What Is Autism Spectrum Disorder?

Understanding the Autism Diagnostic Process

Health care providers diagnose ASD by evaluating a person’s behavior and development. ASD can usually be reliably diagnosed by the age of 2. It is important to seek an evaluation as soon as possible. The earlier ASD is diagnosed, the sooner treatments and services can begin.

Diagnosis in Young Children

Diagnosis in young children is often a two-stage process

Stage 1: General Developmental Screening During Well-Child Checkups

National guidelines recommend autism screenings at 9, 18, 24, and 30 months during routine pediatric checkups to detect early developmental delays. The initial screening involves short evaluations of social, communication, and behavior skills, which are crucial for early identification but do not provide a definitive diagnosis.

Considering caregivers’ experiences and concerns is a crucial part of the screening process for young children. The health care provider may ask questions about the child’s behavior and use answers alongside ASD screening tools and clinical observation of the child.

Stage 2: Additional Diagnostic Evaluation

Children who show potential signs of ASD or have a family history of the condition may be recommended for further diagnostics. The next steps involve assessments by a multidisciplinary team of child specialists who perform several tests alongside family observations to determine the presence and severity of ASD.

The diagnostic evaluation is likely to include:

• Medical and neurological examinations
• Assessment of the child’s cognitive abilities
• Assessment of the child’s speech and language abilities
• Observation of the child’s behavior
• An in-depth conversation with the child’s caregivers about the child’s behavior and development
• Assessment of age-appropriate skills
• Questions about the child’s family history

After the diagnosis, the level of support required is determined, with recommendations for achieving that level of support through psychotherapy or other means.

Diagnosis in Older Children and Adolescents

Caregivers and teachers are often the first to notice symptoms of ASD in older children and adolescents who attend school. The school’s special education team might conduct an initial assessment and then suggest further evaluation by the child’s primary health care provider or a specialist in ASD.

Caregivers might discuss with healthcare providers the child’s social challenges, such as difficulties with subtle communication. These subtle differences can include having trouble understanding tone of voice, facial expressions, or body language. Older children and adolescents might also struggle with understanding figures of speech, humor, or sarcasm, and they may find it difficult to form relationships with their peers.

Diagnosis in Adults

Diagnosing ASD in adults is often more difficult than in children because some ASD symptoms can overlap with symptoms of other mental health disorders, such as an anxiety disorder or ADHD.

Adults who notice signs and symptoms of ASD should talk with a health care provider and ask for a referral for an ASD evaluation, which can be with a neuropsychologist, psychologist, or psychiatrist who has experience with ASD. This evaluation will include questions about:

• Social interaction and communication challenges
• Sensory issues
• Repetitive behaviors
• Restricted interests

This evaluation may also include conversations with caregivers and other family members to learn about the person’s early developmental history, which helps ensure an accurate diagnosis.

Getting an accurate diagnosis of ASD as an adult can be immensely beneficial. It helps individuals understand their past difficulties, recognize their personal strengths, and seek appropriate support. Current studies are focusing on identifying the most effective services and supports to enhance the functioning and community integration of autistic youth transitioning to adulthood.

How Is Autism Different in Kids vs. Adults?

The symptoms of autism present differently across one’s lifespan, with symptoms being more evident in childhood and more often masked in adulthood. Despite being present across development, the prevalence rate for autism in children is about 1/36 vs 1/45 for adults.

This estimate for adults is slightly lower than in children, which is due to many factors, including underdiagnosis in adults, differences in diagnostic criteria over time, and a greater awareness and improved screening for children with autism.

In children, signs such as delayed speech, difficulty with eye contact, and repetitive behaviors are more pronounced. Adults may learn to mask these symptoms, making diagnosis challenging, or have developed sophisticated coping strategies to navigate social situations. Additionally, in adults, the symptoms of ASD may overlap with other mental health disorders, making it more difficult to notice.

Warning Signs of a Bad Autism Evaluation

With a much greater awareness of autism and its symptoms, the number of assessments available has increased dramatically. Many assessments offer quick and easy answers to difficult questions but may lack the accuracy and reliability of a multidisciplinary research-based approach.

Warning signs of a bad autism evaluation include:

• Online questionnaires
• Virtual Evaluations
• One-test diagnoses
• Lack of speech, language, or motor skill evaluations
• Lack of developmental history
• Lack of feedback or next steps following the diagnosis

An appropriate autism evaluation involves a comprehensive, multidisciplinary approach to diagnose it accurately. Essential components include:

• Detailed developmental histories
• Behavioral assessments
• Speech and language evaluations
• Observations across different settings
• Family and peer questionnaires about the individual

Exploring the Spectrum: Understanding Different Types of Autism

Autism, once categorized into distinct conditions such as Asperger Syndrome, is now classified as a spectrum disorder in the DSM-5, the official scientific framework for diagnosing and understanding psychological disorders. This shift reflects an understanding that autism encompasses a broad range of abilities and challenges characterized by persistent social deficits and repetitive behaviors.

Recognizing autism as a spectrum allows for individualized support and interventions tailored to each person’s unique needs. This comprehensive approach aims to improve outcomes and quality of life by addressing individuals’ specific strengths and difficulties across the spectrum.

This reclassification is significant because it ensures that all individuals with autism, regardless of where they fall on the spectrum, receive appropriate diagnosis and support. Former classifications often led to inconsistent diagnoses or support strategies. The spectrum model promotes a more inclusive understanding of autism, encouraging personalized care that considers the full range of symptoms and behaviors.

Understanding Gender Differences in Autism

Gender disparity in autism diagnoses is a significant issue, with statistics showing men diagnosed as many as four times the rate of women. This gap highlights an under- or misdiagnosis in women.

Several factors contribute to this disparity. Historically, diagnostic criteria have been based primarily on studies of male behavior, potentially overlooking how autism presents in women. Women often exhibit less stereotypical symptoms and may have better social camouflage skills.

Improving diagnosis and outcomes for women with autism involves developing gender-sensitive diagnostic criteria and increasing awareness among healthcare professionals. Recognizing and understanding the distinct presentation of autism in women can lead to early and more accurate diagnoses, allowing for better support and interventions.

After the Diagnosis: Next Steps

After receiving a formal autism diagnosis, the next step is getting appropriate, tailored support to help individuals manage their symptoms and thrive with their strengths. Comprehensive psychotherapy plans are a proven method for addressing the diverse challenges associated with autism and enhancing overall development.

Various therapeutic approaches are used to support individuals with autism. These therapies include behavioral, play-based, speech, and physical/occupational methods. Each type of therapy focuses on different aspects of autism, such as improving communication skills, enhancing social interactions, and developing motor abilities. By integrating these therapies into a tailored support plan, individuals with autism can achieve significant progress and lead more fulfilling lives.

Behavioral Therapies

Behavioral therapies, especially Applied Behavior Analysis (ABA) and Cognitive Behavioral Therapy (CBT), play a crucial role in autism treatment. ABA focuses on understanding and modifying behavior through structured techniques. It uses principles of reinforcement to encourage positive behaviors and reduce negative ones. Therapists work on breaking down skills into manageable steps, providing consistent rewards for successful actions.

CBT is a structured, goal-oriented form of psychotherapy that focuses on identifying and changing negative thought patterns and behaviors. In CBT, individuals work with a therapist to recognize dysfunctional thoughts

, challenge them, and replace them with more adaptive, positive ones.

For individuals with autism, behavioral therapies offer significant benefits by addressing the core symptoms of the disorder. These therapies help enhance social skills, reduce certain behaviors, and increase overall functional abilities.

Play Therapies

Play therapies use play as a medium to help children with autism develop essential skills. These therapies provide children a safe and engaging environment to express themselves, explore their emotions, and develop social and cognitive skills.

By participating in structured play activities, children can improve their ability to communicate, understand social cues, and manage their behaviors. Play therapies are designed to be child-centered, allowing children to lead the activities and interact with therapists naturally and enjoyably.

Speech Therapy

Speech therapy is a specialized intervention designed to address the communication challenges commonly faced by individuals with autism. Conducted by speech-language pathologists (SLPs), this therapy is designed to enhance both verbal and non-verbal communication skills, helping individuals express their needs and interact more effectively with others.

For individuals with autism, speech therapy offers substantial benefits by targeting various aspects of communication. It helps improve social interactions through skills like eye contact, turn-taking, and understanding body language. Additionally, speech therapy can support the development of expressive language, helping individuals to articulate their thoughts and emotions more clearly.

Medication

A health care provider may prescribe medication to treat specific symptoms. With medication, a person with ASD may have fewer problems with:

• Irritability
• Aggression
• Repetitive behavior
• Hyperactivity
• Attention
• Anxiety and depression

Read more about the latest medication warnings, patient medication guides, and information on newly approved medications on the U.S. Food and Drug Administration (FDA) website.

Autism Spectrum Disorder Experts at Start My Wellness