Assessing Autism Spectrum Disorders: Guidelines for Parents and Educators (continued)

Parents and educators should know that the terminology surrounding assessment can be confusing. In particular, the terms “medical diagnosis” “diagnosis” and “eligibility” are often misunderstood. While the term “medical diagnosis” is often used, it is a misnomer. “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.” (Autism Society of America, n.d.) Wide use of the term also has resulted in the false belief that the diagnosis must be made by a medical professional. In fact, in the absence of specific medical concerns, many specialized teams do not require staff with medical training.

The contrast between “diagnosis” and “eligibility” is subtle (see Table 1). The term diagnosis is used most often in assessments conducted in the private sector. Diagnosis in the United States most often is based on the current Diagnostic and Statistical Manual (DSM-IV-TR). In this system, the umbrella category of pervasive developmental disorders encompasses autistic disorder, pervasive developmental disorders - not otherwise specified, Asperger’s disorder and others.

Table 1 Diagnosis Versus Eligibility

Assessment in the public school system is conducted for the purposes of establishing eligibility for special education services and gathering information to assist in planning an individualized education program. The Individuals with Disabilities Education Act (IDEA) defines the eligibility category of “autism” as a disability that affects communication and social interaction. When there is a need for an assessment to determine eligibility for autism (or any eligibility category), it is the responsibility of the public schools to provide it, at no expense, to the family. According to IDEA, autism may have associated features, such as repetitive activities, stereotyped movements, resistance to change and unusual sensory responses. Students with characteristics of DSM diagnoses, including autistic disorder, Asperger’s disorder, pervasive developmental disorders - not otherwise specified or other ASDs may qualify under the eligibility category of “autism.” A disability must have an adverse effect on a student’s education for the student to be considered eligible for special education services. Therefore, a previous diagnosis in the private sector does not necessarily result in eligibility in the public schools. Unfortunately, school teams sometimes fail to consider educational factors beyond academics. As a result, academically capable students with ASDs who display deficits in socialization that impact educational progress often are not served.