Early diagnosis of autism makes a tremendous difference in the lives of people with ASD or Autism Spectrum Disorder and their families. However, it is not easy to make a diagnosis of autism. There are no laboratory tests for it; so the doctors depend on the behavior of young children and listen to their parents for autism diagnosis. Autism has several symptoms and while some people who fall on that spectrum have serious mental disabilities, others can live life independently and are highly intelligent. If your child has those symptoms, then you have to get it diagnosed and all starts with a pediatrician.
Autism diagnosis is a tricky task and needs a great deal of understanding. Autism can be detected sometimes at the age of 18 months or even younger. By the time your child attains 2 years, diagnosis by a professional is considered highly reliable. However, there are many children who receive a diagnosis at a much later stage in their lives.
Autism diagnosis for a child involves two steps:
- Developmental Screening
- Comprehensive Diagnostic Evaluation
The methods of diagnosis are described below:
Developmental Screening for Autism
Developmental screening is a small test that can say whether the children are learning the basic skills at the time they should or if that is taking time. During developmental screening stage, the doctor can ask the parents some questions, or play and talk with the children to observe the way they learn, behave, speak, and move. A delay in these areas can be a problematic sign. All children must be screened for developmental disabilities and delays during the regular visit to a doctor at 9 months, 18 months, 24 months, and 30 months.
The child may need additional screenings if the child is at a higher risk for the developmental problems because of low birth weight, preterm birth, or other reasons.
Additionally, children must be screened particularly for ASD at the time of regular visits to a doctor at 18 months and then at 24 months. These visits are a vital part of autism diagnosis.
Additional screening should be required when the child is at a higher risk of autism (having a brother, sister, or any other family member with ASD) or if behaviors are there that are associated with ASD.
It is vital for the doctors to screen children who have developmental delays but particularly monitor those children who have higher risks of ASD because of low birth weight, preterm birth, or having a sister or brother with autism. If the doctor does not check a child routinely with developmental screening test, then they must be referred to a psychologist for an evaluation.
If the doctors note any symptom or suspect autistic features, they will do a comprehensive diagnostic evaluation to confirm autism diagnosis.
Comprehensive Diagnostic Evaluation
The second step in autism diagnosis is a Comprehensive Diagnostic Evaluation. It is a thorough review and it includes observing the behavior and development of the child and interviewing the parents. It may include a vision and hearing screening, neurological testing, genetic testing, and other medical testing. Sometimes, a primary doctor may refer the child and his family to a doctor specialized in autism diagnosis.
The specialist doctors who may do this evaluation include the following:
- Developmental Pediatricians (Doctors having special training in children with special needs and in child development)
- Child Neurologists (Doctors who work on the spine, brain, and nerves)
- Child Psychiatrists or Psychologists (Doctors who can study the human mind).
This evaluation is done to check the development such as the cognitive level of the child, language abilities, and other life skills such as dressing up, eating, and going to a bathroom.
Autism Diagnosis as per DSM-5
For autism diagnosis, the child should meet the standards of DSM-5 or Diagnostic and Statistical Manual of Mental Disorders 5, published by the American Psychiatric Association.
According to this, the child should have problems in two categories so that they fall under the Autism Spectrum:
- Challenges with Social Interaction and Communication. For children with ASD, it is difficult to predict or connect with the reactions of other people, make eye contact, read social cues, or make a conversation. Children may not start speaking like the other children at the right time. They may have a difficult time with their muscle skills required for things such as drawing, writing, or playing sports.
- Repetitive and Restricted Behavior Patterns. Children with autism may repeat phrases or become upset with routine changes. They are often hugely interested in one particular subject. They have sensory issues too.
The doctor may recommend genetic testing for finding out the other conditions that may cause the symptoms.
Some people grow up with autism without getting their condition recognized but it is never very late to have a diagnosis. Some people may feel scared to get their child diagnosed because they think it shall label them and can affect the child. Although, some may feel social burden by getting diagnosed, an autism diagnosis has its own advantages. It helps people and their family to understand autism and they can decide the kind of support they will need. Diagnosis can make it easy to access particularly the autism services and also claim benefits. Most importantly, it helps to plan a play, study and rehabilitation for the child, depending on the individual condition.