Are you wondering if your child may be autistic? Autism is a complex neurobiological disorder characterized by developmental delays, and impairments in language development and social communications. There is no conclusive medical tests to detect the presence of autism; no blood test, CT scan or MRI that can indicate its presence. There are, however, assessments that are used by doctor’s and psychologists to evaluate a child when an autism spectrum disorder (ASD) is suspected. These assessments will help the examiner determine in the child meets the diagnostic criteria for ASD.
Early Screening in Toddlers
Pediatricians routinely screen for developmental delays and autism spectrum disorders during “well baby” visits. When a delay or autism is suspected, parents may be asked to fill out a questionnaire called the Modified Checklist for Autism in Toddlers (M-CHAT). From the answers to these 28 questions the doctor will determine if a child is “at risk” for autism. This is not an autism diagnosis, just a screening for some “red flags “that can indicate an autism spectrum disorder. A follow-up evaluation will be required. See: Autism in Toddlers: Early Signs
When Concerns Are Identified
Your child has been identified as “at risk” according to your physician’s assessment of the M-CHAT, and you may or may not have been sent for a STAT evaluation; Screening Tool for Autism in Toddlers (STAT), where a trained evaluator spends 20-30 minutes performing interactive play exercises with your child. There are concerns that your child may have an autism spectrum disorder (ASD), and it is time for a full autism evaluation, also known as a neuropsychological evaluation.
What Does An Autism Evaluation Entail?
A comprehensive autism evaluation will be performed by either a team of psychologist, psychiatrists, or developmental pediatricians. Any of these trained professionals who have experience with autism spectrum disorders can perform the evaluation. There will likely be more than one evaluator involved in your child’s assessment. The evaluation will consist of interviews with parents and with the child (if age-appropriate), structured interactive-play, and when appropriate I.Q. testing.
The Interview and Paperwork
The clinical interview is aimed at gathering background information and diagnostic data. It is a comprehensive interview with you (the parent) in order to obtain a relative developmental history; questions like when your child first crawled, walked, or ate with a spoon will be asked. You will be asked about your pregnancy, and family medical history. Note: Children with a family history of ASD are at a higher risk for developing autism themselves. You will only need to know about a few generations of your family, but if you find family history interesting you may want to use this as an opportunity to look further back. Searching a social security death index, you may find some interesting family history involving ASD. Of course, alternatively, you may find nothing. Either way, this is useful information. You will likely be asked to fill out a lengthy questionnaire reporting the child’s development and behaviors you have observed. This questionnaire is called the Vineland Adaptive Behavior Scale, and it assesses the child’s development. Sometimes this assessment tool is filled out by the clinician during the interview process.
This portion of the assessment involves a 30-60 minute long structured interaction with a trained examiner. The activities are designed to assess your child’s social, play, and communication skills. The child is directed toward age-appropriate play-story telling, puzzles, imaginative play, imitation-and places the child into one of three ranges according to the Autism Diagnostic Observation Schedule (ADOS): Autism, Autism Spectrum, or Not Autism.For younger children and toddlers, the interactive evaluation will be done with the parents present. Older children may be evaluated independently. Additionally, older children may also be given an IQ test to assess intellectual abilities.
Like most parents you will likely be anxious to receive the “results” of your child’s autism evaluation. Unfortunately, patience may be required. The examiners, after the evaluation, will need time to compile all the data that they have gathered. They will then “score” the assessment, both observed and the ones you filled out, and compile a comprehensive report. In some cases the examiners may be able to give you their initial impressions immediately following their evaluation, or you will be scheduled for a return appointment to review their findings.
Having your child referred for a comprehensive autism evaluation can be scary, but knowing what to expect can help calm your fears. Remember that just because you were referred does not mean your child definitely has an autism spectrum disorder. However, it is important to follow through with the evaluation. Research has shown that children with autism spectrum disorders often do better long-term with early diagnosis and intervention.