Assessing Autism Spectrum Disorders: Guidelines for Parents and Educators

The diagnosis of Autism Spectrum Disorders (ASDs)presents a maze of questions that can be perplexing for parents and educators. When is the righttime to seek an assessment? Who should conduct the asesment? What should be included in the assessment? This article wil provide guidelines to help parents and educators to navigate this maze .

When is the Right Time to Seek an Assessment?

The importance of early identification and treatment of ASDs has been well established. Parents and educators should seek assessment as soon as signs become evident. Early symptoms of ASDs may be apparent by the age of 12 months to 18 months or sooner. While diagnosis often is possible by the age of two (Lord & Spence, 2006), most children are not identified until years later. Indeed, there typically is a delay of two to three years after symptoms first become apparent (Filipek, et al., 2000). Because early intervention makes a critical difference in the progress of people with ASDs, delay in identification is a matter of great concern.

Many factors, including symptom severity, race, gender and attitudes toward diagnosis, contribute to the delay in identification. Children with more severe communication deficits tend to be diagnosed at younger ages than those with primarily pragmatic language (social language) challenges. As a result, the average age of diagnosis of autism is four to five years earlier than Asperger’s disorder. Special awareness of the relationships between race and gender also is needed with early identification. Research has found that African-American children are identified later and receive alternative diagnoses prior to being identified with an ASD (Mandell, Ittenbach, Levy, & Pinto-Martin, 2006). Further, it is well established that girls are diagnosed at a later age than boys. Finally, evaluators sometimes hesitate to assign a diagnosis for fear of the impact of the label or misdiagnosis. Likewise, parents may hesitate to accept the diagnosis for the same reasons. Given the benefits of early intervention, the risks associated with delayed identification carry serious consequences.

Who Should Conduct the Assessment?

There is extensive literature regarding the best instruments and techniques for identifying ASD; however, even the best instruments are meaningless when those interpreting them do not have the training and experience to make accurate judgments. Assessment of ASDs may be completed by a number of professionals, including psychologists, neurologists, pediatricians or psychiatrists. Parents and educators should be careful not to make assumptions about the knowledge base of professionals. In each of these fields, there are those who are knowledgeable in ASD assessment and those for whom this is not a strength. It is most important to find specialists who are knowledgeable and experienced in assessing ASDs. The field of the professional is less important than expertise.

Seeking an assessment from an experienced and knowledgeable professional prevents delay in accurate identification and frustration of unanswered questions. Parents often describe experiences of being told that their child is “going through a phase” and that they need to be patient while their child “grows out of it.” Others report that they have been advised that a single behavior, such as showing affection or using sentences, indicates that their child does not have ASD. These same parents later may learn that their child has the diagnosis. Early encounters with professionals who provided false reassurance may sabotage parents’ receptiveness to the input of others who recognize the symptoms of ASD exhibited by their child. Alternatively, the error of incorrectly assigning the diagnosis of an ASD carries risks. Working with professionals with expertise in ASD helps to avoid these pitfalls.