Diagnosing Autism

When Should I Get My Child Tested?

We frequently hear children’s problems and behaviors described using “catch words” such as, “feeling stuck” or “not progressing like other children.” The most common behaviors described by parents include rigid behavior, which may present as difficulties tolerating changes to their routine or environment, insistence on performing tasks in a specific way, and fixation on certain activities or topics. When these behaviors begin to impact the family unit (e.g., avoiding certain activities) or functioning in the school or community settings, it may be time to consider a diagnostic evaluation.

Ages a Child Can Be Diagnosed

According to the Center for Disease Control and Prevention (CDC), a reliable autism diagnosis can be performed as early as age 2. Despite this, the average age of an autism diagnosis is 4 ½ years. The difference is related to the variations in the development and speed of each child. For example, other findings show that very young children with language delays can show symptoms that could be confused with autism (e.g reductions of eye contact , range of vocalizations, emotional reciprocity). For this reason, many providers are reluctant to diagnose before the age of 3.

Who Can Diagnose a Child With Autism?

Psychological and medical professionals have different levels of experience and qualifications in diagnosing autism. Good evaluation are completed by professionals with an understanding of the presentation of autism across the developmental span. They also have training in the administration and interpretation of specific testing measures. Professionals that may test for autism include:

It is important to note that there are two common types of autism diagnoses: medical and educational. There are significant differences between these two types.

A medical diagnosis is given by a psychologist or physician following an evaluation of symptoms and diagnostic tests. These providers determine whether the child meets the Diagnostic and Statistical Manual of Mental Disorders– 5th Edition (DSM-5) criteria for autism. A medical diagnosis is required by insurance companies to receive therapy services such as ABA Therapy.
An educational determination of autism is given when the school determines that the child meets the IDEA eligibility category of autism. The DSM-5 is not used in this determination. Insurance will not accept an education diagnosis for coverage of therapy services.
Schools cannot give a medical diagnosis of autism. If a child has a medical diagnosis of autism but does not qualify under IDEA eligibility, it does not necessarily mean they are refusing to acknowledge an existing diagnosis.

Autism Tests That Are Conducted

Various tools and measures help providers assess a child’s overall functioning in: (1) social communication, (2) presence of repetitive behaviors, and (3) restricted interests. The following information is generally included in testing:

Detailed information regarding the child’s developmental history from parent or caregiver.
Cognitive measures to assess intellectual abilities to understand how a child approaches tasks and reacts to challenging items and to assess strengths and weaknesses.
Interactive assessment including questions and play-based activities to evaluate a child’s communication, social interactions, and behaviors associated with a diagnosis of autism. This can include the ADOS-2 or MIGDAS-2.
A personalized set of questionnaires (e.g. BASC-3) to determine whether the symptoms reflect Autism Spectrum Disorder and/or another diagnosis(es).
Supporting information from other individuals (e.g., teacher) who have worked with the child to understand behavior across settings.

he Results of a Diagnostic Evaluation

Autism is not a “yes” or “no” condition. Autism is a spectrum because of its wide array of symptoms and severity. When evaluating autism, we don’t look for specific symptoms in isolation. Instead, it is the combination of numerous symptoms and functional impairments that points to autism.

Young children (3 and younger) who have a diagnosis often display more apparent behavioral differences (reduced social communication and repetitive or restricted behaviors) and have other developmental delays. Other individuals with autism may not receive a diagnosis until young or late adulthood. This is attributable to more subtle differences and symptoms that are often attributed to other conditions (e.g., ADHD, OCD).

What Happens After an Autism Diagnosis?

Many parents report mixed feelings following an autism diagnosis – hope, sadness, relief, guilt. It is important to remember that your child is the same person they have always been. The difference is that the family has a better understanding of their needs and how to support them.

After an evaluation, parents are encouraged to educate themselves more about autism. This helps parents understand how autism impacts their child’s behavior and how to interact with them.

Parents are often encouraged to seek services or therapies to support their child. This can include Speech/Language Therapy, Applied Behavioral Analysis (ABA), Occupational Therapy, or other Physical Therapy. Social skills groups offer valuable opportunities to develop the skills needed to engage with others in an appropriate manner.

It is also suggested that parents share diagnosis information with school staff and family members. This can produce additional support at school and from the extended family.

Self-care is especially important for parents, who tend to experience more stress than parents dealing with other disabilities. It is important that parents “recharge their own batteries” to be better able to help their child. This includes nourishing themselves emotionally, mentally, and physically. Seeking balance between caring for their child and themselves helps maintain a higher quality of life.

It is important to note that there are two common types of autism diagnoses: medical and educational. There are significant differences between these two types.

Access to Services After a Diagnosis

With an autism diagnosis, many private insurance companies cover Applied Behavioral Analysis (ABA) services for children 21 years and younger. Applied Behavior Analysis (ABA) is a therapy based on the science of learning and behavior that focuses on improving social, communication and learning skills through reinforcement.