Autism: Diagnosis & Consultation
There are no medical tests for diagnosing autism. An accurate diagnosis must be based on observation of the individual's communication, behavior, and developmental levels. 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. At first glance, some persons with autism may appear to have mental retardation, a behavior disorder, problems with hearing, or even odd and eccentric behavior. To complicate matters further, these conditions can co-occur with autism. However, it is important to distinguish autism from other conditions, since an accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational and treatment program.
A brief observation in a single setting cannot present a true picture of an individual's abilities and behaviors. Parental (and other caregivers' and/or teachers) input and developmental history are very important components of making an accurate diagnosis.
Why Early Identification is Critical
Research indicates that early diagnosis is associated with dramatically better outcomes for individuals with autism. The earlier a child is diagnosed, the earlier the child can begin benefiting from one of the many specialized intervention approaches treatment and education.
The American Academy of Pediatrics recommends that all children be screened for autism by their family pediatrician twice by the age of 2, at 18 months and again at 24 months. The AAP also recommends that treatment be started when an autism diagnosis is suspected rather than waiting for a formal diagnosis. Go to http://www.aap.org/ to see the complete list of recommendations. The advantages of early intervention cannot be overemphasized. Children who receive intensive therapy can make tremendous strides in their overall functioning and go on to lead productive lives. Click here for more information on early intervention.
Screening and Screening Instruments
While there is no one behavioral or communications test that can detect autism, several screening instruments have been developed that are now being used in diagnosing autism:
- CARS rating system (Childhood Autism Rating Scale), developed by Eric Schopler in the early 1970s, is based on observed behavior. Using a 15-point scale, professionals evaluate a child's relationship to people, body use, adaptation to change, listening response, and verbal communication.
- The Checklist for Autism in Toddlers (CHAT) is used to screen for autism at 18 months of age. It was developed by Simon Baron-Cohen in the early 1990s to see if autism could be detected in children as young as 18 months. The screening tool uses a short questionnaire with two sections: one prepared by the parents; the other by the child's family doctor or pediatrician.
- The Autism Screening Questionnaire is a 40-item screening scale that has been used with children age four and older to help evaluate communication skills and social functioning.
- The Screening Test for Autism in Two-Year Olds is being developed by Wendy Stone at Vanderbilt and uses direct observations to study behavioral features in children under two. She has identified three skill areas that seem to indicate autism: play, motor imitation, and joint attention.
Reprinted with the permission of the Autism Society.