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Process of Identifying and Diagnosing Autism Spectrum Disorders

Tammi Reynolds, BA & Mark Dombeck, Ph.D.

Process of Identifying and Diagnosing Autism Spectrum Disorders

The autism spectrum of disorders are difficult to recognize because of their insidious nature. Symptoms come on slowly and gradually and parents are seldom motivated to assume the worst about their children's atypical behavior and symptoms until they become impossible to ignore. Though symptoms might be visible early on to an experienced eye, most parents do not bring their children in for formal diagnosis until they are between eighteen months and three years of age. As awareness of pervasive developmental disorders grows, however, more parents and physicians learn what to look for, more children are diagnosed at earlier ages, and the methods and techniques for identifying pervasive developmental disorders early continue to be refined.

Traditionally, behavioral observation has been the preferred method for identifying autism and related pervasive developmental disorders. Doctors notice children's lack of eye contact and social reciprocity. They recognize the presence of the stereotyped repetitive movements characteristic of children with autism and related disorders. They look for developmental delays or regressions in language and communication skill domains (characteristic of all PDDs except Asperger's Disorder), and social delays (characteristic of all PDDs)

It can be difficult for parents to know what specific signs to look for when concerned about a PDD like autism, even after reading the diagnostic criteria for the condition. To make things easier, the National Institute of Child Health and Human Development has provided a list of warning signs and milestones all revolving around the crucial theme of communication deficits. The presence of any one of these signs should raise a flag that a child might benefit from professional assessment and help. You should be concerned about your child if:

  • The child does not babble or coo by twelve months.
  • The child does not use gestures to communicate and the child does not wave.
  • The child does not grasp objects or point to objects by twelve months.
  • The child does not say single words by the age of sixteen months and does not say two-word phrases on his or her own by 24 months.
  • The child has a loss of any language or social skills at any age.

Typically, diagnosis unfolds in the following manner. Parents or guardians become concerned about their child's atypical behaviors or developmental delays, and take their child to see a pediatrician who conducts a medical exam, and notices symptoms consistent with a PDD. The pediatrician will then often refer the family to a specialist child psychiatrist or psychologist for further assessment.

The psychiatrist or psychologist observes the child's behavior, and interviews the parents or guardians so as to learn more about the child's behavior. He or she might also administer one or more formal tests designed to measure PPD-like behavior and compare it to normal children's behavior so that the degree of the child's impairments can be determined. The specialist doctor will then review test results and observation notes and make a diagnosis based on observable criteria.