Medical history for autism

A complete medical history will be taken along with a physical examination to help confirm the diagnosis of autism or to see whether there are other causes for unusual behaviors.¹ Additionally, the health professional will ask questions to assess the child's strengths and weaknesses and the family's resources.

Information from this interview will help your health professional apply the diagnostic standards from the American Psychiatric Association.² These standards are the basis for recommendations used by the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry (AACAP).

The health professional will ask questions about:

· The mother's pregnancy.

• How was the mother's general health during pregnancy? Was she exposed to infection? Did she drink alcohol, smoke, or use drugs?
• How was the child delivered, and were there problems during delivery?
• How much did the child weigh, and did he or she have problems after birth?

· The child's communication skills.

• Is the child able to speak at the same level as others his or her age?
• Does the child ever bring parents items that are of obvious interest or enthusiastically engage with parents to point out objects or events?
• Without making eye contact, will the child take a parent's hand and guide the parent to a desired object instead of asking for it?
• Can the child follow simple commands?
• Does the child respond to his or her name?
• Does the child have any unusual speech patterns, such as repeating heard phrases over and over (echolalia), pronoun reversal, or using a monotone voice?

· The child's social interaction.

• Is the child interested in social interaction, or does the child distance himself or herself from others?
• Does the child make and sustain eye contact?
• Does the child have a social smile that he or she initiates or responds with to others' gestures?

· The child's interests and unusual behaviors.

• Does the child have an attachment to any unusual objects, such as a hard, metal object, rather than a blanket or stuffed animal?
• Does the child stare frequently?
• Has the child ever had any seizures?
• Does the child play with toys in an unusual manner?
• Does the child play "pretend" (if older than age 2)?
• Does the child have severe temper tantrums that can last a long time?

· Parents and siblings.

• What are the parents' occupations and education? Other resources?
• Is there a family history of mood or anxiety problems?
• Are any other siblings developmentally disabled in any way? Have they had problems developing language skills?

Citations

1. Committee on Children with Disabilities, American Academy of Pediatrics (2001). Technical report: The pediatrician's role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics, 107(5): 1–18.

2. American Psychiatric Association (2000). Autistic disorder. In Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text rev., pp. 70–75. Washington, DC: American Psychiatric Association.