20. Autism
What is a multidisciplinary evaluation team, and how do they help to diagnose an autistic child?
A multidisciplinary evaluation team (MET) is a group of certified physicians and therapists from various professional disciplines who specialize in the diagnosis of children with developmental deficits.
As has been mentioned, the diagnosis of a child with autism is a two-stage process. The first stage involves developmental screening by a pediatrician during well child check-ups. The second stage entails a comprehensive evaluation by a multidisciplinary team. The multidisciplinary team typically is composed of one or more representatives of the following specially trained professionals:
Developmental pediatrician. He or she is an expert in the diagnosis and treatment of the health problems of children with developmental delays or handicaps.
Child psychiatrist. This person is a medical doctor who may be involved in the initial diagnosis. In addition, they can prescribe medication and provide help in behavior, emotional adjustment, and social relationships.
Clinical psychologist. A clinical psychologist specializes in understanding the nature and impact of developmental disabilities on a child and family. They may perform psychological and assessment tests and help with behavior modification and social skills training.
Occupational therapist. This specialist focuses on practical, self-help skills that will aid in daily living including dressing and eating. In addition, this therapist may work on sensory integration (SI), coordination of movement, and fine motor skills.
Physical therapist. The physical therapist (PT) is an expert in rehabilitation. He or she helps to improve the use of bones, muscles, joints, and nerves to develop the child’s muscle strength, coordination, and motor skills.
Speech/language therapist. This professional helps to make diagnoses in speech and swallowing pathology. He or she is focused on the improvement of communication skills including speech and language. The speech therapist also works with children who are unable to speak by utilizing alternate communication strategies such as sign language and picture-aided communication.
Social worker. This person may provide counseling services or act as a case manager by helping to arrange therapeutic services, such as speech, physical, or occupational therapies.
As part of the team’s work, a multidisciplinary evaluation might include a complete neurological examination, a comprehensive speech/language/communication evaluation, a cognitive and adaptive behavior evaluation, a sensor motor and occupational therapy (OT) evaluation, and neuropsychological, behavioral, and academic assessments. If the parents are suspicious of autism, or not confident in the initial diagnoses made by their pediatrician, they can request an evaluation by this type of multidisciplinary team. If this type of team is not available locally, an excellent alternative for the parents is to have the child evaluated by a pediatrician with a specialty in the evaluation of developmental problems or a pediatric neurologist.
William’s comment:
I’ve found that not every child requires every one of these services. Although our son receives OT and speech therapy, the area of concentration is primarily behavioral. His gross motor skills are for the most part typical; he needs help developing the fine motor skills and his speech at the present time (1 year into services) is starting to expand nicely.
Terms:
Multidisciplinary evaluation team (MET) - A minimum of two persons who are responsible for conducting a comprehensive evaluation of students suspected of being handicapped or children with disabilities being reevaluated.
Sensory integration (SI) - This is a term applied to the way the brain processes sensory stimulation or sensation from the body and then translates that information into specific, planned, coordinated motor activity. Information is received from both internal and external environments through the five senses of vision, touch, taste, hearing, and smell. Our senses are integrated when the nervous system directs this information to the appropriate parts of the brain that enable an individual to attain skill
Physical therapist (PT) - A licensed health professional who applies principles, methods, and procedures for analyzing motor or sensor motor functions to determine the educational significance of the identified areas including areas such as mobility and positioning in order to provide planning, coordination, and the implementation of strategies for eligible individuals.
Occupational therapy (OT) - A type of treatment that assists in the individual’s development of fine motor skills that aid in daily living. It also can focus on sensory issues, coordination of movement and balance, and on self-help skills such as dressing, eating with a fork and spoon, grooming, and the like. It can also address issues pertaining to visual perception and hand-eye coordination.
Gross motor - Movement that involves balance, coordination, and large muscle activity.
