How is Autism Diagnosed?
In the 1960’s, approximately 1 in 10,000 Americans were diagnosed with autism while today, 1 in 54 children are. Though increases in environmental factors leading to autism have been considered as a possible explanation for the dramatic increase in numbers, current research implicates a more likely factor: changes in how the condition is diagnosed. My name is Dr. Jennifer LaTreill, postdoctoral psychology resident, and here is some helpful information about diagnosing autism.
Research has found that genetic and environmental components of autism remain consistent over time; however, awareness and education regarding the diagnosis have greatly increased. Environmental factors such as infection during pregnancy and older paternal age have been considered, but findings appear to invalidate these concerns. Instead, it is likely that cultural and diagnostic shifts are responsible for the increase in numbers. In addition, the measures that are used to diagnose autism have become more standardized and widely used.
So, how is autism diagnosed? Autism Spectrum Disorder (ASD) is diagnosed by analyzing a child's behavior by conducting an in-depth evaluation. Clinicians take into consideration the child’s whole development (intellect, social skills, behavioral and emotional functioning, developmental skills and more) and looks closely into limitations (e.g., not speaking) as well as what they are doing too much of (e.g., repetitive behaviors).
There are several well-known diagnostic tools that are used to assess for autism. These measures can be in the form of interviews, questionnaires, computerized testing, behavioral observation, and ASD specific measures such as the Autism Diagnostic Observation Scale 2 (ADOS-2) and the Childhood Autism Rating Scale (CARS-2). In addition, the American Psychiatric Association's Diagnostic and Statistical Manual, Fifth Edition (DSM-5) provides standardized criteria to help diagnose ASD.
Autism is considered a spectrum disorder because there is a wide variation of symptom severity, and the challenge is that individuals on the spectrum can present very differently. For example, a child may have a significant problem with a certain skill (e.g., not speaking) or have a specific area of strength, making their diagnosis completely unique compared to another individual on the spectrum. Simply put, there is no one size fits all presentation. Some individuals may have autism along with cognitive limitations that require substantial support, while other individuals require minimal support. As a result, some children and adults go years without ever receiving a diagnosis or an explanation for why they behave the way they do. Although ASD is a life-long disability, many individuals show significant progress with treatment and develop the ability to independently participate in learning, social, and community activities with typically developing peers.
The variability of symptoms highlights the need to find a qualified psychologist that is competent and experienced in assessing for autism and other neurodevelopmental disorders. An accurate diagnosis regarding a child’s symptom presentation helps inform treatment planning, provides effective interventions at home and at school, and increases the likelihood for future success. If you suspect your child may have ASD or have been recommended to consider an autism evaluation, please reach out today and schedule a phone consult to discuss options going forward and setup an individualized testing plan based on the unique needs of the your child!