How Is Autism Diagnosed?

Autism is best known as Autism Spectrum Disorder. Autism Spectrum Disorder (ASD) is a developmental disability characterized by differences in social communication or interaction and repetitive, restrictive patterns in behaviors, interests, or activities.

Autism is not a rare condition. In fact, there are many different autism types and the The Centers for Disease Control and Prevention (CDC) estimates that around 1 out of every 44 eight-year-old children have been identified with ASD. People of all backgrounds and ages can live with ASD.

ASD can range in severity, and because it is a spectrum, the way that symptoms present can vary from person to person.

Understanding Autism and receiving a diagnosis can be highly beneficial, as it allows individuals to pursue the appropriate treatments and learn skills that can help people with Autism succeed in their daily life. A diagnosis is often the first step that allows someone to get the care they need.

How Is Autism Diagnosed?

Autism can be diagnosed by a professional (such as a neurologist) at any age, but symptoms will be present in one’s childhood years. In young children, differences in child development and behavior may be detected early on if they have Autism Spectrum Disorder, even if they don’t necessarily receive a diagnosis of ASD at that time.

Well-Child Visits

A child should attend a well-child visit seven times between the ages of 1 and 4 as recommended by the American Association of Pediatrics (AAP). Autism may appear different in girls and boys.

A well-child visit is a regular checkup where a physician meets with a child and their parent or caregivers to check on developmental milestones and make sure that all is well with a child’s general health and functioning.

These visits are in addition to other visits that may occur when, for example, a child is injured or ill (for example, visits for a broken bone or a sinus infection don’t count).

A medical professional may detect symptoms that lead to an Autism diagnosis later on during these appointments. Autism may be diagnosed early on upon noticing differences in development, or it may be detected later in life, meaning that someone may receive a diagnosis at any point in their childhood, teenage years, or adult life.

While early detection can be challenging in some cases, it can be beneficial for your child’s needs as to allow for early intervention.

Other screening tests and tools

The Autism Diagnostic Observation Schedule or ADOS is a common testing tool used to screen for Autism utilized by child psychologists and neurologists and is often considered the gold standard for testing for Autism.

However, a professional should also screen for Autism thoroughly with other measures (such as screening questionnaires or diagnostic interviews) to check over any other possible causes that might explain symptoms, as there can sometimes be flaws in diagnosis when this test is used on its own.

Keep in mind that there are no medical tests that can be conducted to detect autism in children.

Are All Children Screened for Autism?

All children should have regular, up-to-date wellness visits where a doctor acknowledges their development and if they are meeting childhood development stages as expected. However, this doesn’t mean that every person with Autism Spectrum Disorder is detected or diagnosed in childhood. An individual can receive a diagnosis of Autism Spectrum Disorder at any age, and it is not uncommon that Autism is overlooked.

With this in mind, if you notice symptoms or signs of Autism Spectrum Disorder in your child, you can ask their developmental pediatrician about an Autism assessment using DSM-5 which was established by the American Psychiatric Association. If you notice symptoms of Autism Spectrum Disorder in yourself, you can consult with your primary care physician, psychiatrist, or another medical or mental health professional who may be able to help. There are testing centers that work with adults, which could be advantageous for those seeking a diagnosis after childhood.

Cost

One thing to keep in mind about Autism Spectrum Disorder is that it can be costly to pursue a diagnosis. Without insurance, both an Autism and ADHD evaluation can be more costly. The Autism evaluation can cost up to around $5,000. Insurance coverage can vary based on your location and other factors. Physician-recommended treatments for Autism, such as behavior therapy, should generally be covered.

What to Expect

Criteria for ASD in the most recently updated version of the diagnostic and statistical manual of mental disorders (DSM) is what a healthcare professional will use to provide an official diagnosis of Autism Spectrum Disorder.

During an evaluation, a healthcare professional will look at symptoms associated with ASD in the following areas:

1. Ongoing challenges in social communication and interaction with others across various contexts as defined by the following:

• Differences in social-emotional reciprocity (IE, failure to respond to or start social interactions, abnormal social approach, or reduced sharing of emotions and/or effect).
• Deficits in behaviors associated with nonverbal communication (IE, trouble understanding body language, lack of eye contact, inconsistent facial expressions).
• Developmental delays, maintaining, and understanding social relationships.

2. Repetitive and restrictive patterns of behaviors, interests, or activities as defined by the following:

• Atypically restricted, fixated interests (IE, a strong attachment to unusual topics of interest or objects).
• Hyper-reactivity or hypo-reactivity to sensory input (or unusual interest in sensory aspects of one’s environment).
• Repetitive behaviors or body/motor movements (IE, stims), speech (IE, echolalia), or use of objects (IE, lining up toys).
• An insistence on sameness or inflexibility with regard to one’s routines (an autistic child may have atypical difficulty with change, rigid thinking patterns, or communication/greeting rituals).

Other criteria include the existence of these symptoms in early childhood or other family members even if someone’s not diagnosed at that time, and clinically significant impairment in occupational, social skills, or other areas of functioning.

Some symptoms may be attributed to a different developmental disorder, though it is important to note that it’s very possible and in fact common, for someone with Autism to have multiple diagnosable disorders. For example, a person might live with both ADHD and Autism.

If Autism is diagnosed after early childhood, the professional who is providing an autism assessment will want to go over their developmental history. This is certainly something to be mindful of and to expect, whether that means that you will relay developmental history of your own to a medical professional or the developmental history of your child.

When to Talk to Your Healthcare Provider

Talk to your healthcare provider if you notice symptoms of Autism in yourself or a child who is in your care. Evaluations can be time-consuming, some more than others, but they can also help an individual get the support that they need.

This article is for informational purposes and is not a substitute for individual medical or mental health advice. Please consult with your or your child's prescribing doctor before changing, starting, or stopping a medication routine.