Diagnostic Process

While there are no definite known causes of autism, the process of diagnosing it often requires the involvement of multiple professionals and various assessments. As a result, it may not be a straightforward procedure, but early diagnosis is crucial for both the child and their family to enhance their quality of life and meaningfully navigate the condition.

Developmental Screening

If any delays or concerns are observed, the next step is to undergo developmental screening, a more formal evaluation of a child's developmental progress. This screening process is conducted typically by a developmental pediatrician/ psychologist. It entails the use of structured questionnaires and checklists covering areas like language, physical abilities, cognitive skills, as well as behavioral and emotional aspects.

In instances where there are concerns or if a child is at a higher risk for Autism Spectrum Disorder (ASD), such as having a family member with ASD, additional screening may be recommended. It's worth noting that developmental screening can be conducted as a standard part of a child's regular health checkup, even if there are no apparent concerns.The American Academy of Pediatrics (AAP) recommends developmental and behavioral screening for all children during regular visits at the ages of 9 months 18 months and 30 months.

In addition, AAP recommends that all children be screened specifically for ASD during regular visits at 18 months and 24 months.

Screening Instruments

Most often the Modified Checklist for Autism in Toddlers, Revised with Follow-Up (MCHAT - R/F) or the Childhood Autism Rating Scale (CARS) is used.

• MCHAT is a brief checklist of yes/no items for early detection among children 16 to 30 months of age.
• Childhood Autism Rating Scale (CARS) observes a child’s behavior and uses a 15-point scale to evaluate a child’s relationship to people, body use, adaptation to change, listening response, and verbal communication.

A well-executed screening will determine whether a more comprehensive assessment for autism is required. Additionally, it aids in the identification or exclusion of any other potential issues or conditions that may be present.

Screening outcomes and diagnosis

Parental responses in the child's screening are highly significant. If all results are within normal parameters and parents have no concerns, that will conclude the process. However, if the child exhibits developmental challenges or if the doctor shares any concerns, they will direct the parents to a specialist for further evaluations, which may include tests to rule out other issues, such as speech-hearing impairment.

Once other conditions are ruled out, and the child meets the ICD (International Classification of Diseases)- 10 or DSM - 5 (The Diagnostic and Statistical Manual of Mental Disorders) criteria for Autism Spectrum Disorder, the child will be diagnosed with Autism Spectrum Disorder (ASD).

Next steps

Based on the test results, the pediatrician may refer the parents for therapies (speech, behavioral, or occupational therapy). At this stage, it is vital that parents are taking informed decisions, understand the difficulties of their child and are aware and mindful of the choices they are making.