs associated with undiagnosed childhood conditions to the individual as well as health and education services.

Performance on educational measures taken universally in school reception class can flag children at risk of autism spectrum disorders.

It is feasible to link routine education and health data for a cohort of children in England.

What is known about the subject?

What this study adds?

Example Parental Quote

Early years skills foundation profile (EYFSP): weighted subscore

The Connected Bradford project is a Northern Health Science Alliance led programme funded by the Department of Health and delivered by a consortium of academic and NHS organisations across the north of England. The work uses data provided by patients and collected by the NHS as part of their care and support. We would like to acknowledge the support of Cathy Hulin and Poppy Konstantopoulou.

Acknowledgments

Contributors: Contributed to the writing of the manuscript: BW, MM-W, BK, SW, DS, FM, KS, JEB and JW. Statistical analysis BK. Agree with the manuscript’s results and conclusions: BW, MM-W, BK, SW, DS, FM, KS, JEB and JW. All authors have read, and confirm that they meet, ICMJE criteria for authorship.

Funding: This work was supported by the UK Prevention Research Partnership (MR/S037527/1), which is funded by the British Heart Foundation, Cancer Research UK, Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Health and Social Care Research and Development Division (Welsh Government), Medical Research Council, National Institute for Health Research, Natural Environment Research Council, Public Health Agency (Northern Ireland), The Health Foundation and Wellcome.

Disclaimer: The views expressed are those of the author(s) and not necessarily those of the NHSA, NHS or the Department of Health.

Competing interests: None declared.

Patient consent for publication: Not required.

Ethics approval: Ethical approval was granted by Bradford NHS Research Ethics Committee (Ref 07/H1302/112).

Provenance and peer review: Not commissioned; externally peer reviewed.

Data availability statement: Data are available upon reasonable request.