When family members or support providers become concerned that a child is not following a typical developmental course, they turn to experts, including psychologists, educators and medical professionals, for a diagnosis.
At first glance, some people with Autism may appear to have an intellectual disability, sensory processing issues, or problems with hearing or vision, and the diagnosis of Autism may become more challenging.
These conditions can co-occur with Autism and it can be confusing to families when they receive multiple diagnoses. However, it is important to identify Autism, as an accurate and early Autism diagnosis can provide the basis for appropriate educational and home-based support.
There are many differences between a medical diagnosis and an educational determination, or school evaluation, of a disability.
A medical diagnosis is made by a psychologist, developmental pediatrician, or other specialized physician based on an assessment of symptoms and diagnostic tests. A medical diagnosis of Autism spectrum disorder is most frequently made according to the Diagnostic and Statistical Manual (DSM-5, released 2013) of the American Psychiatric Association. This manual guides physicians in diagnosing Autism spectrum disorder according to a specific set of criterion.
A brief observation in a single setting cannot present a true picture of someone’s abilities and behaviors. The person’s developmental history and input from parents, caregivers and/or teachers are important components of an accurate diagnosis.
An educational determination is made by a multidisciplinary evaluation team of various school professionals. The evaluation results are reviewed by a team of qualified professionals and the parents to determine whether a student qualifies for special education and related services under the Individuals with Disabilities Education Act (IDEA) (Hawkins, 2009).
An educational determination can qualify an individual for support within school settings. However, an educational determination is not the same as a medical diagnosis, and often will not qualify an individual for therapies and support outside of school that would typically be covered by insurance or Medicaid. Additionally, a medical diagnosis of Autism does not guarantee an educational determination.
Early identification is associated with dramatically better outcomes for people with Autism. The earlier a child is diagnosed, the earlier they can begin benefiting from early intervention therapies and education.
The Centers for Disease Control and Prevention’s National Center on Birth Defects and Developmental Disabilities (NCBDD) recommends that all children be screened for Autism by their family pediatrician three times by the age of three – at nine, 18, and 24 or 30 months. Intervention should start when an Autism diagnosis is suspected, rather than when a formal diagnosis is made.
The advantages of early intervention cannot be overemphasized. Children who receive early intervention can make tremendous strides in their overall skill development, leading to improved quality of life.
The CDC provides a wealth of information on the early signs of Autism through its “Learn the Signs. Act Early” initiative.
While there is no one behavioral or communication assessment that can detect Autism, several screening instruments have been developed for use in determining if a child might need further evaluation for developmental delay and/or Autism, including the Ages and Stages Questionnaire (ASQ) and the Modified Checklist for Autism in Toddlers (M-CHAT).