“Autism: Where the ‘randomness of life’ collides and clashes with an individual’s need for sameness. “ – Eileen Miller, Behind the Pictures (Autism: Strategies for Change); Muki Baum Association, 2011.
Research overwhelming supports early intervention for children who have Autism Spectrum Disorder (ASD) (Rebecca J. Landa (2018) Efficacy of early interventions for infants and young children with, and at risk for, autism spectrum disorders, International Review of Psychiatry, 30:1, 25-39, DOI: 10.1080/09540261.2018.1432574). However, early intervention requires an early diagnosis by a specialist, like a neuropsychologist. In spite of understanding the importance of early therapy, diagnoses before the age of 3 are often missed. There are a couple of reasons why this may be happening. Let’s read about them and understand why it might occur.
Listed below are some of the common reasons for a delayed Autism Diagnosis:
ASD confused for ADHD. It is quite possible that diagnosticians / physicians may diagnose a child with ASD for ADHD or “severe ADHD”. This is because the two developmental disorders have overlapping symptoms. The main overlapping symptom being that children with either condition may experience challenges communicating and focusing. Plus children who have ADHD with ASD may be diagnosed with severe ADHD, hence the ASD goes undiagnosed.
Autism is a spectrum, with a multitude of behaviors. A non – specialist may not pick up its symptoms which may be subtle and varied. Plus, what the clinician / Physician observes in a short period of time; they may not see the behaviors observed at home by the parents or family members.
At times, the family physician / Pediatrician may not be able to make a diagnosis due to short visits to the clinic. The evaluation process is lengthy, involving assessment tools that can take a few hours to administer. Additionally, the process includes intensive interaction with the parents which can take a couple of hours.
The family physician / Pediatrician may not be sure of the diagnosis and would prefer to allow the child’s development to run its course. As we know, children all develop at different rates. Therefore doctors may want to put off making a hasty diagnosis and calm the parents. Or the family adopts a wait-and-see attitude to observe if their child shows development signs and catches up with their peers.
The family could be in denial for a host of personal reasons. In some cases, there may be shame or embarrassment as well. Hence families do not dive into the diagnosis process for some time or maybe at all, thus the benefits of early therapy are missed.
Some new parents may not have a lot of experience with children, and may not know what are typical milestones and skills for a given age range. A new parent might not recognize that their child is developing differently than the child’s peers.
Both parents and physicians may be reluctant to “assign a label” to a young child, believing that an Autism Spectrum Disorder diagnosis would be stigmatizing.
Families may live in an area where access to specialists who can diagnose their child’s difficulties is extremely limited or unavailable. Often, these families need to travel to large, metropolitan areas to find such specialists, and travel is prohibitive due to cost and time restrictions.
Parents know their kids like no one else ever will. Therefore, if they notice any subtle symptoms in their toddler, they should immediately seek help and go in for a diagnosis, whether the diagnosis is correct or not. The child’s future is at stake and it should not be compromised by a delayed diagnosis