How Autism is Diagnosed in Children
The American Psychiatric Association (APA) is in the process of updating the definition of autism spectrum disorder (ASD), which could influence how the condition is diagnosed. This revised diagnostic criteria, expected to be included in the DSM-5, may be implemented sometime in 2013.
Doctors use the Diagnostic and Statistical Manual of Mental Disorders (DSM) to determine if a child has autism. Currently, the DSM-IV is used, but the APA recommends that children be regularly screened for autism during routine check-ups. This helps doctors identify autism or related conditions such as language disorders or avoidant personality disorder.
For parents concerned about autism, the autism rating scale can be a helpful tool. This scale includes questions about the child’s responses and behaviors. However, it’s best to consult a specialist—such as a neurologist, developmental pediatrician, child psychiatrist, or speech therapist—rather than relying solely on a general practitioner. These specialists conduct a series of tests and screenings to make a thorough diagnosis. Here’s a general overview of the screening process:
Behavioral Screening
Behavioral screening involves evaluating the child’s development through various methods, including case studies. During a medical history interview, parents or caregivers answer questions about the child’s milestones, such as responding to their name, following eye movements, and gestures.
Doctors also use specific diagnostic guidelines for autism from the American Association of Childhood and Adolescent Psychiatry (AACAP). They may utilize behavioral questionnaires designed for children under three years old.
Clinical screening observes the child’s behavior in different environments. Parents might be asked to document and interpret their child’s responses in various settings. Developmental and intelligence tests are also conducted to assess whether developmental delays affect cognitive abilities and decision-making.
Physical Screening
Physical screening checks for any physical disabilities or issues. This includes measuring the child’s head size, weight, and height. Hearing tests are performed to determine if hearing problems are contributing to developmental delays or difficulties with language and social interaction.
Additionally, doctors may test for lead poisoning, which can lead to a condition known as pica, where the child craves non-food items like dirt or paint. Children with delayed growth might continue to put objects in their mouths, which can increase the risk of lead poisoning.
By combining these approaches, doctors can develop a comprehensive understanding of a child’s condition and provide an accurate diagnosis.
