How Do Doctors Diagnose Autism?

Early diagnosis can make a huge difference in the lives of children with autism spectrum disorder (ASD) and their families.

But it’s not always easy to make an ASD diagnosis. There’s no lab test for it, so doctors rely on observing the behaviors of very young children and listening to the concerns of their parents.

ASD has a very wide range of symptoms. Some people who are “on the spectrum” have severe mental disabilities. Others are highly intelligent and able to live independently.

Wherever your child falls on the spectrum, getting an autism diagnosis is a two-stage process, and it starts with your pediatrician.

Well-Child Visits

Pediatricians are the first step in the autism diagnosis process. Every child gets an assessment at their 18- and 24-month checkups to make sure they’re on track, even if they don’t seem to have any symptoms.

At these visits, your child’s pediatrician will watch him and talk to him. She’ll ask you questions about family history (whether anyone in the family is on the spectrum), and about your child’s development and behavior.

Here are some milestones your doctor will be looking for:

  • Did your baby smile by 6 months?
  • Did he mimic sounds and facial expressions by 9 months?
  • Was he babbling and cooing by 12 months?

Also, she’ll ask about these things:

  • Are any of his behaviors unusual or repetitive?
  • Does he have trouble making eye contact?
  • Does he interact with people and share experiences?
  • Does he respond when someone tries to get his attention?
  • Is his tone of voice “flat”?
  • Does he understand other people’s actions?
  • Is he sensitive to light, noise, or temperature?
  • Any problems with sleep or digestion?
  • Does he tend to get annoyed or angry?

Your responses are very important in your child’s screening. If everything checks out and you have no concerns, that’s the end of it. But if your child shows developmental problems or your doctor has concerns, she will refer you to a specialist for more tests.

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Other Tests

If your child needs more tests, your next appointment probably will be with a team of ASD specialists -- child psychologist, speech-language pathologist, and occupational therapist. You may also meet with a developmental pediatrician and a neurologist.

This evaluation is usually to check things like your child’s cognitive level, language abilities, and other life skills like eating, dressing himself, and going to the bathroom.

For an official diagnosis, your child must meet the standards of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Your child must have problems with two categories to fall on the autism spectrum.

  1. Challenges with communication and social interaction. For kids with ASD, it’s hard to “connect” with or predict the reactions of other people, read social cues, make eye contact, or have a conversation. They might not begin to speak as early as other children do. They might also have a hard time with the muscle skills needed for things like playing sports or drawing and writing.
  1. Restricted and repetitive patterns of behavior. Children with ASD might rock their bodies, repeat phrases, or become upset with changes in their routines. They’re often deeply interested in one subject. They also have sensory issues.

Your child’s doctors also might recommend genetic testing to rule out any other conditions that could cause these symptoms.

WebMD Medical Reference Reviewed by Roy Benaroch, MD on November 18, 2016

Sources

SOURCES:

CDC. “Autism Spectrum Disorder (ASD): Screening and Diagnosis for Healthcare Providers.”

National Institute of Child Health and Human Development. “How do health care providers diagnose autism spectrum disorder (ASD)?”

National Institute of Mental Health. “Autism Spectrum Disorder.”

Mayo Clinic. “Autism Spectrum Disorder.”

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