How is Autism Spectrum Disorder Diagnosed?
Jan 7, 2022 You’ve read about the signs and symptoms of a child that is on the autism spectrum, and you want to get your child properly diagnosed. Where do you start? What do you do? Where do you go?
In This Article
This blog outlines the steps for how to determine if your child is diagnosed for Autism Spectrum Disorder (ASD), and what the typical evaluation is like. Some children can be diagnosed at as early as 18 months, but most aren’t until they are at least two years of age. Some children receive a diagnosis much later.
Autism and Speech Blubs
Speech Blubs is a speech therapy app with more than 1,500 activities, face filters, voice-activated activities, and educational bonus videos.
We initially developed Speech Blubs for children with autism, Down syndrome, and apraxia of speech! The app uses video modeling, which is a proven method for engaging kids on the spectrum.
Our “Emotions” section, for example, was created for children with autism in mind. We know they have a hard time recognizing and expressing emotions. In this section, they learn about emotions while practicing speech.
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Step 1: Screening
The first step in testing your child is a screening. This screening usually takes 15 minutes, and tries to determine what skills your child already has and what skills might be delayed. During the screening, the doctor may engage in play with your child and may ask you questions. The play is very important because it will show how your child learns, speaks, his/her behavior, and turn-taking skills.
Children should be screened during their well-child visits at:
- 9 months
- 18 months
- 24 or 30 months (depending on your pediatrician)
If your child is at higher risk for developmental disorders due to genetic history, low birth rate, or prematurity, there may be more visits to schedule.
As well, your child should be screened for ASD during their:
- 18-month visit and
- 24-month visit.
Your child may have to have more screening if (s)he has a sibling or family member who has previously been diagnosed with ASD, or if (s)he shows signs of ASD. If your child’s doctor does not do these screens, please ask them! My children’s pediatrician sends a survey about their skills, and then we discuss it at their next visit.
Step 2: Developmental Pediatrician
After seeing the results of the screening, your child needs an appointment with a doctor who evaluates kids’ development, learning, or behavior. These professionals are ‘developmental pediatricians,’ and have extensive training and experience in identifying a range of developmental and behavioral differences.
A developmental pediatrician can evaluate your child’s overall development, provide a diagnosis, and recommend specific treatment plans.developmentaldoctor.com
They often act as an advocate during school planning, and provide documentation and support to make sure your child receives needed services. Developmental pediatricians can also initiate medical evaluations or prescribe medications when appropriate. Also, they give long-term monitoring as your child moves through different educational settings, they assist with educational programming and behavioral and medical management, and often act as a care coordinator.
Kids may be referred to them through the early intervention program in their state or through their regular doctors. Often times, their waiting lists can be months long, so ask your child’s pediatrician for a list of several options and compare their wait times.
Step 3: A Full Comprehensive Evaluation
Based on the wellness visits and ASD screening, the developmental pediatrician, child neurologist, child psychologist, or speech-language pathologist will perform the evaluation.
The child neurologist is a doctor that focuses on the brain, spinal cord, and nerves, and the child psychologist specializes in the child’s mind.
Speech therapists alone cannot diagnose Autism Spectrum Disorder, but they have evaluations they can complete that show if a child exhibits signs and symptoms of ASD. These evaluations may also take place in your child’s daily environment. For example, they may want to see them interact at daycare or at home, so prepare yourself for the medical professional to request these types of things.
4 Tests to Diagnose Autism Spectrum Disorder
There are many tools for diagnosing ASD in young children. These tools usually rely on the child’s behavior and an interview with parents. Here’s an outline below of the basic tests that your child may complete:
- Autism Diagnosis Interview – Revised (ADI-R): A clinical diagnostic instrument for assessing autism in children and adults. The instrument focuses on behavior in three main areas: reciprocal social interaction; communication and language; and restricted and repetitive stereotyped interests and behaviors. The ADI-R is appropriate for children and adults with mental ages about 18 months and above.
- Autism Diagnostic Observation Schedule – Generic: A semi-structured, standardized assessment of social interaction, communication, play, and the imaginative use of materials for individuals suspected of having ASD. The observational schedule is four 30-minute modules, each designed to be administered to different individuals according to their level of expressive language.
- Childhood Autism Rating Scale (CARS): A brief assessment suitable for use with any child over 2 years of age. The CARS includes items drawn from five prominent systems for diagnosing autism; each item covers a particular characteristic, ability, or behavior.
- Gilliam Autism Rating Scale – Second Edition (GARS-2): Assists teachers, parents, and clinicians in identifying and diagnosing autism in individuals ages 3 through 22. It also helps estimate the severity of the child’s disorder.
Once you do the screening and evaluation, you will get a full report from the doctor. You will probably get this in a few weeks, depending on how busy the office is at the time of your visit. Most doctors give you feedback as soon as they finish the evaluation, and if they do not, don’t be afraid to ask them.
Then Contact Your Child Study Team
Once you have this report, you should contact your school’s Child Study Team (if your child is school-aged). It is VERY important that they have the most updated testing on your child. This will help with program placement and modifications your child may need implemented in your child’s school curriculum.
In the meantime, don’t hesitate to check out Speech Blubs for activities you can do while you are waiting for that evaluation or to get into a therapy.
My son is five years and is not communicating but gestulate and have irregular sleeping and eating habit. He is not talking but occasion pronounce audible words and hardly repeat what he said. He has his brain screened with MRI machine and report suggest normalcy. Please what advice do you have for us.
I am assuming by your question that the MRI scan was more for the sleeping habits, than the speech. The first thing I’d suggest you do is seek out an evaluation by a speech-language pathologist. At five years old, children should be communicating in complete sentences with their speech being about 90-100% intelligible to all listeners. The good news is that if he is producing words at times, you know he has the ability to formulate the words. There is something that is preventing him from putting those words into conversations. I’d also recommend a hearing screening by an audiologist. The audiologist will rule out any type of hearing loss to make sure that’s not why he isn’t producing speech.
Stacie Bennett, M.S. CCC-SLP
I have a question about my 24 month old son. I took him for autism evaluation where he has received provisional diagnosis. This is where he shows signs of autism but they are not 100% sure if he has autism or not. My question I had was he was saying about seven words. He has regressed saying those words. I wanted to know with speech therapy and ABA will he be able to gain those words back and learn to be verbal? My other question is we speak to him in Bengali and English and he understands both the languages but just doesn’t say those words is that causing his speech delay as well? Should we speak to him in one language?
First of all, when a child is bilingual, that does not cause speech and/or language delays. I would recommend speaking to him in whichever language you would like him to learn, just make sure you are taking turns with both languages. For example, if you say “milk” in Bengali, make sure you say it again in English so he can correlate the two as the same word. Secondly, speech and ABA therapy will most certainly help him as far as speech/language and behaviors, however, I cannot accurately predict if your son will ever learn those words again or be verbal. There is just no way to determine that as every child is different. Getting therapy is a step in the right direction to get him back on track, but please remember that it can take weeks, months or years for a child to speak.
Stacie Bennett, M.S. CCC-SLP