From Finding The Right Clinician To Diagnostic Tools And Parent Interviews There Are Many Steps
An autism diagnosis covers a spectrum of children with a wide range of skills and impairments. Because of this, the developmental disorder can look very different from child to child. Many experts who diagnose and treat children with autism like to say, If youve seen one child with autism, youve seen one child with autism.
The diversity of autism spectrum disorder can make it difficult to correctly diagnose. Sometimes autistic children are mistakenly diagnosed with a different disorder, like ADHD, or are told that nothing is wrong. Other times kids are diagnosed as autistic when they actually arent.
Thats why its important for parents to know what the components of an autism diagnosis should be: What kinds of information should a clinician whos evaluating your child be considering? How can you know whether your clinician is following best practices in doing an autism assessment?
Ongoing Assessment For Autism
Your childs school district and/or clinician may perform a Functional Behavioral Assessment. This evaluation seeks to determine causes for specific, often challenging, behaviors. Based primarily on observations in various settings, strategic intervention are developed to address these behaviors. Other assessments may include interviews with parents and teachers and completing behavioral and sensory rating scales.
It is recommended that families, educators, and pediatricians track their childs progress over time. Regular assessments help guide treatment choices throughout the entire lifetime. The Autism Treatment Evaluation Checklist , a frequently used, no-cost, online tool developed to monitor symptoms and behaviors and assess the effectiveness of various treatments over time.
The following webinar is the first in a two-part series about the importance of ongoing assessment and evaluation for children with symptoms of autism. It is presented by Claire Schute, Psy.D.
Watch to learn:
- What assessment and evaluation are
- The benefits of assessment and evaluation
- About different types of assessments and evaluations
- How to prepare for the assessment process
Families can also use the CDCs developmental milestone tracker to monitor child development and to help them decide whether its time to share their concerns with a physician.
What Does Aspergers Look Like
The three characteristics a child with Aspergers exhibits are social awkwardness, obsessiveness, and sensory issues, says John Carosso, PsyD, a child psychologist and certified school psychologist at Community Psychiatric Centers at the Autism Center of Pittsburgh, Pennsylvania. They might be bossy, very physical, and lack empathy, he says. They may be aggressive. They want to be friendly with other children but they dont know how. Temper tantrums, self-injury, and aggression are other possible signs, as are language delays and the habit of avoiding eye gaze.
Look for deficits in social communication, repetitive behaviors, and rigidity, says Eric Hollander, MD, director of the Autism and Obsessive-Compulsive Spectrum Program in the Department of Psychiatry and Behavioral Sciences at Montefiore Medical Center in New York City. A child with Aspergers may obsess over one item, always carrying it around, he says. This also can interfere socially since this may be all the child talks about, he says. And they may be hypersensitive to clothing, sounds, touch, textures and smells.
Additionally, Dr. Hollander says, because life is generally so difficult for these children, they may mishandle social situations. These kids tend to be very emotional and are always having tantrums, he says. They are routine-oriented and very rule-oriented. They have the attitude: These are the rules and you stick with the rules.
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What Do The Results Mean
If results show signs of ASD, your provider may refer you to specialists for more testing and/or treatment. These specialists may include a:
- Developmental pediatrician. A doctor who specializes in treating children with special needs.
- Neuropsychologist. A doctor who specializes in understanding the relationship between the brain and behavior.
- Child psychologist. A health care provider who specializes in treating mental health and behavioral, social, and development issues in children.
If your child is diagnosed with ASD, it’s important to get treatment as soon as possible. Early treatment can help make the most of your child’s strengths and abilities. Treatment has been shown to improve behavior, communication, and social skills.
ASD treatment involves services and support from a variety of providers and resources. If your child is diagnosed with ASD, talk to his or her provider about making a treatment strategy.
How Do You Talk With Your Child About Their Autism Diagnosis
It can be hard to decide what and how much information to share when talking to your child about their autism diagnosis. Setting a positive tone when discussing autism spectrum disorder and making sure you understand what your child is truly asking is very important. Establish a positive attitude about their differences from the outset, then answer their questions simply and honestly. If your child is of reading age, you may want to consider finding some childrens books on the topic of autism spectrum disorder to read with them.
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How Is Autism Diagnosed
Doctors diagnose children as autistic by observing them at play and interacting with others.
There are specific developmental milestones that most children reach by the time theyre 4 years old, such as having a conversation or telling a story.
If your 4-year-old has signs of autism, your doctor may refer you to a specialist for a more thorough examination. A specialist will observe your child while they play, learn, and communicate. Theyll also interview you about behaviors youve noticed at home and may request input from your childs teachers or other adults who interact with your child.
While the ideal age to diagnose and treat the symptoms of autism is 3 years old or younger, the sooner your child receives treatment, the better.
Under the Individuals with Disabilities Education Act , all states and Washington, D. C., are required to provide an adequate education to school-age children with developmental issues. Contact your local school district to find out what resources are available for preschool-age children in your area.
Get An Autism Diagnosis
Arrange an autism assessment for your child as early as you can. A thorough assessment is important for an accurate autism diagnosis. It helps to think of the assessment as a benchmark or starting point for support for your child. You can use the assessment to measure your childs progress.
For a thorough assessment and a specific autism diagnosis, make an appointment with a professional trained in diagnosing autism, like apsychologist, speech pathologist or paediatrician. You might need a referral from your childs nurse or GP.
Autism diagnosis is based on observing your child, talking to you and others about your child, and looking at your childs developmental history. It usually involves many health professionals.
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Testing For Other Medical Difficulties And Delays
Because other medical conditions sometimes occur with autism, your paediatrician might also do other tests, like a physical examination and history, and a hearing test. These tests:
- check for signs of other conditions that might explain your childs symptoms
- help to identify any other medical conditions that might need treatment.
Its also good for you and the professionals youre working with to know more about your childs strengths and difficulties in thinking and learning. Professionals assess these strengths and difficulties differently depending on your childs age:
- Developmental assessment this is for children under four years old.
- Cognitive assessment this is for children over four years old.
These assessments can help professionals understand whether your childs difficulties are caused by development delays or intellectual disability rather than autism.
Most children will also have a communication andlanguage assessment by a speech pathologist.
Some children might also have their daily living skills, like feeding themselves and dressing, assessed by an occupational therapist.
Waiting For An Autism Diagnosis
You might be put on a waiting list for assessment. Try not to see this as a period when nothing happens. If you can, look for other options you might be able to get an assessment sooner.
Occasionally, the outcome of your assessment might be a recommended period of watchful waiting, especially if your child is younger than 1-2 years. This means your health professional wants to see whether your childs symptoms change with a few more months of development. Its possible the symptoms might reduce over time or become more pronounced.
If youre told to wait and watch, again the key is to be proactive:
- Contact the NDIS. The NDIS can support children with developmental difficulties, even before an official diagnosis of autism.
- Get your child checked every three months by your child health nurse, GP or paediatrician.
- Seek a second or even third opinion if you feel you want one.
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How Accurate Is It
This quiz is NOT a diagnostic tool. Mental health disorders can only be diagnosed by licensed healthcare professionals. If youd like to learn more about autism read Psycoms guide to autism spectrum disorder .
Psycom believes assessments can be a valuable first step toward getting treatment. All too often people stop short of seeking help out of fear their concerns arent legitimate or severe enough to warrant professional intervention.
How Parents Can Spot The Warning Signs
As a parent, youre in the best position to spot the earliest warning signs of autism. You know your child better than anyone and observe behaviors and quirks that a pediatrician, in a quick fifteen-minute visit, might not have the chance to see. Your childs pediatrician can be a valuable partner, but dont discount the importance of your own observations and experience. The key is to educate yourself so you know whats typical and whats not.
Monitor your childs development. Autism involves a variety of developmental delays, so keeping a close eye on whenor ifyour child is hitting the key social, emotional, and cognitive milestones is an effective way to spot the problem early on. While developmental delays dont automatically point to autism, they may indicate a heightened risk.
Take action if youre concerned. Every child develops at a different pace, so you dont need to panic if your child is a little late to talk or walk. When it comes to healthy development, theres a wide range of typical. But if your child is not meeting the milestones for his or her age, or you suspect a problem, share your concerns with your childs doctor immediately. Dont wait.
Regression of any kind is a serious autism warning sign
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Diagnosing Autism Spectrum Disorder In Children
Autism spectrum disorder is a group of complex neurological and developmental disorders that affect brain development and cause social, communication, and behavioral challenges.
People with the condition have difficulty with social interactions and verbal and nonverbal communication. They may also exhibit repetitive behaviors or restricted interests. Signs of autism spectrum disorder begin to appear during early childhood and typically last throughout a persons life.
Children with autism spectrum disorder develop social and communication skills in different ways and at different ages than their peers. Some babies become overly focused on certain objects, rarely making eye contact. They may fail to engage in typical back-and-forth play and babbling with their parents. Other children may develop typically but then show a regression in social, language, or other skills.
A young child with autism spectrum disorder may not smile in social situations, have poor social interactions, prefer to be alone, and not make gestures, such as pointing or showing objects. Imaginative play may be minimal or nonexistent.
What Are The Symptoms Of Autism
The early signs and symptoms of autism vary widely. Some children with ASD only have mild symptoms, and others have severe behavioral issues.
Toddlers usually like to interact with people and the environment they live in. Parents are typically the first to notice that their child is showing atypical behavior.
Every child on the autism spectrum experiences challenges in the following areas:
- restricted or repetitive behaviors
Early symptoms of ASD can include the following:
- developing language skills late
- not pointing at objects or people or wave goodbye
- not tracking people with their eyes
- showing a lack of responsiveness when their name is called
- not imitating facial expressions
Some individuals arent diagnosed until adulthood.
At present, theres no one official test for diagnosing autism. A parent or doctor may notice early indications of ASD in a young child, though a diagnosis would need to be confirmed.
If symptoms confirm it, a team of specialists and experts will usually make an official diagnosis of ASD. This could include a psychologist or neuropsychologist, a developmental pediatrician, a neurologist, and/or a psychiatrist.
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What Does Research On Autism Tell Us
A recent study focused on this question. Researchers looked at more than 1,200 toddlers who had at least two developmental evaluations between 12 and 36 months. Less than 2% of the toddlers initially thought to have autism were subsequently thought to have normal development. And on the flip side, 24% initially thought to not have autism were then later diagnosed as having it. So while the picture is not always clear at first, once the diagnosis is made, it usually sticks.
At what age can the diagnosis be reliably made? At 12 to 13 months the diagnostic stability of the autism diagnosis meaning the degree to which it was certain and stuck was about 50%. This went up to 80% by 14 months, and 83% by 16 months. This makes sense if you think about the development of a toddler. At 12 months, they are just starting to say words, respond to commands, and interact with others. So a child who isnt reliably doing those things would be cut some slack. But by 18 months, all those skills should be solidly in place, raising alarm bells about a child who doesnt have them.
Related Health Conditions To Autism
Autism often develops alongside other health conditions. Your specialist will be able to spot these and can offer a dual diagnosis. They can involve:
Other learning issues like:
The earliest testing in the UK for autism is usually between 18-24 months, using a test called CHAT .
But, according to the charity Child Autism UK, actual diagnosis is rarely given before the age of two, and in fact most diagnoses happen after a child starts school, at aged five.
Delaying having your child tested, as you worry he or she will then be stigmatised? Or making excuses like, my child will grow out of it, he or she is just naughty, he is just shy?
Its important to keep in mind that research shows an earlier diagnosis can lead to better long-term outcomes for children.
And keep in mind that your childs developmental difficulties could stem from something different than autism, including physical health issues. So it is important to seek help.
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Prenatal Factors That May Contribute To Autism
Taking antidepressants during pregnancy, especially in the first 3 months.
Nutritional deficiencies early in pregnancy, particularly not getting enough folic acid.
The age of the mother and father
Complications at or shortly after birth, including very low birth weight and neonatal anemia
Maternal infections during pregnancy.
Exposure to chemical pollutants, such as metals and pesticides, while pregnant.
More research on these prenatal risk factors is needed, but if youre pregnant or trying to conceive, it cant hurt to take steps now to reduce your babys risk of autism.
Reducing the risk of autism: Tips for expectant mothers
Take a multivitamin. Taking 400 micrograms of folic acid daily helps prevent birth defects such as spina bifida. Its not clear whether this will also help reduce risk of autism, but taking the vitamins cant hurt.
Ask about SSRIs. Women who are taking an SSRI should talk with a clinician about all the risks and benefits of these drugs. Untreated depression in a mother can also affect her childs well-being later on, so this is not a simple decision to make.
Practice prenatal care. Eating nutritious food, trying to avoid infections, and seeing a clinician for regular check-ups can increase the chances of giving birth to a healthy child.
Source: Harvard Health Publications
What Is An Autism Test
An autism test is not just a series of questions, nor is it as simple as a blood test.
In fact you cant find autism using a medical test. This said, a thorough medical examination is part of the process to rule out other physical conditions that can affect a childs development, like downs syndrome. And autism testing will include testing your childs hearing and vision.
An autism test is rather a very thorough set of screenings and evaluations that can involve one or several specialists.
Your specialist will ask you many questions about your childs behaviour and health, but also about your family history. They will likely then talk to your childs GP as well as his or her school, and teachers.
And the specialist will of course observe your childs behaviours and interactions. This might involve several appointments, where your child is asked to try specific activities to measure their skills. Note that everything will be done to put your child at ease during this process.
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How To Test A Child For Autism
You may ask your childs healthcare provider to periodically check your child for signs of autism with a developmental screening test. A screening test alone will not result in a diagnosis but can indicate if your child should see a specialist. A developmental pediatrician, child psychologist or psychiatrist, pediatric neurologist, speech-language pathologist, occupational therapist, or other specialist can conduct a formal developmental evaluation.