Human beings fall along a spectrum of neurodiversity, and for that reason, many experts no longer consider autism spectrum disorder (ASD) the developmental tragedy depicted in '90s television and Lifetime movies. In fact, falling somewhere along that spectrum can be a pretty amazing sign of individuality and difference. That said, children with ASD often face unique challenges, and they can truly benefit from diagnosis and targeted support in early childhood. How are children tested for autism? The "gold standard" assessment is rigorous, involved, and, when performed by an experienced professional, a helpful tool for self-understanding.
"Usually when parents are concerned about their child's development, they speak with their child's pediatrician," explains Dr. Crystal I. Lee, of LA Concierge Psychologist. Lee tells Romper that pediatricians use a tool called the Modified Checklist for Autism in Toddlers (M-CHAT), a basic screener for Autism Spectrum Disorder when children are between 16 and 30 months of age. However, the M-CHAT can't itself diagnose ASD. As parents seek to better understand the needs of a neuro-divergent child, a battery of assessments lie ahead.
According to the Centers for Disease Control and Prevention (CDC), while ASD can be detected as young as 18 months of age, many people don't receive a diagnosis until they're much older, which may prevent them from getting the help they need. There is no blood test for autism, so all assessments rely on observing how children speak, behave, and move compared with their neuro-typical peers.
After the M-CHAT, pediatricians will refer parents to a psychologist or neuropsychologist, explains Lee. What follows is the "gold standard" of psychological assessment, a battery of tests that include observation, structured play, and social interactions: the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2), the Autism Diagnostic Interview, Revised (ADI-R), the Vineland Adaptive Behavior Scales, Second Edition (Vineland-II), cognitive and language testing, and school observation.
While this series of tests is considered the most accurate way to diagnosis autism spectrum disorder, they aren't required. This means that not every clinician will follow this tried-and-true model. "This is unfortunate because sometimes people will miss an ASD diagnosis because of inadequate expertise or lack of necessary testing instruments," Lee tells Romper. Shockingly, some children are diagnosed with ASD without any testing at all.
Writing on the Autism Women's Network, Cynthia Kim discussed how painful and confusing it can be to receive another mental health diagnosis — like depression, an eating disorder, or bipolar disorder — and how damaging the resulting interventions can be. When it comes to autism testing, it's truly important to "get it right," and not to fear the diagnosis.
"In the past 10 years or so there has been a movement within the ASD community to push for acceptance of neuro-diversity, which I personally think is an empowering movement," explains Lee. "There is no doubt there is neuro-diversity among humans, and I agree that ASD is not a disease that needs to be cured."
Nevertheless, some experiences that go along with ASD can be distressing, especially in the context of a society that demonizes autism spectrum disorders. For Lee, autistic individuals can receive help and assistance based on their assessment to improve school experience, family relationships, and overall quality of life.
It's frightening to think of your young child spending so much time in a psychologist's office. However, a solid diagnosis can yield crucial insights into a child's way of being in the world for their families and for themselves. Assessment by a qualified professional can also help you begin to better understand your child's thoughts, dreams, hopes, challenges, and needs — an essential job for any parent, whether their child is on the spectrum or not.
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