When family members or support providers become concerned that a child is not following a typical developmental course, they turn to experts for a potential diagnosis. Experts, include but not limited to: psychologists, educators and medical professionals.
At first glance, some children with Autism may appear to have an intellectual disability, sensory processing issues, or problems with hearing or vision, and the diagnosis of Autism may become more challenging.
These conditions can co-occur with Autism, and it can be confusing to families when they receive multiple diagnoses. However, at Right Start Inc we know it is important to specifically identify Autism, as an accurate and early Autism diagnosis can provide the basis for appropriate educational and home-based support.
There are many differences between a medical diagnosis and an educational determination, or school evaluation, of a disability.
Over the past several years there has been an increase in the number of children diagnosed with ASD. Current estimates published by the US Centers for Disease Control indicate that approximately 1 in 59 children are diagnosed with Autism Spectrum Disorder (roughly 1.7 percent of US children).
Understanding how a child is diagnosed with ASD is important for parents, educators, therapists, and anyone else that may be interested in increasing their knowledge base in this area.
What is the purpose of a diagnostic evaluation?
There is no lab test or other medical tests that can diagnose ASD. A Diagnostic Evaluation would be appropriate if ASD is suspected. Diagnostic evaluation focus on behaviors that can be observed by parents, teachers, and others.
To help us at Right Start Inc determine if a child has ASD (often called being “on the spectrum”), we need to observe and evaluate his or her development in several key areas. These areas include, but are not limited to: language & communication, social awareness and interaction, and restricted interests & repetitive behaviors.
The purpose of the diagnostic evaluation is to discover whether the child has any symptoms of ASD, how many symptoms they have, and the extent that these symptoms impact the child’s ability to fully interact with their environment.
How are ASD symptoms evaluated?
The evaluation of ASD symptoms should include at least two key components: Parent/Caregiver Interview and Direct Observation.
The parents/caregivers are interviewed about the child’s development from birth to the time of evaluation and will focus on symptoms of ASD specifically.
This interview may also explore pregnancy and birth history, health history, school history, behavioral and emotional health, and any other details that may affect the child’s behavior or development.
The child must also be observed by a trained evaluator who can determine if symptoms reported in the interview are visible to others.
In some cases, the parent/caregiver interview and direct observation may be enough to evaluate the Autism Spectrum Disorder symptoms.
In other situations, it is helpful to interview the child’s teacher or other adults who know the child well. This can be done in person or over the phone.
The goal is to have enough information about the child to understand how she functions in different environments. The person conducting the evaluation compiles all the information and applies his or her training and experience to determine the diagnosis.
Who can diagnose a child with ASD?
Autism Spectrum Disorder can be diagnosed by a medical or mental health professional with knowledge of ASD. There is a growing understanding of the importance of specialized training for professionals and also the use of high-quality diagnostic tools and methods.
Some Agencies may not regard a diagnosis of ASD as “official” unless it was made by a psychologist, developmental pediatrician, or neurologist. Some agencies may require the use of a specific test (often the ADOS) when deciding whether a child qualifies for services or benefits.
At Right Start Inc, our evaluators are psychologists with advanced training and experience in conducting Diagnostic Evaluations. We strive to always conduct a comprehensive evaluation that takes into account the child’s strengths and weaknesses and how the child interacts in various social and play situations before making a determination.
While there is not a single behavioral or communication test that can detect Autism, several Autism-specific tools are now used for formal diagnosis. These include the Autism Diagnostic Observation Schedule, Second Edition (ADOS™-2), the Autism Diagnostic Interview (ADI), the Screening Tool for Autism in Toddlers (STAT), the Childhood Autism Rating Scales (CARS), and the Tele-ASD-Peds for diagnosis for use in telehealth. All of these tests should be used as part of a larger assessment, and not just on their own, as the determination of Autism is best completed with multiple sources of information.
What can I expect from the diagnostic evaluation?
A comprehensive evaluation will result in an increased understanding of your child’s unique strengths and challenges, diagnosis and severity of the condition at the time of the evaluation, and direction regarding treatment and educational planning.
Eligibility for the Early Intervention Program may be determined only by the New York State Department of Health approved evaluators. Right Start Inc. is under contract with the New York City Intervention Program to perform evaluations and provide other Early Intervention Program approved services.
If a child is found eligible for the Early Intervention Program, all Early Intervention services are identified in collaboration with the parent and must be authorized by the Early Intervention Official Designee (EIOD). The services will be authorized at an IFSP Meeting and will take into consideration the individual needs of the child and the family.