Autism Spectrum Disorder - Part II

Last week we talked about the symptoms of autism spectrum disorder (ASD). This week I thought we could focus on screening and diagnosis.

Unfortunately, there is no specific medical test to diagnose ASD, so the diagnosis can sometimes be difficult. Doctors must look at many features of a child's behavior and development in order to make the diagnosis. It is important to make the diagnosis as early as possible, in order to provide the child with as much help as we can. Early intervention can make all the difference in the world to these kids. The first step in screening is developmental screening.

Developmental Screening
Your pediatrician or family doctor will ask questions about what your child can or cannot do, and compare this to a chart of usual developmental milestones and when they usually happen. Normal development varies among all children. My daughter talked much earlier than my son, but they both fell within the normal range.

Your pediatrician or family doctor will also talk and play with your child during an exam to see how they move, behave, speak, etc. Sometimes they are watching your child's actions without you even realizing it. Sometimes they may seem to be just playing (and don't we all love to play with a baby!), but they are gathering important information during this interaction.

Developmental screening is routinely done at all well child exams, especially at 9 mo
nths, 18 months, and 24 months. If your child has a developmental delay, or is at risk due to prematurity or other reasons, your doctor may do additional screenings.

Autism-Specific Screening
The American Academy of Pediatrics currently recommends that all children be screened with an ASD-specific screening test during well-child visits at 18 months and 24 months, in conjunction with the routine developmental screening. The Modified Checklist for Autism in Toddlers (M-CHAT) is the currently recommended test for the age group 18-24 months. It is a 20 question quiz that a parent fills out about their child's behavior, which is then scored and interpreted by the pediatrician.

Comprehensive Diagnostic Evaluation
If your child's doctor suspects ASD, based on the screening tests, the next step in the process of diagnosis is a comprehensive evaluation. This is a thorough review which may include:

• More extensive behavioral and developmental testing and parental interviews
• Hearing and vision testing
• Genetic testing
• Neurologic testing
• Other medical testing may be required

Many times, your child's doctor may choose to refer you and your child to a specialist for the comprehensive diagnostic evaluation, such as a pediatrician who specializes in developmental disorders or a pediatric neurologist.

The Latest Research
There is a new research study that just came out in the last couple of months, which indicates that ASD may be diagnosed as early as 14 months with specific standardized testing starting at 14 months. In this study, by doing standardized testing, they were able to diagnose ASD with 84% accuracy. Only 2% of the children who these researchers thought had ASD went on to develop normally, and 14% ultimately were diagnosed with another developmental disorder. This is very promising.

With earlier diagnosis of ASD, we can provide earlier intervention. Earlier intervention could lead to improvement in overall function of kids with ASD by improving the connections in the brain that develop at a young age. If you suspect that your child may have symptoms of ASD, it is important to bring these concerns to your child's doctor as early as you can.

If you have any questions about autism spectrum disorder, please log into your account and send us your question. We are here to help.

Dr. Anita Bennett MD - Health Tip Content Editor