Autism Assessment and Diagnosis

Assessment and Diagnoses of Autism

Finding out that somebody close to you may require assessment into whether they have autism is never an easy process to go through. But it is one that is best done as early as possible.

Early diagnoses of the problem, especially in children, can lead to vital interventions that could be potentially life-altering.

So how do you know whether to call the doctor?

There are certain signs to look out for when assessing the risk or possibility that a person has autism. While most people get assessed for autism in their early years, there are people who have high-functioning autism who only get diagnosed in their teens or later years.

The good thing is that no matter when the diagnosis is made, there is help and hope of treatment.

Assessing Autism in Kids

The watch phrase for kids who might be at risk of being autistic is “Early detection, early treatment”. The earlier diagnosis is made, the sooner the child can begin treatments and therapy which could have a profound effect on their quality of life later in life.

People with autism generally possess brains that are more activated towards sensory experience than those of regular people. So every sound is louder and every light is brighter. To make matters worse, their brains process information about a third slower than other people.

What this means is that you have people who are constantly overwhelmed by a world that moves too fast or is too loud or too bright, hence the stimming, meltdowns.

Indicators for autism in kids can be divided into linguistic, behavioural and social.

Social Indicators: Social behaviour is a skill that has to be learned. Children learn habits like making eye contact and how to smile by observing those around them. Autistic children process these observations much slower and thus need more time to catch up to their peers.

Social indicators of autism in kids therefore are:

  • Does not smile.
  • Has no idea of how to play with toys.
  • Sometimes seems to be hearing impaired. The real reason is they don’t know how to respond yet.
  • Poor eye contact.

Linguistic Indicators: Autistic children have difficulty in processing sensory information including those from the people around them and this in turn leads to impairment in gross motor skills such as pointing as well as verbal skills.

This delay in social development leads to a delay in linguistic development.

Linguistic indicators of autism in kids therefore are:

  • Does not respond to the sound of name
  • Does not utter one word by 16 months after birth
  • Does not babble, point or make gestures by 12 months
  • Failure to combine 2 words by 24 months or two years
  • Loss of language or social skills

Behavioural Indicators: The world around them can be overwhelming and unduly confusing for autistics. Any order is welcome. This is the reason why once the settle into a routine, any change is met with stiff opposition.

The motions of rocking and stimming are a way to control their sensory experience.

The obsession with order such as when a child insists on lining up toys is a way of imposing order on the world and has a calming effect. There are other ways in which the nature of their brains affects the behaviours of autistics.

Behavioural indicators of autism in kids therefore are:

  • Settles into a strict routine
  • Is disturbed by the slightest change in routine
  • Performs repetitive movements such as rocking or spinning
  • Obsessed about lining up toys and other objects
  • Shows extreme attachment to one particular object or toy
  • May become fixated on a part of an object rather than the whole for example ts exaample

Example the spinning wheels of a toy car.

These indicators are by no means universal, as there is wide ranging heterogeneity when it comes to autistic traits. Many of those who fall in the high-functioning part of the spectrum get diagnosed much later in life when they start experiencing social and linguistic challenges in their chosen fields of life.

Assessing Autism in Adults

Image Courtesy: NHS Choices

Assessing Autism in Adults

Assessing autism in adults is not as easy as in children where there are a lot of milestones and warning signs to watch out for. The probability is also high that an individual who has gone so long without a formal diagnosis is very likely to fall in the high-functioning part of the autism spectrum where the symptoms of autism are not as pronounced or do not get in the way so much.

So they may be enjoying careers in highly visceral fields such as mathematics and music. This is common with those who Aspergers syndrome, a condition that falls within the autism spectrum.

That does not mean they find it easy however; just that they have learned to cope, each in their own way.

There are many people who go about in life feeling that they do not really belong. If by any means you feel you may be autistic then by all means go for a formal diagnosis from a qualified specialist.

A good way to look into possible signs that an adult could be in need of autistic diagnosis is to look back on old family videos to look upon their behaviour with fresh eyes.

Behaviour that may have brought on reprimands for being spoiled or wilful may actually have been autistic traits in full bloom.

Diagnosis of Autism in Kids and Adults

The occurrence of the above symptoms are not conclusive and do not do away with the need for a comprehensive diagnostic evaluation.

In the case of children, the observations of the parent are or paramount importance in the process of diagnosing for autism. If a parent is not sure of the milestones that their child should be reaching they can refer to the CDC’s list of milestones for the first five years of life to check if their child is at any risk of developmental delay or not.

In addition to that clinicians have a host of screening tests that they can carry out on children to have a better idea about their behavioural characteristics. These tests include:

  • Screening Tool for Autism in Two-Year Olds (STAT)
  • Checklist for Autism in Toddlers (CHAT)
  • Modified Checklist for Autism in Toddlers (M-CHAT)
  • Social Communication Questionnaire (SCQ) (aimed at children 4 years or older)

These checks have been known to not identify children with high-functioning autism, mild autism or Asperger’s syndrome. For kids who exhibit social or behavioural impairments without any language delay, the following tests which are used:

  • Childhood Asperger’s Syndrome Test (CAST)
  • The Autism Spectrum Screening Questionnaire (ASSQ)
  • The Australian Scale for Asperger’s Syndrome (A.S.A.S.)

After going through this screening, if there is further need, the medical specialist will go on to a second stage of tests that will determine the child’s level of functioning:

  • Autism Diagnostic Observation Schedule (ADOS-G)
  • Autism Diagnosis Interview-Revised (ADI-R)
  • Childhood Autism Rating Scale (CARS)

All of these tests are aimed at assessing the level of social, motor and linguistic behaviours of the child.

After a thorough examination, the specialist will meet you and explain their findings. Autism is a spectrum, and manifests in different ways for different people.

In the case of young adults and adults, a trip to the psychiatrist, clinical psychologist or a multi-disciplinary team will do well for a diagnosis.  A multi-disciplinary team will include a host of practitioners from a wide range of fields such a general practitioner, a dentist (autistic people have problems communicating such ailments), an educational psychologist, social worker and so on.

More often than not you will be required to come with somebody who knows you well-a sort of informant on you-who could give proper insight into your behaviour growing up.


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