Autism testing is done if the standard screening tests indicate a possible autism diagnosis. These include assessments of social functioning and behavior.
At the early childhood well-check appointments, autism screening is a standard part of the protocol. The pediatrician assesses the baby’s language skills as well as his or her ability to communicate emotion. Significant delays in language development, or the loss of previously held language skills, are signs of autism. An important behavior is sharing; babies with autism will not point to objects of interest or hold them out to show to others, while babies without autism do this frequently.
If the pediatrician believes that a child may have autism, then the child will be referred to a specialist to do more thorough testing. There is not one easy test to definitively diagnose autism; rather, the diagnosis relies on a set of tests as well as an overall assessment of the child.
Some of the tests that are used include:
• Observing the child’s current social interactions, communication, and behavior
• Taking a detailed history of these aspects of the child’s life, to find out how they have changed over time
• Tests for developmental level (cognition), speech and language, and behavioral issues
• Structured interactions with the child, and scoring these according to specific criteria
You may be given questionnaires to complete ahead of time. These would include questions about your child’s current symptoms and how they have developed over time. You may also be asked to give questionnaires for other adults who interact with your child, such as teachers or babysitters; you should bring these completed questionnaires with you to the appointment.
The specialist will then spend some time observing your child. There will be toys available, and the specialist will watch your child play with these, and will also watch the child interact with you. There are specific behaviors that the specialist is looking for during your child’s play and social interactions.
There are several structured interactions that the specialist will use. The specialist will ask the child specific questions, and rate his or her responses. There are certain criteria that the specialist is looking for. There will also be some tests of your child’s speech and language abilities and overall developmental level. Your child will likely not experience these as tests; the specialist will just ask your child some questions.
The diagnosis of autism requires difficulties with social interactions, nonverbal communication, and relationship formation; all of these must be present. The child must also have some problems with behavior, such as repetitive motor movements, unusual attachment to routines, unusual interests in objects or topics, and heightened or reduced sensitivity to sensory input; two of these must be present.
Autism spectrum disorders show wide variation in severity. When testing for autism, the specialist will also determine the severity of the disorder.
In some cases, the symptoms of autism are caused by another disorder, such as a genetic or metabolic disorder. Your doctor or the specialist may request blood tests and imaging tests (such as X-rays) to check for these conditions. Some are treatable, while others are not.
Mayo Clinic Staff. “Autism spectrum disorder: Tests and diagnosis.” Mayo Clinic website (2014). http://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/basics/tests-diagnosis/con-20021148
Centers for Disease Control and Prevention. “Autism Spectrum Disorder (ASD): Screening and Diagnosis.” CDC website (2015). http://www.cdc.gov/ncbddd/autism/screening.html
National Institutes of Health. “Autism Spectrum Disorder.” MedlinePlus (2015). http://www.nlm.nih.gov/medlineplus/autismspectrumdisorder.html