The diagnostic interview for social and communication disorders (DISCO – 11; Wing 2006), is a semi-structured, interview-based instrument used in the diagnosis of children with autism spectrum disorder (ASD). This paper explores the psychometric properties of the DISCO-11 used in a specialist Paediatric clinical setting. Two key research questions were examined; (1) Does the factor structure of the DISCO-11 reflect the diagnostic and statistical manual 5th edition (DSM-5, American Psychiatric Association [APA], 2013) dyad of impairment in ASD? (2) Is there evidence of diagnostic stability over time using the DISCO?

Review assessments of 65 children with ASD were carried out using standardised measures including the DISCO-11 and the autism diagnostic observation schedule.

The results revealed two factors resembling the DSM-5 algorithms, as used in DISCO-11, which were named as social-communication, and restricted and repetitive behaviours. The reliability, for the overall DISCO score was good (Cronbach’s alpha = 0.78). The social communication and social interaction subscale showed good reliability (Cronbach’s Alpha = 0.77) as did the restricted and repetitive patterns of behaviour, interests or activities subscale (Cronbach’s Alpha = 0.74). Acceptable internal reliability was found for the overall DISCO score and the subscales of social communication and social interaction and the restricted and repetitive patterns of behaviour, interests or activities. Test–retest showed good stability of diagnosis over time.

This study supports that the DISCO-11 shows potential as a valid and reliable instrument that can be used both for clinical and research purposes.

The provision of 24-hour specialist child and adolescent mental health services (CAMHS) is a key target for service commissioners. However, a lack of data exist on models of service delivery or levels of need for out-of-hours specialist CAMHS to guide service development. We aim to describe a model of 24-hour service provision and provide information on the demand for and outcome of assessments of a service in Dublin, Ireland, using a 6-year retrospective case study design.

A total of 468 emergency presentations occurred during the study period; 80% presented with self-harm or suicidal ideation. Two-thirds presented outside of working hours. All presentations received a specialist CAMHS consultation. Over 50% required admission to a paediatric ward and 80% required onward referral to specialist CAMHS.

There is a need for a 24-hour specialist CAMHS and this allows increased rates of specialist assessment and onward referral for a high-risk group.