How Autism Is Diagnosed In Older Children And Teenagers
Theres no single test for diagnosing autism in children and teenagers. Instead, diagnosis is based on:
- watching how your child interacts with others that is, how;your child is developing now
- interviewing you and your child
- reviewing your childs developmental history that is, how;your child has developed in the past.
Diagnosis usually involves many specialists and professionals testing and assessing your child this is called a multidisciplinary assessment. When many specialists work with your child, it gives your child the best chance of an accurate diagnosis. It also helps to develop the best plan to support your child.
A multidisciplinary team will usually include a;paediatrician, a;psychologist, a;speech pathologist, and sometimes a child psychiatrist. It might also include other professionals, like an occupational therapist.
The professionals might want to see you and your child several times. Theyll ask you questions about your childs current and past development and behaviour. Theyll measure your childs strengths and difficulties in areas like thinking, moving, communicating and so on. And theyll watch how your child interacts with others.
You might meet with all the team members on the same day in the same place. Or you might see one professional at a time. For example, you might see a speech pathologist or psychologist first and then a paediatrician at a later time.
Most children will also have a language assessment by a speech pathologist.
Why Girls May Be Underdiagnosed
Girls who have overt symptoms;such as obvious self-stimulating behaviors , extreme difficulties with speech and language, severe difficulties with social communication, or significant cognitive challenges, are usually referred for evaluation and diagnosed at a young age.
But girls whose symptoms are subtle, or whose intelligence level allows them to mask symptoms, may only be diagnosed as pre-teens or teens. Our culture may be to blame for some missed diagnoses in girls. In general, girls are expected to be quieter and less assertive than boys.
A girl who appears shy and withdrawn may be seen as acceptably “feminine,” while a boy with the same behaviors is considered to be atypical. Similarly, a girl who seems “spacey” and unengaged is often described as “dreamy,” while a boy with similar behaviors may attract negative attention.
May Exhibit Difficulty Recognizing Facial Expressions And Making Eye Contact
From an early age, children learn to make eye contact with their parents, smile when they are being smiled at, and point or wave at things they find interesting, such as an animal at the zoo or a favorite toy.
Children on the autism spectrum have a harder time recognizing emotion in facial expressions and may show little to no emotion themselves. When something startling occurs , its actually normal for a child to look to their parent and in seconds process their facial expression to identify what emotion is being conveyed. This is done as a way to verify if they too need to be concerned with what just happened. With an autistic child, however, there is often no reaction at all, which for a parent, can be very puzzling and concerning.
Older children with ASD will often look at the ground or let their eyes wander when an adult is speaking to them; making eye contact is often a key struggle for children with ASD.
Because children on the spectrum have trouble reading facial expressions, they may fail to react or even react inappropriately when a parent or sibling is expressing joy, anger, or sorrow.
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Behavioural Signs In Infants Between 6 And 12 Months Can Predict Asd
A 2005 Canadian study published in the;International Journal of Developmental Neuroscience,;with over 200 participants was the first to;pinpoint specific behavioural signs in infants as young as 12 months that can predict, with remarkable accuracy, whether a child will develop autism.
Autism is one of the most prevalent disorders today, and while a bio marker was finally found last year to help with early diagnosis, its normally only 80% effective, and so far mostly being used on higher risk infants. Also it is found using an MRI, and wait times can be long. Most doctors instead must rely on parent observations, observing the child themselves, and;using standardized tools like the Checklist for Autism in Toddlers . However these tools are made for children who are 18 months and older, a long time especially when early detection and intervention can help with many of the frustrations that develop from communication problems.
Because of the research done, a scale was developed to help doctors with early assessment in infants as young as 6 months . The Autism Observation Scale for Infants has been a fantastic new tool to help parents and doctors get an early diagnosis.
What Are The Levels Of Asd
ASD is divided into three levels:
- Level 1. People at this level may have symptoms that dont interfere too much with their work, school, or relationships. This is what most people are referring to when they use the terms high-functioning autism or Aspergers syndrome.
- Level 2. People at this level require some outside support on a daily basis. Examples of outside support include speech therapy and social skills training.
- Level 3. People at this level require substantial outside support on a daily basis. In some cases, support may include full-time aides or intensive therapy.
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When Do These Signs Typically Begin To Appear
Signs of ASD can change from childhood to adulthood. In many cases, autism cant by definition be diagnosed unless its signs are present when your child is young so that a pattern of behavior can be established.
Of course, theres no exact time when these signs of autism will become noticeable in your teen.
But as with many teens, you may start to see behavioral and emotional changes happen when they hit puberty, usually at 11 to 13 years old.
Signs of autism may also become more noticeable when they start attending middle and high school, where social relationships often become more central to a teens life.
Should I Get My Child Assessed
You should get your child assessed for ASD if:
- you have concerns
- you notice any signs or symptoms
- your child has a close relative with ASD
Normally, your health care provider will test your child first. You can help your health care provider understand the unusual behaviour you see by:
- taking photographs
- maintaining logs or diaries
- capturing these behaviours on video
If there are concerns, then your health care provider should refer you to a specialist for more tests. A specialist is the best person to help diagnose your child.
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Diagnosing Children With Autism Spectrum Disorder
The National Institute of Neurological Disorders and Stroke cites four major classic symptoms which are often used by pediatricians to diagnose children with autism:
- Poor communication skills
- Stimming and repetitive behaviors
- Limited to no verbal skills
However, many of the above are almost impossible to see in a small baby who is not yet in the age range of talking or developing interests. This means many parents do not seek diagnosis until a later stage, and their child might miss out on the benefits of early intervention.
So, lets break down some of the early signs of autism parents can look out for.
Autistic People Cant Speak
Autism is a spectrum condition, meaning that the level of difficulties autistic people face varies hugely from person to person. One of the main areas affected by autism is the ability to speak, because autistic people find processing and interpreting language very tricky. Expressing what they feel using words can be a real struggle, but autistic people are autistic, not stupid, so many of them will find ways to compensate for this, allowing their spoken language skills to improve hugely over time. In fact, one of the recognised characteristics of autistic people with higher functioning language skills is their enormous vocabulary and their tendency to speak for far longer than is generally acceptable about the things they find interesting.
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Signs That Your Baby May Have Autism
Most of these are that would show up between the 6 months to 1 year range. Before that, many of these may not show up at all. It is also important to know that any one of these traits on its own is not a diagnosis. If your child is showing a number of these traits over the 6 month period, it is always good to;see a doctor for assessment. Early diagnosis and treatment can really make a difference in skills building later on. Again this list should not be considered a diagnosis, only used as a tool to start a conversation with your doctor who can then start a proper assessment process.
Attention Deficit Hyperactivity Disorder
Many children have trouble with thinking before they act, sitting still and focusing. But in children with attention deficit hyperactivity disorder , these behaviours can be extreme and have a big effect on their daily lives. The behaviours usually happen together, although some children can be mainly inattentive.
How common is ADHD in autistic children? Autism and ADHD share some common characteristics like not seeming to listen when people speak, interrupting, or intruding on other peoples personal space. Many autistic children have behaviour thats very similar to ADHD.
How is ADHD treated? Theres no cure, but children and teenagers can learn to manage ADHD;using behaviour strategies, taking medication, or a combination of the two.
Find out more
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When To See Your Pediatrician
During checkups, your childs pediatrician will assess developmental progress. In between appointments, however, you may notice signs of autism or suggestions your child is not developing similarly to his/her peers. He/She may not engage with you the same way other babies engage with their parents, or he/she may exhibit some of the other symptoms listed above.
If you feel something is amiss, consult your childs pediatrician to run a series of diagnostic exams. These exams are non-invasive and will often include a behavioral and developmental assessment. You might also be given a questionnaire for you and other caregivers in your childs life.
Differences In Language Development Especially Comprehension
- Unusual use of language (e.g. made up words; reference to self as you or she/he beyond 3 years, unusual vocabulary for childs age or social group
- Poor response to name
- Limited non-verbal communication
- Failure to smile socially to share enjoyment and respond to the smiling of others
- Unusual language development, including muteness, odd or inappropriate intonation patterns, persistent echolalia ,
- Limited use of language for communication and/or tendency to talk freely only about specific topics.
When Can My Child Be Diagnosed With Autism
According to the Center for Disease Control , an autism diagnosis can be appropriately given at 18 months of age or sooner. Doctors screen for autism spectrum disorders at the nine-month, 18 month, 2-year, and 3-year wellness checkups. Many children with autism do not receive an official diagnosis until they reach the age of two or three. It is often after the child has started school. This is when the childs challenges in social skills become obvious. It is never too late to get a diagnosis and begin identifying resources to help make life with autism easier.
The earlier a child gets a diagnosis , the sooner the child can start therapy or treatment.
Early Signs Of Autism In Preschool Kids
You may notice differences in your childs behaviors and communication right before they go to school. Some of these signs may mean that your kid is at risk for autism spectrum disorder. Here are some of the signs listed by CDC:
- Speaking less than 15 words
- Seeming confused by the function of everyday items
- Not responding to their name when called
- Not walking
- Has repetitive behaviors like rocking back and forth
Most girls show symptoms in infancy or early childhood. But they may not be recognized.
Some studies suggest that certain symptoms are seen more commonly in boys than in girls. Repetitive behaviors, for instance, may appear more often in boys. They are easier to spot.
In addition, girls deal with ASD differently than boys. They may hide their symptoms or spend more energy on adapting to social norms.
They are more able to form friendships. This may cause ASD to not be determined early on.
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What To Do If Youre Worried
If your child is developmentally delayed, or if youve observed other red flags for autism, schedule an appointment with your pediatrician right away. In fact, its a good idea to have your child screened by a doctor even if he or she is hitting the developmental milestones on schedule. The American Academy of Pediatrics recommends that all children receive routine developmental screenings, as well as specific screenings for autism at 9, 18, and 30 months of age.
Schedule an autism screening. A number of specialized screening tools have been developed to identify children at risk for autism. Most of these screening tools are quick and straightforward, consisting of yes-or-no questions or a checklist of symptoms. Your pediatrician should also get your feedback regarding your childs behavior.
All Autistic People Have Savant Skills
Many autistic people have amazing talents and skills in certain areas, yet struggle with basic things like tying their shoe laces. A large number have particular gifts in art, science or mathematics, but many others dont and have instead a more generalised skill set. In extreme cases, the difference in skill levels from one subject to another is very large and this led to the wonderfully insulting term idiot savant being applied to autistic people in the past. It means idiot genius and refers to people who struggle to function in everyday life yet show flashes of genius in their specialist areas of interest.Its widely believed that the term mad professor comes from the high number of university lecturers who are on the spectrum, although theyre mostly undiagnosed as yet. Being able to speak in depth and at length about quantum physics while wearing odd socks and making no eye contact doesnt necessarily make you autistic, but if you also have anger management issues, frequently walk into doors, avoid social engagements and prefer atoms to people, you might want to give it some thought!
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What Are The Signs Of Autism
The autism diagnosis age and intensity of autisms early signs vary widely. Some infants show hints in their first months. In others, behaviors become obvious as late as age 2 or 3.
Not all children with autism show all the signs. Many children who dont have autism show a few. Thats why professional evaluation is crucial.
The following may indicate your child is at risk for an autism spectrum disorder. If your child exhibits any of the following, ask your pediatrician or family doctor for an evaluation right away:
Early Signs Of Autism
Signs of autism in babies
Autism spectrum disorder is a developmental disorder, which means that signs become apparent as a child does not develop as expected, for example developing speech or learning to crawl later than expected.
As such, there are few signs of autism that are noticeable in newborns. However, if a baby fails to reach the developmental milestones expected at two months old, four months old, six months old, nine months old and a year old, this could be one of the first signs of autism or another developmental condition.
Good to know: Not all babies reach developmental milestones at the exact same time. It is normal to have some variation in development. If in doubt about a childÃ¢â¬â¢s development, check with a doctor.
Some of the early signs that a baby under one year old may have autism spectrum disorder include:
- Not babbling by four months old
- Not smiling by five months old
- Not laughing by six months old
- No interest in games like pat-a-cake or peek-a-boo by eight months old
- Not responding to their name by 12 months old
- Not looking at objects pointed out by other people by 12 months old
- Being upset by loud noises
- Not looking to a parent for comfort in new situations
- Being happy to play alone for long periods of time
- Not making eye contact
Signs of autism in toddlers
Some of the signs that a toddler, between one year old and two years old, may have autism spectrum disorder include:
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Be Consistent And Supportive
Autism doesnt go away or get better. It represents your teens:
Its crucial to be there for your teen as they experience not only the typical struggles of being a teen but also the added pressure to conform to neurotypical standards.
Consistency in maintaining a positive, accepting environment can be an enormous influence on the direction of their lives well past the teen years.
Helping your teen learn certain life skills or behaviors they may have difficulty mastering can also be a form of support. To build skills in these areas, you can:
- See a psychologist or psychiatrist who can help your teen work through personal challenges. They can also prescribe medications for anxiety, depression, obsessive-compulsive disorder , or other conditions that may affect your teens sense of personal fulfillment or be perceived as disruptive.
- See a speech pathologist to help with any communication challenges, or do speech therapy.
- See a behavioral specialist to help with routines, activities, or habits that may be disruptive to activities your teen wants to do.
- See a dietitian who may be able to help optimize your teens diet or supplement intake to reduce their experience of challenging behaviors or emotions.