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How is Autism diagnosed?

To qualify for a diagnosis, a person must have a total of six or more items from (1), (2), and (3), with at least two from (1)and one each from (2) and (3):

1. Qualitative impairment in social interaction, manifest by at least two of the following:A. Marked impairment in the use of multiple nonverbal behaviors, such as eye-to-eye gaze, facial expression, bodypostures and gestures, to regulate social interactionB. Failure to develop peer relationships appropriate to developmental levelC. Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by lack ofshowing, bringing, or pointing out objects of interest)D. Lack of social or emotional reciprocity

2. Qualitative impairment in communication, as manifest by at least one of the following:A. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt to compensatethrough alternative modes of communication such as gesture or mime)B. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with othersC. Stereotyped and repetitive use of language, or idiosyncratic language

D. Lack of varied, spontaneous make-believe, or social imitative play appropriate to developmental level

3. Restrictive repetitive and stereotypic patterns of behavior, interests, and activities, as manifested by at least one ofthe following:A. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal eitherin intensity or focusB. Apparently inflexible adherence to specific nonfunctional routines or ritualsC. Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body

movements)D. Persistent preoccupation with parts of objects.

4. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:1. Social interaction2. Language as used in social communication3. Symbolic or imaginative playThe disturbance is not better accounted for by Retts Disorder or childhood disintegrative disorder.

Worried about your child? The simplest way for a parent to determine whether their child may require further screeningfor autism is to use the list of criteria from the American Psychiatric Associations Diagnostic and Statistical Manual ofMental Disorders, Fourth Edition. It is easy enough for even parents to be able to evaluate their children within areasonable degree, allowing for further medical assessment and intervention. The list of criteria is available at the end

of this entry.

Additional methods of screening are available, the simplest for toddlers being the Checklist for Autism in Toddlers(CHAT) typically issued by a GP, family physician or pediatrician at the childs 18 month checkup. There is also the M-CHAT, or Modified Checklist for Autism in Toddlers. Both tools are freely available for use and are recommended

standards by which to screen.

Beyond screening, the tools for proper assessment and diagnosis are to be used by a trained psychologist andpreferably a BCBA- Board Certified Behavioural Analyst. Some of these tools are the CARS, GARS, and Vineland

Adaptive Behavior Scale, and the ABLLS test to measure academic capabilities if applicable.

A proper behavioural, developmental, and psychological assessment takes a few hours with the child as well aninterview with the parents to determine where the childs weaknesses, strengths, and problem behaviours lie. Followingthe assessment, parents should expect a detailed report as well as an explanation of the results by the clinical

psychologist who conducted the assessment.

The American Psychiatric Association guidelines are as follows:

A. To qualify for a diagnosis, a person must have a total of six or more items from (1), (2), and (3), with at leasttwo from (1) and one each from (2) and (3):

1. Qualitative impairment in social interaction, manifest by at least two of the following:

y A. Marked impairment in the use of multiple nonverbal behaviors, such as eye-to-eye gaze, facial expression,body postures and gestures, to regulate social interaction

y B. Failure to develop peer relationships appropriate to developmental level

y C. Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people (e.g., by lack

of showing, bringing, or pointing out objects of interest)

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y D. Lack of social or emotional reciprocity

2. Qualitative impairment in communication, as manifest by at least one of the following:

y A. Delay in, or total lack of, the development of spoken language (not accompanied by an attempt tocompensate through alternative modes of communication such as gesture or mime)

y B. In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation withothers

y C. Stereotyped and repetitive use of language, or idiosyncratic language

y D. Lack of varied, spontaneous make-believe, or social imitative play appropriate to developmental level

3. Restrictive repetitive and stereotypic patterns of behavior, interests, and activities, as manifested by at least one ofthe following:

y A. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that isabnormal either in intensity or focus

y B. Apparently inflexible adherence to specific nonfunctional routines or rituals

y C. Stereotyped and repetitive motor mannerisms (e.g., hand or finger flapping or twisting, or complex whole-body movements)

y D. Persistent preoccupation with parts of objects.

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:

1. Social interaction

2. Language as used in social communication

3. Symbolic or imaginative play

C. The disturbance is not better accounted for by Retts Disorder or child hood disintegrative disorder.