Autism Spectrum Disorders Diagnosis, Assessment & Treatment

Prior to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders 5th Edition, APA, 2013), a cluster of Pervasive Developmental Disorders (PDD) were considered “autism spectrum disorders” (ASDs). These included Autistic Disorder, Asperger’s Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). However, revisions that led to the publication of the newest edition of the DSM (i.e. DSM-5), have resulted in significant changes to the criteria and categories of ASDs. One of the most significant changes is that one umbrella term Autism Spectrum Disorders will now replace the previously separated diagnostic labels of Autistic Disorder, Asperger’s Disorder, and PDD-NOS. Distinctions, which will influence support services and academic accommodations required by the child, will be made according to severity levels. These changes have implications for both autistic individuals and parents with children with features of and/or previous diagnoses of ASDs.

Often one of the two questions are asked:

1. Why do I or does my child need to be evaluated and,
2. How do you evaluate?

Evaluations leading to a diagnostic label can be daunting for most people. However, an accurate and proper diagnosis is crucial for understanding current functioning and, level of challenges. Rather, it is also imperative in assisting psychologists, medical doctors and educators, identify individualized treatments, strategies, educational placements and academic/occupational accommodations that aim at assisting you and your child develop to your/his/her fullest potential, whilst continuously challenging yourself/him/her to develop further.

Signs of ASD include:

• Delayed speech and language skills
• Consistent repetition of words or phrases (i.e., echolalia)
• Persistent avoidance of eye-contact and preference for social isolation
• Difficulty understanding other people’s feelings and perception taking
• Difficulty sustaining a conversation
• Under developed play and social skills
• Presence of obsessive, restricted interest(s)
• Being easily upset by minor change(s) in a routine
• Unusual reactions to certain sounds, smells, tastes, textures or sights
• Odd repetitive body movements

This understanding then naturally leads to the latter question: how do you assess? Diagnosing ASD can be challenging, since there is no medical/blood test available for diagnostic purposes. Doctors and psychologists look at the child’s behaviour and development to make a diagnosis. Children can be screened at 12 months of age, with a reliable diagnosis by a trained professional being possible after 2 years of age.

An ASD assessment is two-fold: comprising of developmental screening to ensure that development has been age appropriate and, comprehensive diagnostic evaluation which is often carried out by either Developmental Paediatricians, Child Neurologists, Clinical/Developmental Psychologists or Psychiatrists. Speech and Occupational Therapy assessments, at times, are also done concurrently to rule out any underlying conditions that maybe the cause of communication and behavioural symptoms.

Comprehensive diagnostic evaluations consist of both observing the child in various setting and, objective tools assessing the triad of challenges (i.e. Language/Communication Delays, Play/Social Delays and Restricted and Rigid Behaviours) seen among individuals with ASD.