Early Intervention and AutismDiagnosis Ismy18-month-oldsontooyoungtobeevaluated for autism? This is a common question with a complicated answer because there can be a lot of variation in how and when the symptoms of autism become apparent. It’s never too early for a general developmental evaluation. According to the American Academy of Pediatrics, pediatricians should screen babies and young children for developmental delays at every checkup. Many of these delays – including the language and social delays associated with autism – can be identified at 18 months, if not earlier. be difficult, since there is no medical test, like a blood test, to diagnose the disorder. 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. This delay means that children with an ASD might not get the help they need. Diagnosing an ASD takes two steps: • Developmental Screening • Comprehensive Diagnostic Evaluation
Understand the Changeable First Year As for autism, studies demonstrate that behavioral signs can begin to emerge as early as 6 to 12 months. However, most professionals who specialize in diagnosing the disorder won’t attempt to make a definite diagnosis until 18 months. This is because autism symptoms can continue to emerge – or fade away – until around 24 months. At that time, we say that an autism diagnosis tends to become “stable.” Consider the example of a toddler who is meeting all his or her developmental milestones at 18 months, but then begins to lose skills, or “regress.” In other words, autism can’t be ruled out at 18 months. Conversely some babies show early signs and delays, but then catch up with their peers by 24 months. Recognize the Range That said, some children can be diagnosed earlier than 24 months. It’s also important to remember that many high-functioning children with autism aren’t diagnosed until they enter school and start struggling socially. Trust Your Parental Instincts Importantly, research shows that parents are good at picking up on early signs of autism. So if you’re concerned, ask your doctor for a referral to a developmental pediatrician or psychologist who specializes in the disorder. Even if your child is too young to be assessed for autism, you can still request an evaluation for developmental delays.
Developmental Screening 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. All children should be screened for developmental delays and disabilities during regular well-child doctor visits at: • 9 months • 18 months • 24 or 30 months Additional screening might be needed if a child is at high risk for developmental problems due to pre-termbirth, lowbirth weight, or other reasons. In addition,allchildrenshouldbescreenedspecifically for ASD during regular well-child doctor visits at: If your child’s doctor does not routinely check your child with this type of developmental screening test, ask that it be done. If the doctor sees any signs of a problem, a comprehensive diagnostic evaluation is needed. Comprehensive Diagnostic Evaluation The second step of diagnosis is a comprehensive evaluation. This thorough review may include • 18 months • 24 months
looking at the child’s behavior and development and interviewing the parents. It may also include a hearing and vision screening, genetic testing, neurological testing, and other medical testing. In some cases, the primary care doctor might choose to refer the child and family to a specialist for further assessment and diagnosis. Specialists who can do this type of evaluation include: • Developmental Pediatricians (doctors who have special training in child development and children with special needs) •ChildNeurologists (doctorswhoworkon thebrain, spine, and nerves) • Child Psychologists or Psychiatrists (doctors who know about the human mind) References https://www.autismspeaks.org/blog/2013/03/15/how-early- can-autism-be-diagnosed Lord C, Risi S, DiLavore PS, Shulman C, Thurm A, Pickles A. Autism from 2 to 9 years of age. Arch Gen Psychiatry. 2006 Jun;63(6):694-701.
Diagnosing autism spectrum disorder (ASD) can
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