This article will give you information about the screening and assessment processes, including:

• How to prepare for your appointment(s)
• What to do during your appointment(s)
• Answers to frequently asked questions, such as what to do if you are told to “wait and see”

Screening vs Assessment

Developmental Screenings

Developmental screenings are brief, informal evaluations to identify children who are at risk for developmental delays and need further evaluation. Doctors, nurses, or other professionals in healthcare, community, or school settings can perform developmental screenings.

During the screening process, your child will be given a brief test and you’ll be asked to complete a questionnaire. The results will help determine if your child needs to be referred for further evaluation.

Developmental Assessments

If areas of concern are identified in the screening process, an in-depth, formal developmental assessment is needed. Developmental assessments need to be conducted by a trained specialist or a team of trained specialists (developmental pediatricians, child psychologists, occupational therapists, speech-language pathologists, etc.).

Many specialists have wait lists, so you will want to call and schedule an appointment for a developmental assessment immediately following your referral.

How To Get An Appointment For A Screening And/Or Assessment

There are a number of ways to get the evaluation process started. One way is through your child’s pediatrician. Another way is through your state’s Early Childhood Intervention Program (ECI).

Your Child’s Pediatrician

Contact your child’s pediatrician, tell them you are concerned about your child’s development, and request a developmental screening for your child.

If your child’s pediatrician identifies areas of concern during the screening process, they should refer you to a trained specialist (developmental pediatrician, child neurologist, child psychiatrist, or child psychologist) for further evaluation in an autism assessment.

Your State’s Early Childhood Intervention Program (ECI)

Another option is contacting your state’s Early Childhood Intervention Program (ECI) to have your child screened and evaluated for autism. Screenings and evaluations through ECI are almost always free of charge.

Your child’s age will determine how you go about scheduling an appointment to have your child screened and assessed through ECI.

Children Under 3:

• Find your state’s ECI contact information here

Children Over 3

• Contact your local public elementary school to receive ECI services through them

Before Your Appointment

Preparing for your appointment paves the way for effective advocacy for your child and helps ensure they receive a thorough evaluation. You can prepare for your appointment by:

• Compiling a list of questions and concerns to discuss with your doctor or the person who will be evaluating your child
• Collect video data of your child doing any concerning behaviors that you feel your child may not engage in during an assessment
• Completing a milestones checklist. Some free options include:
  • The CDC’s “Learn the Signs. Act Early.” website has printable and digital trackers
  • Modified Checklist for Autism in Toddlers (M-CHAT)
  • Autism Treatment Evaluation Checklist (ATEC)
• Complete any surveys or questionnaires given to you by your child’s doctor or ECI office
  • Be sure to do this 3-5 days before your appointment to allow for ample time for completion
• Call your insurance company to discuss coverage and any out-of-pocket expenses that you might incur
  • Screenings and assessments through state’s ECI program should be free of charge (see above)

During Your Appointment

During the screening and assessment processes, your child may be asked to perform some simple tests that may look like play. As the parent, you will be asked questions about your child’s development and behaviors.

Go over your completed milestone checklists and/or M-CHAT with your doctor. Point out all of the missed or delayed milestones. Do not be embarrassed to accurately describe concerns and issues. Do not “sugar coat” or downplay any delays. Minimizing or downplaying answers will not help your child in the long run. Don’t be afraid to speak up. Your input is invaluable throughout this process!

Remember, screenings are brief, informal, and may look like a well-child visit. However, their informal nature doesn’t excuse the person conducting the screening from taking this process seriously. Your concerns should never be dismissed. If the person screening your child tells you to “wait and see” or suggests this a “just a stage” your child will grow out of, go and get a second opinion! Always listen to your intuition.

Developmental assessments, are more comprehensive and in-depth than screenings. Assessments can take a long time to complete, so they may be broken up into several appointments. They might also be conducted by several different specialists who are trained in specific areas (speech-language pathologist, occupational therapist, physical therapist, child psychologist, etc.).

In order to ensure your child receives a comprehensive assessment, your child should be observed in a number of different settings to obtain an understanding of how they behave in various environments. Depending on your child’s comfort level, you may be asked to be in the room with your child, view the from an observation room, or remain in the waiting room.

Frequently Asked Questions

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I Think My Child May Have Autism

Diagnostic Criteria for ASD

The post I Think My Child May Have Autism appeared first on The Autism Community in Action.

Only well-qualified, trained professionals can issue an autism diagnosis. The American Psychiatric Association has outlined diagnostic criteria for autism in its Diagnostic and Statistical Manual of Mental Disorders (DSM).

In the most recent version of the DSM, the DSM-5, autistic disorder, pervasive developmental disorder-not otherwise specified (PDD-NOS), and Asperger syndrome were consolidated under one diagnosis of “autism spectrum disorder.” In addition, the DSM-5 now requires healthcare providers to categorize individuals into “severity levels” to help identify their support needs.

Below you will find the diagnostic criteria for autism spectrum disorder under both DSM-5 and the DSM-IV.

DSM-5 Diagnostic Criteria for ASD

1. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive; see text):
   1. 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.
   2. 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.
   3. 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.
2. 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):
   1. Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
   2. Insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).
   3. 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 interests).
   4. Hyper- or hypo-reactivity to sensory input or unusual interest 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).
3. 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).
4. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.
5. 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.
• Specify if:
  • With or without accompanying intellectual impairment
  • With or without accompanying language impairment
  • Associated with a known medical or genetic condition or environmental factor.
    Coding note: Use additional code to identify the associated medical or genetic condition.
  • Associated with another neurodevelopmental, mental, or behavioral disorder.
    Coding note: Use additional code[s] to identify the associated neurodevelopmental, mental, or behavioral disorder[s].
  • With catatonia (refer to the criteria for catatonia associated with another mental disorder for definition).
    Coding note: Use additional code 293.89 [F06.1] catatonia associated with autism spectrum disorder to indicate the presence of the comorbid catatonia.

Severity Levels for Autism Spectrum Disorder

LEVEL 3: Requiring very substantial support

• Social Communication:
  Severe deficits in verbal and nonverbal social communication skills cause severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others. For example, a person with few words of intelligible speech who rarely initiates interaction and, when he or she does, makes unusual approaches to meet needs only and responds to only very direct social approaches.
• Restricted, Repetitive Behaviors:
  Inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres. Great distress/difficulty changing focus or action.

LEVEL 2: Requiring substantial support

• Social Communication:
  Marked deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others. For example, a person who speaks simple sentences, whose interaction is limited to narrow special interests, and who has markedly odd nonverbal communication.
• Restricted, Repetitive Behaviors:
  Inflexibility of behavior, difficulty coping with change, or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress and/or difficulty changing focus or action.

LEVEL 1: Requiring support

• Social Communication:
  Without supports in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions, and clear examples of atypical or unsuccessful responses to social overtures of others. May appear to have decreased interest in social interactions. For example, a person who is able to speak in full sentences and engages in communication but whose to-and-fro conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful.
• Restricted, Repetitive Behaviors:
  Inflexibility of behavior causes significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning hamper independence.

The DSM-5 was published in May 2013.

The post Diagnostic Criteria for ASD appeared first on The Autism Community in Action.