Know Before You Go: Advice for Parents Who Have Concerns About ASD for Their ChildTuesday April 3, 2018
About 1 in 68 children in the United States has been diagnosed with Autism Spectrum Disorder (ASD) by age 8 (1 in 42 boys, 1 in 189 girls)1, making it one of the most common childhood developmental disorders. Yet it can sometimes be confusing or difficult for parents or other caregivers to know what to do if they suspect their child may have ASD, and what to expect from an evaluation. The following information can help:
- Children can be diagnosed with Autism Spectrum Disorder as young as 2 years old, and some show signs as early as infancy.2 If you are concerned about a child’s development, there is no need to “wait and see” until a particular age, because early diagnosis and early intervention (if needed) lead to better outcomes.
- The American Academy of Pediatrics recommends Pediatricians administer screening checklists for ASD at Well Child Checkup visits within the first two years of life (usually starting at around 15-18 months of age). You may be asked to fill out a questionnaire called the M-CHAT (The Modified Checklist for Autism in Toddlers) at one or both of these visits. If your child is screened for possible ASD at a pediatric visit, make sure you ask about the results and follow any recommendations for additional assessment or intervention.
- If your pediatrician does not screen for autism, and/or you have a concern that is not being addressed at any age, ask for a referral to a developmental and behavioral pediatrician, child psychologist, or other specialist who can fully evaluate your child for concerns related to ASD. You can also complete the M-CHAT screening measure yourself and share the results with your pediatrician: https://actearlytexas.org/
- When a developmental professional evaluates your child for possible ASD, he or she should spend adequate time learning about your child – the evaluation should include a comprehensive parent/caregiver interview to gather information about your child’s development and current concerns, direct observation and interaction with your child during structured and unstructured activities, completion of standardized measures or checklists, and review of records or consultation with other professionals who have worked with your child, if applicable. There is no one medical or psychological test that diagnoses ASD, but a good evaluation will combine information from multiple sources to make an accurate diagnosis, and then provide referrals and recommendations for appropriate treatments and services.
- Families should also know about Early Childhood Intervention (ECI). ECI is funded by the federal and state governments to provide developmental evaluations and interventions to children with disabilities and developmental delays from birth to 3 years old. ECI professionals include speech therapists, occupational therapists, physical therapists, developmental specialists, and other health professionals. Intervention services are provided according to a Family Cost Share plan based on income level, and many children receive services at no cost. Evaluations, case management, development of the child’s intervention plan, and translator or interpreter services are provided at no cost. ECI professionals cannot diagnose autism, but they can identify delays that qualify the child for intervention services, and they may alert the family to the need for a referral for an autism evaluation. More information about ECI is available here: https://hhs.texas.gov/services/disability/early-childhood-intervention-services/eci-information-parents/eci-what-a-parent-needs-know.
- Some children with more subtle signs of Autism Spectrum Disorder are not identified until later in childhood. These children may demonstrate mild or more subtle developmental delays, and may be bright and academically advanced yet struggle with social relationships or show rigid, repetitive behaviors. Some of these children may have been diagnosed with other conditions earlier before an underlying ASD is recognized. If you have concerns about possible ASD in a child of any age, talk to your pediatrician or seek out additional information to gain a better understanding of areas your child may struggle with as well as their strengths. It’s never too early to gain insight into your child’s development and behavior, and it’s never too late!
Guest post by Cathy Guttentag, Ph.D.
Dr. Guttentag is a licensed clinical child psychologist and associate professor of pediatrics at UTHealth's McGovern Medical School. Dr. Guttentag provides diagnostic and developmental evaluations to infants and children with concerns about autism and related disorders.