How is the Diagnosis of Autism Made?
The diagnosis of autism in a child is made by a professional experienced in the evaluation of children with developmental disorders. A qualified professional may be a pediatrician, pediatric neurologist, child psychiatrist, or psychologist. The diagnosis is based on a history of the child’s development provided by those who know the child well, as well as a clinical interview/observation of the child.
Diagnosing autism in a child is an important first step in determining the best path for learning and communications improvement.
AT WHAT AGE CAN AUTISM BE DIAGNOSED?
Although some children show autistic patterns of social interaction almost from birth, it is difficult to give a definitive diagnosis of autism before age three. This is because rates of development in infants and young children are widely variable. Also, autism is frequently accompanied by mental retardation (about 70% of the time). Some behaviors associated with autism are also frequently found in children who are mentally retarded.
This may make it difficult to discriminate between the two conditions, or determine that both conditions are present, in very young children. By the time a child is three or four, cognitive development can be more accurately assessed. At the same time, social development can be more clearly assessed for delay or deviance.
HOW CAN MY CHILD BE ASSESSED FOR AUTISM IF HE/SHE CAN NOT TALK?
A child’s social development can be assessed by observation of the child’s pattern of non-verbal interaction with both familiar and unfamiliar people. Parents can help in this assessment by observing and reporting how the child relates (non-verbally) through gestures, facial expression, and eye contact with peers and adults.
SHOULD I DO ANYTHING TO PREPARE FOR MY CHILD BEING ASSESSED FOR AUTISM?
The doctor may want to see any previous assessments that your child has had; if you have them, bring them along to the appointment. Also, as a part of the assessment, developmental milestones will be discussed. It is helpful to think of these beforehand and gather any records you may have (for instance, a baby book that you have recorded milestones). Make a list of the characteristics, problems, or behaviors that are concerning you before the appointment. As well, write out any questions that you may have for the doctor.
WHAT IS THE PROCESS INVOLVED IN GETTING A DIAGNOSIS FOR AUTISM FROM A PROFESSIONAL?
It depends on the individual completing the assessment and the individual being assessed. Some doctors may not make a diagnosis immediately and will prefer instead to wait and see how a young child progresses over time. Those who are very familiar with PDD conditions may feel confident about making a diagnosis immediately.
During the interview(s) the assessor will want to know the characteristics that are concerning and the child’s or adult’s developmental milestones. Standardized tests (such as tests of intelligence and language abilities) may be a part of an assessment, especially if the diagnostician is a psychologist.
WHERE CAN I GO TO GET A DIAGNOSIS FOR AUTISM?
Start with your family doctor. They may be able to refer you to a specialist in the field. As well, some local hospitals have specialized clinics for children experiencing developmental, behavior, or mental health problems.
MY CHILD ALREADY HAS ANOTHER DIAGNOSIS. WILL THAT DIAGNOSIS REMAIN IF THEY ARE DIAGNOSED WITH AUTISM OR PDD?
This is a complex question and there may be considerable variation as to how professionals respond to this issue. Sometimes, a diagnosis that is given before a diagnosis of PDD or Asperger’s, addresses some of the problems that may be evident (for example, a learning disability or attention deficit problem).
However, this label may not account for the whole range of characteristics that a diagnosis of PDD addresses. It is therefore most helpful to think of your child as having the diagnosis which is most inclusive of all the symptoms which s/he exhibits.
If an individual has symptoms which are not explained by a diagnosis of PDD (such as depression or severe anxiety), these labels may be given in addition to a diagnosis of PDD. In this case, they may need special attention in the individual’s care plan. Most doctors are open to their patients getting a second opinion, and it is your right to do so.
Conditions and Causes
WHAT CAUSES AUTISM IN CHILDREN?
Given the limits of our neurological understanding of autism, it is impossible to point to a single cause of autism. It appears that there are many causes, and research continues. Recent research in neuroanatomy has indicated abnormalities in the brains of individuals with autism.
It is still unknown why these areas of the brain develop differently in individuals with autism.
Studies have shown a genetic correlation to autism in some individuals. Other possible causal factors, such as birth trauma, vaccine reactions and prenatal viruses, have also been associated with autism. In short, anything that causes the central nervous system to develop abnormally may cause autism.
Because of a lack of specific information about what causes this syndrome, some people may be distracted from seeking effective interventions.
(*NOTE: Using EEG Biofeedback, Sensory Integration Training, Auditory Integration Training, and Sound Therapy techniques that are customized for each patient’s individual needs, The Attention & Achievement Center has produced significant improvements in the lives of patients with autism and autistic spectrum disorders. Request an appointment if you wish to learn more.)
WHAT ARE THE SIGNS OF AUTISM?
When an infant or toddler:
- Does not cuddle or respond to affection and touching.
- Does not make eye contact.
- Appears to be unable to communicate.
- Displays persistent failure to develop two-way social relationships in any situation.
- Does not show a preference for parents over other adults.
- Does not develop friendships with other children.
- Has poor language skills; or nonexistent ones.
- Shows unusual, extreme responses to objects – either avoidance or preoccupation.
- Finds moving objects, such as a fan, hold great fascination.
- May form an unusual attachment to odd objects such as a paper or rubber band.
The symptoms of autism range from mild to severe. Although symptoms of the disorder sometimes can be seen in early infancy, the condition may appear after months of normal development. About 7 in every 10 children and adolescents with autism, also have mental retardation or other problems with their brain function or structure.
IS IT AUTISM OR IS MY CHILD BEING _____?
When trying to address specific behaviors, a good place to start is to take into consideration how these behaviors may be the result of the neurological impairments that are associated with autism. From this perspective, parents and teachers can then begin to examine their student’s sensory environment for things that may be causing problematic behaviors.
Things such as fire alarms and school bells may be causing physical pain for someone with autism who has a high degree of sensitivity to high-pitched sounds. Other possible causes of problematic behaviors could be uncomfortable or ill fitting clothes that a student may be asked to wear.
HOW COMMON IS AUTISM IN CHILDREN?
Recent studies estimate that as many as 14 children out of 10,000 may have autism or a related condition. About 125,000 Americans are affected by these disorders, and nearly 4,000 families across the country have two or more children with autism. Three times as many boys than girls have autism.
WHAT IS DIFFERENT ABOUT MY CHILD’S SENSORY SYSTEMS?
Children with autism may be hyposensitive or hypersensitive in their responses to various sensory inputs. Being hyposensitive may include a high degree of tolerance to pain. This circumstance can be dangerous and should always be considered when children with autism are working around hot surfaces or objects.
Other children with autism may be hypersensitive to pain or refuse to wear anything but loose fitting, soft clothing. This circumstance is often referred to as tactile defensiveness and should be considered whenever touching a child with autism.
IF I HAVE ONE CHILD WITH AUTISM, WHAT ARE THE CHANCES OF HAVING ANOTHER?
Current data suggest that the likelihood of having a child with autism, if the biological parents already have one child with autism, is at least 1/20. This rate may be an underestimate, given that many families with one autistic child will stop having children due to stress or the fear of having another child with the disorder.
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