This page contains a compilation of information provided by the U. S. Centers for Disease Control and Prevention (CDC).
What is Autism?
Autism spectrum disorder (ASD) is one of a group of neurodevelopmental disorders. Conditions in this diagnostic category have an onset during the developmental period (pregnancy and early childhood), with signs typically seen before the child enters grade school. ASD is characterized by difficulties in social communication and social interaction, along with restricted, repetitive patterns of behavior, interests, or activities. Symptoms can change with development (becoming more or less severe) making diagnosis sometimes difficult. As a spectrum disorder, each person with ASD can have very different skills, abilities and needs. In addition, individuals with ASD may also have other medical or behavioral health issues that can be related or unrelated to their ASD.
Signs and Symptoms
ASD begins very early in a child’s life, with signs and symptoms typically emerging by age 3. Emerging research suggests that it may be possible to diagnose ASD prior to age 2. Regular screening for development throughout the first few years of life provides the greatest opportunity for a child with ASD to receive an early diagnosis and appropriate intervention.
Age-specific developmental checklists from the CDC’s “Act Early” program can be found here.
Because ASD is a spectrum disorder, symptoms and severity vary tremendously from person to person. In addition, there is no medical test (like a blood test) to provide a diagnosis. As a result, it is important that evaluations be conducted by professionals who have been specially trained and are experienced in conducting diagnostic evaluations for possible ASD.
There is no cure for ASD. However, research shows that early diagnosis and appropriate intervention services offer a child with ASD the best opportunity to achieve his or her maximum potential. Services are based upon your child’s individual needs, and may include behavioral therapy as well as other services to help your child talk, interact with others and develop independent living skills. Early Intervention (EI) is a program through the Illinois Department of Humans Services for children under the age of 36 months who are at risk of having developmental delays. To get more information about the EI program in your community, click here.
If your child is over 36 months old, even if not old enough for kindergarten or to be enrolled in a public school, contact your local elementary school, school district office, or TAP Partner to find out how to have your child evaluated for school-provided services. Click here to find your local TAP Partner.
There are many other treatment options available for individuals with ASD. When evaluating different options, you may find it helpful to review the suggestions on this tip sheet.
Diagnosis information is provided courtesy of the Centers for Disease Control and National Institute of Mental Health.
ASDs can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable. However, many children do not receive a final diagnosis until much older. This delay means that children with an ASD might not get the help they need.
Diagnosing an ASD takes two steps:
A “well child” check-up should include a developmental screening test. If your child’s pediatrician does not routinely check your child with such a test, ask that it be done. Your own observations and concerns about your child’s development will be essential in helping to screen your child. Reviewing family videotapes, photos, and baby albums can help parents remember when each behavior was first noticed and when the child reached certain developmental milestones.
Several screening instruments have been developed to quickly gather information about a child’s social and communicative development within medical settings. Among them are the Checklist of Autism in Toddlers (CHAT), the modified Checklist for Autism in Toddlers (M-CHAT), the Screening Tool for Autism in Two-Year-Olds (STAT), and the Social Communication Questionnaire (SCQ) (for children 4 years of age and older).
Some screening instruments rely solely on parent responses to a questionnaire, and some rely on a combination of parent report and observation. Key items on these instruments that appear to differentiate children with autism from other groups before the age of 2 include pointing and pretend play. Screening instruments do not provide individual diagnosis but serve to assess the need for referral for possible diagnosis of ASD. These screening methods may not identify children with mild ASD, such as those with high-functioning autism or Asperger syndrome.
During the last few years, screening instruments have been devised to screen for Asperger syndrome and higher functioning autism. The Autism Spectrum Screening Questionnaire (ASSQ), the Australian Scale for Asperger’s Syndrome, and the most recent, the Childhood Asperger Syndrome Test (CAST), are some of the instruments that are reliable for identification of school-age children with Asperger syndrome or higher functioning autism. These tools concentrate on social and behavioral impairments in children without significant language delay.
If, following the screening process or during a routine “well child” check-up, your child’s doctor sees any of the possible indicators of ASD, further evaluation is indicated.
Comprehensive Diagnostic Evaluation
The second stage of diagnosis must be comprehensive in order to accurately rule in or rule out an ASD or other developmental problem. This evaluation may be done by a multidisciplinary team that includes a psychologist, a neurologist, a psychiatrist, a speech therapist, or other professionals who diagnose children with ASD.
Because ASDs are complex disorders and may involve other neurological or genetic problems, a comprehensive evaluation should entail neurologic and genetic assessment, along with in-depth cognitive and language testing. In addition, measures developed specifically for diagnosing autism are often used. These include the Autism Diagnosis Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS-G).The ADI-R is a structured interview that contains over 100 items and is conducted with a caregiver. It consists of four main factors—the child’s communication, social interaction, repetitive behaviors, and age-of-onset symptoms. The ADOS-G is an observational measure used to “press” for socio-communicative behaviors that are often delayed, abnormal, or absent in children with ASD.
Still another instrument often used by professionals is the Childhood Autism Rating Scale (CARS).It aids in evaluating the child’s body movements, adaptation to change, listening response, verbal communication, and relationship to people. It is suitable for use with children over 2 years of age. The examiner observes the child and also obtains relevant information from the parents. The child’s behavior is rated on a scale based on deviation from the typical behavior of children of the same age.
Two other tests that should be used to assess any child with a developmental delay are a formal audiologic hearing evaluation and a lead screening. Although some hearing loss can co-occur with ASD, some children with ASD may be incorrectly thought to have such a loss. In addition, if the child has suffered from an ear infection, transient hearing loss can occur. Lead screening is essential for children who remain for a long period of time in the oral-motor stage in which they put any and everything into their mouths. Children with an autistic disorder usually have elevated blood lead levels.
Customarily, an expert diagnostic team has the responsibility of thoroughly evaluating the child, assessing the child’s unique strengths and weaknesses, and determining a formal diagnosis. The team will then meet with the parents to explain the results of the evaluation.
Although parents may have been aware that something was not“quite righ” with their child, when the diagnosis is given, it is a devastating blow. At such a time, it is hard to stay focused on asking questions. But while members of the evaluation team are together is the best opportunity the parents will have to ask questions and get recommendations on what further steps they should take for their child. Learning as much as possible at this meeting is very important, but it is helpful to leave this meeting with the name or names of professionals who can be contacted if the parents have further questions.
Treatment information is provided courtesy of the Centers for Disease Control, National Institute of Mental Health, and Autism Society of America.
There is no single best treatment package for all children with ASD. One point that most professionals agree on is that early intervention is important; another is that most individuals with ASD respond well to highly structured, specialized programs.
Before you make decisions on your child’s treatment, you will want to gather information about the various options available. Learn as much as you can, look at all the options, and make your decision on your child’s treatment based on your child’s needs. You may want to visit public and specialized schools in your area to see the type of program they offer to special needs children. In addition, you may want to seek out the availablility of statewide resource networks, such as The Autism Program of Illinois.
Guidelines used by the Autism Society of America include the following questions parents can ask about potential treatments:
- Will the treatment result in harm to my child?
- How will failure of the treatment affect my child and family?
- Has the treatment been validated scientifically?
- Are there assessment procedures specified?
- How will the treatment be integrated into my child’s current program? Do not become so infatuated with a given treatment that functional curriculum, vocational life, and social skills are ignored.
The National Institute of Mental Health suggests a list of questions parents can ask when planning for their child:
- How successful has the program been for other children?
- How many children have gone on to placement in a regular school and how have they performed?
- Do staff members have training and experience in working with children and adolescents with autism?
- How are activities planned and organized?
- Are there predictable daily schedules and routines?
- How much individual attention will my child receive?
- How is progress measured? Will my child’s behavior be closely observed and recorded?
- Will my child be given tasks and rewards that are personally motivating?
- Is the environment designed to minimize distractions?
- Will the program prepare me to continue the therapy at home?
- What is the cost, time commitment, and location of the program?
Adults with Autism
Entering Adult Life With Autism from The Autism Program of Illinois