How Autism is Diagnosed

Autism can be defined as “presence of at least six symptoms or more in total, including at least two (or more) symptoms of qualitative impairment in social interaction, at least one (or more) symptom of qualitative impairment in communication, and at least one (or more) symptom of restricted and repetitive behavior in an individual.”

Diagnosis of autism is based on behavior and not by cause or mechanism of development of autism. The onset of symptoms should be before the age of three years. There may be delays or abnormal functioning in social interaction, language as used in common social communication, and symbolic or imaginative play. Some examples of autism symptoms are stereotyped and repetitive use of language, lack or absence of social and/or emotional reciprocity, persistent preoccupation with objects such as toys or their parts.

There are several diagnostic instruments/tools available for diagnosis of autism. (CARS) is commonly used tool/instrument for diagnosis of autism by clinicians/pediatricians. There are two commonly used instruments/tools in research, namely ADI-R (Autism Diagnostic Interview-Revised) for interviewing parents and ADOS (Autism Diagnostic Observation Schedule) for interaction and observation with the affected child.

The primary diagnostic physical examination and developmental history taking is performed by pediatrician for diagnosis of autism. If required help from ASD specialist can be taken for observing and assessing cognitive, communication, family, and other factors using standardized tools. Any associated medical condition must be taken into account while diagnosing autism. A pediatric neuropsychologist can help in assessing behavior and cognitive skills of the child, to aid diagnosis as well as to help and recommend educational interventions which will be best for the child.

In many cases genetic evaluation can be done after diagnosis of autism is made, especially if the symptoms suggest a genetic cause. There are some practical problems in diagnosis of autism, especially for marginal cases, as there may be under-diagnosis or over-diagnosis. Practical problem for diagnosis also arise if child is visually impaired, as many diagnostic tests depend on vision of the child.


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