You’ve read about the signs and symptoms of a child that is on the autism spectrum and want to get your child properly diagnosed. Where do you start? What do you do? Where do you go?
This blog will outline what the next steps are and how a typical evaluation will go when diagnosing Autism Spectrum Disorder (ASD). Some children can be diagnosed as early as 18 months, but most are not diagnosed until they are at least two years of age. Some children are diagnosed much later.
Step 1: Screening
The first step in testing your child will be a screening. This screening may be 15 minutes long and will look at 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 additional visits that are scheduled.
In addition, children should be screened for ASD during their:
- 18 month visit
- 24 month visit
Additional screening may be completed if the child has a sibling or family member who has previously been diagnosed with ASD or if signs of ASD are present. 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 the results of the screening, your child needs to be seen by a doctor that evaluates kids who aren’t developing, learning or behaving the way their peers are. These professionals are called developmental pediatricians. Developmental pediatricians are highly trained and experienced in identifying a range of developmental and behavioral differences.
“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, providing documentation and support to make sure your child receives needed services. Developmental pediatricians can also initiate medical evaluations or prescribe medications when appropriate. They also provide long term monitoring as a child moves through different educational settings, assisting with educational programming, behavioral and medical management, and often acting 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: 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 human 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 an 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 be prepared for the medical professional to request these types of things.
4 Tests to Diagnose Autism Spectrum Disorder
There are many tools that can be used to diagnose ASD in young children. These tools usually rely on the child’s behavior and parent interview. Outlined below are some of the basic tests that can be completed:
- 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 imaginative use of materials for individuals suspected of having ASD. The observational schedule consists of four 30-minute modules, each designed to be administered to different individuals according to their level of expressive language.
- Childhood Autism Rating Scale (CARS): Brief assessment suitable for use with any child over 2 years of age. 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 the screening and evaluation are completed, you will receive a full report from the doctor. This evaluation will probably be given to you in a few weeks, depending on how busy the office is at the time of your visit. Most doctors will give you feedback as soon as the evaluation is complete, and if they do not, don’t be afraid to ask them. 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 that may need to be 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.
Stacie Bennett has been practicing as a Speech-Language Pathologist for the past ten years. Currently, she works full-time at a vocational high school in New Jersey and have her own private practice. Feel free to contact Stacie if you have any questions!