How is autism Diagnosed

Dignosing autism spectrum disorder (ASD) can be difficult, since there is no medical test, like a blood test, to diagnose the disorders. Doctors look at the child’s behavior and development to make a diagnosis.

ASD 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.

Diagnosing an ASD takes two steps:

  • Developmental Screening
  • Comprehensive Diagnostic Evaluation

Developmental screening is a short test to tell if children are learning basic skills when they should, or if they might have delays. During developmental screening the doctor might ask the parent some questions or talk and play with the child during an exam to see how she learns, speaks, behaves, and moves. A delay in any of these areas could be a sign of a problem.

If the doctor sees any signs of a problem, a comprehensive diagnostic evaluation is needed.

After establishing the clinical diagnosis we can utilize  specialized tests like CARS (Childhood Autism Rating Scale) through which autism is classified into Non autistic mild/moderate/ severe categories

Diagnostic tools:

Childhood Autism Rating Scale (CARS)

The Childhood Autism Rating Scale (CARS) is a behavior rating scale intended to help diagnose autism. The childhood-autism rating scale was designed to help differentiate children with autism from those with other developmental delays, such as intellectual disability. Although there is no gold standard among rating scales in detecting autism, CARS is frequently used as part of the diagnostic process.

Brief assessment suitable for use with any child over 2 years of age,  CARS includes items drawn from five prominent systems for diagnosing autism; each item covers a particular characteristic, ability, or behavior.
The Childhood Autism Rating Scale is a diagnostic assessment method that rates children on a scale from one to four for various criteria, ranging from normal to severe, and yields a composite score ranging from non-autistic to mildly autistic, moderately autistic, or severely autistic. The scale is used to observe and subjectively rate fifteen items.

  • Relationship to people
  • Emotional response
  • Nervousness and fear
  • Verbal communication
  • Non-verbal communication
  • Activity level
  • Level and consistency of intellectual response
  • General impressions

Autism Testing Evaluation Criteria (ATEC)

The Autism Treatment Evaluation Scale (ATEC) is a 77-item diagnostic assessment tool.
he questionnaire, which is completed by a parent, takes about 10–15 minutes to complete and is designed for use with children ages 5–12. The ATEC is currently available in 17 different languages.
Several research studies support the ATEC as a reliable and valid instrument in the assessment of children’s autism symptoms and improvements. Research has also found the ATEC to be successful in measuring interventional effects as well as tracking behavioral development over periods of time.

Questions are divided into four subscales based on content.
1. speech/language and communication
2. sociability
3. sensory and cognitive awareness
4. physical/health behavior

VSMS- Social Quotient (SQ)

The Vineland Social Maturity Scale (VSMS) is a psychometric assessment instrument designed to help in the assessment of social competence.
It is a quality psychometric questionnaire and a good measure of adaptive behavior

The test consists of 8 sub-scales measuring:

  • Communication skills
  • General self-help ability
  • Locomotion skills
  • Occupation skills
  • Self-direction
  • Self-help eating
  • Self-help dressing
  • Socialization skills

Clinical Features:

Firstly there are the behavioural issues such as hyperactivity, temper tantrums, poor attention span, decreased concentration and poor focusing.Secondly there are the speech, language and communication issues that are a major concern for parents.Thirdly there are the social skills impairment such as poor eye contact and poor interaction with peers.

Early diagnosis and treatment helps young children with autism develop to their full potential. The primary goal of treatment is to improve the overall ability of the child to function.

References:
Ozonoff, S, Boodlin-Jones, B, & Solomon, M. (2005). Evidence-based assessment of Autism Spectrum Disorder in children and adolescents. Journal of Clinical Child and Adolescent Psychology
Schopler E, Reichler RJ, DeVellis RF, Daly K (1980). "Toward objective classification of childhood autism: Childhood Autism Rating Scale (CARS)". J Autism Dev Disord. 10 (1): 91–103. doi:10.1007/BF02408436. PMID 6927682.
Echo Armman. "Childhood Autism Rating Scale (CARS)". Autism-World. Retrieved 2007-03-28.

Doll, Edgar Arnold (1953). The measurement of social competence: a manual for the Vineland social maturity scale