April 12, 2005

• Well…we’re back!!  Unfortunately we headed right into a blizzard on our way home!  That was not a fun drive on Sunday.  I’ll give you more details on the trip as soon as I get the pics uploaded.

  
  

   

  
  

  Diagnosing Autism

  
  

  There are no medical tests for diagnosing autism. An accurate diagnosis must be based on observation of the individual’s communication, behavior, and developmental levels. However, because many of the behaviors associated with autism are shared by other disorders, various medical tests may be ordered to rule out or identify other possible causes of the symptoms being exhibited.
  
  A brief observation in a single setting cannot present a true picture of an individual’s abilities and behaviors. Parental (and other caregivers’) input and developmental history are very important components of making an accurate diagnosis. At first glance, some persons with autism may appear to have mental retardation, a behavior disorder, problems with hearing, or even odd and eccentric behavior. To complicate matters further, these conditions can co-occur with autism. However, it is important to distinguish autism from other conditions, since an accurate diagnosis and early identification can provide the basis for building an appropriate and effective educational and treatment program.

  
  

  Early Diagnosis

  
  

  Research indicates that early diagnosis is associated with dramatically better outcomes for individuals with autism. The earlier a child is diagnosed, the earlier the child can begin benefiting from one of the many specialized intervention approaches (see “Treatments and Education“).

  
  

  Diagnostic Tools

  
  

  The characteristic behaviors of autism spectrum disorders may or may not be apparent in infancy (18 to 24 months), but usually become obvious during early childhood (24 months to 6 years).

  
  

  As part of a well-baby/well-child visit, your child’s doctor should do a “developmental screening” asking specific questions about your baby’s progress. The National Institute of Child Health and Human Development (NICHD) lists these five behaviors that signal further evaluation is warranted:

  
  

  
  
  • Does not babble or coo by 12 months
    
  • Does not gesture (point, wave, grasp) by 12 months
    
  • Does not say single words by 16 months
    
  • Does not say two-word phrases on his or her own by 24 months
    
  • Has any loss of any language or social skill at any age.

  
  

  Having any of these five “red flags” does not mean your child has autism, but because the characteristics of the disorder vary so much, a child should have further evaluations by a multidisciplinary team that may include a neurologist, psychologist, developmental pediatrician, speech/language therapist, learning consultant, or other professionals knowledgeable about autism.

  
  

  While there is no one behavioral or communications test that can detect autism, several screening instruments have been developed that are now used in diagnosing autism.

  
  

  
  
  1. 
     

     CARS rating system (Childhood Autism Rating Scale), developed by Eric Schopler in the early 1970s, is based on observed behavior. Using a 15-point scale, professionals evaluate a child’s relationship to people, body use, adaptation to change, listening response, and verbal communication.

     
     
  2. 
     

     The Checklist for Autism in Toddlers (CHAT) is used to screen for autism at 18 months of age. It was developed by Simon Baron-Cohen in the early 1990s to see if autism could be detected in children as young as 18 months. The screening tool uses a short questionnaire with two sections, one prepared by the parents, the other by the child’s family doctor or pediatrician.

     
     
  3. 
     

     The Autism Screening Questionnaire is a 40 item screening scale that has been used with children four and older to help evaluate communication skills and social functioning.

     
     
  4. 
     

     The Screening Test for Autism in Two-Year Olds, being developed by Wendy Stone at Vanderbilt, uses direct observations to study behavioral features in children under two. She has identified three skills areas – play, motor imitation, and joint attention – that seem to indicate autism.

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