There is no blood test or X-ray test for diagnosing autism. An accurate diagnosis must be based on observation of the child’s communication, behavior, and developmental levels. Autistic children have characteristic behaviors that may be obvious to both parents and clinicians in the first months to years of life.
However, because many of the behaviors associated with autism are shared by other disorders, various medical tests may be ordered to rule out or identify other possible causes of the symptoms being exhibited.
To diagnose a child, clinicians must observe a consistent deficit in one of three areas:
1. Impairment in social functioning. Clinicians will look for:
● Impairment in many forms of nonverbal expressions (posture, eye contact)
● Failure to develop age-appropriate peer relationships
● Doesn’t’t seek to share enjoyment, interests with others
● No social or emotional exchange; avoids cuddling or touching
2. Impairments in communication. Clinicians will look for:
● Delay or lack of language development
● Inability to begin or sustain a conversation with well-spoken individuals
● Stereotyped/repetitive use of language
● Lack of varied, imaginative play or social actions (age appropriate)
● Lack of response to normal teaching methods or verbal clues
● Frequent outbursts and tantrums
3. Restricted, repetitive patterns of behavior, interest, and activities. Clinicians will look for:
● Abnormal intensity or focus on a certain stereotyped and restricted behavior
● Inflexible routine of specific nonfunctional ritual
● Stereotyped or repetitive motor mannerisms (flapping arms, spinning their body, walking on their toes)
● Persistent interest with certain parts of objects
Because autism encompasses such a broad spectrum of behaviors, a brief observation in a single setting cannot predict an individual’s true abilities. Several evaluations done on different days or in different settings (e.g., home, physician’s office, child’s school) will yield a more reliable diagnosis. Parental input and developmental history are very important components of making an accurate diagnosis.
Typically, the diagnosis of a child with autism is a two stage process. The first stage involves developmental screening by a pediatrician during well-child checkups. It is important that the evaluation be performed when the child is feeling well. A sick child may act differently than normal and this makes the observation unreliable.
The second stage entails a comprehensive evaluation by a multidisciplinary team. The team is composed of a pediatrician, developmental neurologists, and speech, physical, and occupational therapists as well as a social worker.
William’s comment:
A physician, who is a family friend, told me during the time Liam was being evaluated, that it didn’t take a “rocket scientist” to diagnose autism, but only some experience with the condition and knowledge of the diagnostic criteria. How true that statement was. The developmental pediatrician who spent 10 minutes with my son was able to give me a diagnosis that was consistent with what we got from a child psychologist who spent several hours with him, to a psychologist who administered a Bailey test and an ADOS, to another group study at UCLA that administered further tests after even more time spent with him.
Everything seemed to be consistent, from the 10-minute evaluation to the ones that involved hours and hours of observation.
Terms:
Comprehensive evaluation – A series of tests and observations, formal and informal, conducted for the purpose of determining eligibility for special education and related services and for determining the current level of educational performance.
Multidisciplinary team – A team whose members come from multiple disciplines; they interact and rely on the others for information and suggestions.
Neurologists – Doctors specializing in medical problems associated with the nervous system, specifically the brain and spinal cord.
Occupational therapists – Individuals who specialize in the analysis of purposeful activity and tasks to minimize the impact of disability on independence in daily living. The therapist then helps the family to better cope with the disorder by adapting the environment and teaching sub skills of the missing developmental components.
Psychologist – A specialist in one or more areas of psychology; a field of science that studies the mind and behaviors. Areas of specialty can include psychological testing and practitioners of therapy or counseling.
