“Catch it early” is a phrase we often hear in relation to healthcare and illness (mental, physical, or emotional) as early diagnosis is key for treatment or therapy. This is especially true when it comes to getting a diagnosis for Autism Spectrum Disorder (ASD) in young children. An early diagnosis makes a huge difference to these children and their families. The ASD diagnosis is based on observation of the child by a professional as there are no tests that can be performed in a medical laboratory, etc.
The two steps for an ASD diagnosis are:
Engagement with a pediatrician is the first step. The pediatrician will observe and interact with the toddler (around 18 months and 24 months) and ask questions of the parents regarding development, behavior, and family history. Questions like, “Did your baby smile by 6 months and did the baby babble and coo by 12 months?” If the child has not met milestones or the doctor is concerned after the evaluation, then the child will be referred to a specialist for further evaluation etc.
An intensive engagement with a neuropsychologist is the second step. This engagement delves into your child’s cognitive level, language skills, and other life skills such as eating, dressing themselves, and going to the bathroom. The standards of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association are the basis for the evaluation and diagnosis. The two categories of problems that a child must have in order to be diagnosed with ASD are:a. Persistent deficits in communication, social interaction, and impairment of basic skills.
The diagnosis of the severity of the ASD is arrived at during the engagement with the neuropsychologist and is segmented as below:
Level or Tier 1: The child needs support. The child has challenges with organization, planning, and flexibility. Social skills may be impaired.
Level or Tier 2: The child needs additional support. The child’s communication skills (verbal and non – verbal) are inadequate. Attention to the environment is lacking. The child displays restricted and repetitive patterns of behavior.
Level or Tier 3: The child needs a significant amount of support. All forms of communication are severely challenged, and the child may not be able to express their basic needs.
The tools used by professionals to arrive at a diagnosis include:
Autism Diagnostic Observation Schedule (ADOS) - It is composed of a series of structured & semi-structured tasks that involve interaction between the professional and the child.
Childhood Autism Rating Scale (CARS) - This tool scores child on a scale ranging from normal to severe and gives a holistic score ranging in scale from non-autistic to severely autistic, with many levels in between.
Autism Diagnosis Interview (ADI) – It refers to the interview(s) with the parents and marks behavior with regard to social interaction, communication & language, and patterns of behavior.
We hope the above information regarding the process, the diagnosis, and the tools used is of help and sheds light on the entire process of arriving at a diagnosis for ASD. Education empowers and paves the way for getting help for your loved one.