Getting An Autism Diagnosis

Diagnosis

The Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) is a standardized tool that is considered the gold standard in helping providers to diagnose an autism spectrum disorder (ASD). The ADOS assesses communication, social interaction and play using a variety of assessment materials (e.g., toys, puzzles).

The assessment usually takes about 30-45 minutes, during which the client is engaging in a variety of activities with a provider. The provider collects data on the client’s behavior and uses an algorithm to determine the presence of symptoms related to ASD.

Although early indicators are no substitute for a proper diagnostic assessment, there are some warning signs to be aware of.

These warning signs do not necessarily indicate that your child has ASD, and some are indicative of other disorders, but concerns can be brought up during screenings and with your Primary Care Physician.

• Lack of eye contact or avoidance of eye contact (culturally sensitive – not applicable in all cultures)
• Lack of or limits to use of words, sounds, gestures to communicate wants and needs
• Lack of understanding words
• Lack of use of objects (in play and exploration)
• Lack of imitation of adult and peer actions and sounds
• Failure to gain joint attention or lack of attempts from child to gain your joint attention (joint attention – parent and child attending to same object or action)
• Failure to follow eye gaze of others or attend to where others are pointing
• Inappropriate behaviors used to gain your attention (tantrums, does not use “Mommy/Mama” or “Daddy/Dada/Papa”)
• Is not interested in things when others are interested in them
• Does not show things to parents that they are interested in
• Failure to respond to name (does not turn head, look in direction of speaker when name is called)
• Does not wave, point, nod yes/no
• Does not ask for help
• Does not play with toys
• Engages in repetitive actions, makes same sounds over and over, has very limited interests
• In addition to other indicators; cries, tantrums, or behaves inappropriately when transition to new location or activity
• Engages in self-injury

Official Diagnostic Criteria for Autism

In addition to other assessments used for diagnosing ASD, clinicians will also use the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision (DSM-5-TR) (American Psychiatric Association, 2022). According to the DSM-5-TR, all of the following criteria must be met for diagnosis:

• Persistent deficits in social communication and social interaction across multiple settings, including difficulty in social-emotional reciprocity, difficulty using nonverbal communication behaviors for social interaction, and deficits in making, maintaining, and comprehending relationships.
• Restricted and repetitive patterns of behaviors, such as repetitive motor movements, inflexibility and rigidity in routines, highly restricted patterns of interest, and over or under-responsiveness to the environment.
• Symptoms must be present during the developmental period but may not become obvious until social expectations are more demanding later in childhood.
• Symptoms cause clinically significant hindrance of functioning across settings.
• The symptoms are not better explained by an intellectual disability (ID) or global developmental domain. However, when ASD and ID are comorbid, social communication skills are lower than expected given the developmental level of the child.

ASD may be diagnosed with or without language impairment.