How is ASD diagnosed?
Autism and Autistic Spectrum Disorders (ASD) are now on everyone’s radar thanks to increasing awareness and understanding that early intervention can make a difference. It’s also become a minefield for many concerned parents, with a massive amount of information available on the internet, including Dr Google (for good and bad!). The trouble is, there’s no single test for ASD, like a blood test or genetic testing, to make it consistent across the health professionals encountering and involved in diagnosing ASD. And every child with ASD is different, often making it confusing for parents and family. For some children and families it’s a straightforward process to making a diagnosis and accessing extra support, while for others it’s a convoluted road of seeing multiple professionals and multiple opinions.
So what’s the consensus?
The consistent features of autism are that children (and adults) have difficulties with social interaction and restricted or repetitive interests. These have to be present and causing significant disruption in day-to-day life in order to make a diagnosis.
The gold standard for making a diagnosis of ASD, according to National Health and Medical Research Council (NHMRC) guidelines is to use:
- A multidisciplinary assessment.
- At least one standardised ASD assessment tool such as the Autism Diagnostic Observation Schedule (ADOS) or the Autism Diagnostic Interview-Revised (ADI-R).
In private practice, where we have the benefit of seeing children over time and not just for the assessment alone, there are two other factors that I like to take into account:
- What happens over time? Does your child seem to be ‘growing into’ the diagnosis or moving away from it? We can specifically use time as a diagnostic tool.
- What happens in response to intervention? If we support your child to develop this skill, do those ASD-type features lessen and reduce your concern?
And there’s one other factor that needs to be specifically addressed:
- Does this make sense for you as parents? Does it ‘fit’ what you see and know about your child so that the downside of having a ‘label’ is outweighed by the empathy and understanding that may come?
Sometimes parents are at different stages in this journey and need to allow themselves time to process what all this means – parents are allowed that time and space too if they need it. Supporting each other is a critical part of supporting your child with resilience as a family.
I’m happy to talk with you about any concerns you may have about your child and whether they may be on the autism spectrum.
This post was written by Specialist Developmental Paediatrician Dr Andrea McGlade.
PhD candidate UQ: Neuroprotective Developmental Care (NDC- The Possums Program) as very early intervention for high risk siblings for ASD