There are currently no distinct medical tests that can diagnose a child with an autism spectrum disorder (ASD). Diagnoses are made through a combination of information gathered from parents’ expertise in their child’s development in early years and formal clinical observation of children. I adopt a multi-disciplinary approach to ensure a thorough and comprehensive assessment is undertaken. A tool frequently used by specialists to diagnose ASDs is the Autism Diagnostic Observation Schedule (ADOS). This is a group of structured tests that can be tailored to varied age groups.
Parents, family, teachers and friends are often confused by a diagnosis of ASD. Many parents say, “My child can’t be autistic because they’re affectionate, make eye contact, like to be hugged, don’t bang their head, etc.” Some children with ASD may not make eye contact; other children do, some of the time while other children may seem to stare. Some children with ASD like to be hugged but others do not. As much as children share similarities they also can be incredibly different from one another. Like all children, children with ASD have a lot of different likes and dislikes. A diagnosis of ASD means that your child’s development will look different in two main areas:
Social communication (including social interaction and play), behaviour and interests which are repetitive or limited.
During the evaluation, the paediatrician will seek information about a child’s developmental history such as speech and language and social communication skills, social, play skills, behavioural functioning and motor (gross and fine motor) adaptive skills and sensory profile. Children will participate in some of the tests. These tests require the child to follow some directions, answer questions and/or play. These evaluations may require more than one appointment with professionals from different disciplines (for example speech-language therapy, psychology, occupational therapist, questionnaires and nursery or school reports). The number of appointments and professionals participating will be determined based on each child’s specific needs and reason for referral (usually medical or behavioural). Feedback about your child’s diagnosis and recommendations for appropriate interventions and referrals will be provided once the evaluation has been completed. Additionally, medical tests (for example genetic testing or brain imaging) may be required to rule out any neurological or biological explanations for delays in development.
Professionals who are trained in this area can identify ASD in children as young as 18 months old. However some children with ASD who have their language skills intact but have more subtle difficulties with peer interactions may not be identified until the child goes off to school. This is when difficulties with social interaction may become more significant. A lot of these children are not diagnosed with ASD until around primary or secondary school. If a teacher first notices signs and symptoms, they will talk to the parents and discuss a plan to do a full assessment of the child. Additionally, parents can also request that the school provide an assessment of the child social and educational profile if they have concerns about their child’s academic/behavioural progress.