How is Autism Spectrum Disorder diagnosed?
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that is diagnosed by a specialist in the field of Developmental and Behavioral Pediatrics, Neurology, Psychiatry, or Psychology. Primary care providers in pediatrics and family medicine are generally first to hear concerns from parents, or notice that a child is not developing typically. It is extremely important to not minimalize parents’ concerns as research has shown that early treatment is the key to improved outcomes in children with Autism Spectrum Disorder. Children with signs or symptoms concerning for ASD should be referred to a specialist for evaluation as well as referred to a local early intervention program to be evaluated for additional services, such as speech, physical, or occupational therapy.
Diagnosis of ASD typically involves taking a detailed history from the caregiver, in addition to observation of the child, and evaluation consisting of standardized assessment tools specifically designed to assist in the diagnosis of Autism Spectrum Disorder. Inter-disciplinary teams consisting of physicians, psychologists, physical or occupational therapists, speech-language pathologists, and social workers also work together to see children with concerns of ASD.
What are some early signs/symptoms of Autism Spectrum Disorder?
- Lack of response to name
- Inappropriate gaze
- Lack of pointing or sharing joint attention
- Repetitive movements with objects, or posturing of body
- Difficulty with changes in routine and schedule
For more information regarding diagnosis of Autism Spectrum Disorder
- SM- 5 diagnostic criteria of Autism Spectrum Disorder
- Autism Case Training (ACT) Web-based course
Autism Spectrum Disorder 299.00 (F84.0)
A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history
- Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
- Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
- Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
Specify current severity: Severity is based on social communication impairments and restricted repetitive patterns of behavior (See table below)
B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):
- Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
- Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day).
- Highly restricted, fixated interests that are abnormal in intensity or focus (e.g, strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interest).
- Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment (e.g., apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
Specify current severity: Severity is based on social communication impairments and restricted, repetitive patterns of behavior (See table below)
C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).
D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.
Note: Individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the diagnosis of autism spectrum disorder. Individuals who have marked deficits in social communication, but whose symptoms do not otherwise meet criteria for autism spectrum disorder, should be evaluated for social (pragmatic) communication disorder.