Autism
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How do doctors diagnose autism?

It may be hard to work out the diagnosis of autism. Your doctor will look closely at how your child behaves and how they have developed for signs of autism.

You may think that the name for your child's problems doesn't really matter. This may be especially so if your child gets upset by seeing doctors or being examined.

But if your child has autism, they need the care and treatment that suits them. And the sooner, the better. So it's important to get autism diagnosed properly and early on.

This is done by a health professional who specializes in autism, usually a doctor.
 
 
 
 
 
Source:
Howlin P.
Autism and intellectual disability: diagnostic and treatment issues.
Journal of the Royal Society of Medicine. 2000; 93: 351-355.
 
 
 
 
 
1 But your child may have to see other professionals too before your doctor can make the diagnosis.

Signs of autism
The three main signs of autism that doctors look for in your child are:
 
 
 
 
 
Source:
World Health Organization.
The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research.
1993. Available at http://www.who.int/classifications/icd/en (accessed on 21 April 2009).
 
 
 
 
 
2
 
 
 
 
 
Source:
American Psychiatric Association.
Diagnostic and statistical manual of mental disorders.
4th edition. APA, Washington, U.S.A.; 1994.
 
 
 
 
 
3

  • Having problems with speaking, as well as seeming to not understand what others are saying
  • Having problems getting along with people socially (for example, not looking people in the eye, not using facial expressions or body language, and not having many interests in common with other children)
  • Having problems with behavior (for example, having only a few activities or interests, constantly doing actions over and over, and maybe needing to have a strict routine all the time).
These problems usually start before the age of 3 years. So doctors can typically diagnose autism between the ages of 2 years and 3 years.
 
 
 
 
 
Source:
Baird G, Cass H, Slonims V.
Diagnosis of autism.
BMJ. 2003; 327: 488-493.
 
 
 
 
 
4 But they can look for signs earlier, especially if you notice something is wrong, or if you have another child who has autism.

Tests
Some reliable tests can help your doctor and other professionals tell whether your child has autism.

  • Your doctor will ask you, as the main caregiver, about your child. These questions focus on how your child behaves and has developed from birth. Your doctor takes notes on a special form.
  • Your doctor may spend time with your child, watching how they play and communicate, and checking how well they do certain things.
     
     
     
     
     
    Source:
    Lord C, Risi S, Lambrecht L, et al.
    The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism.
    Journal of Autism and Developmental Disorders. 2000; 30: 205-223.
     
     
     
     
     
    5 This should be done in a situation your child knows (for example, at school or playing a game they like). Your doctor may also test how your child does in a new situation, such as meeting new people or visiting a new place.
Your doctor may also do tests for the medical conditions that are linked to autism in a few children.
 
 
 
 
 
Source:
Howlin P.
Autism and intellectual disability: diagnostic and treatment issues.
Journal of the Royal Society of Medicine. 2000; 93: 351-355.
 
 
 
 
 
1
 
 
 
 
 
Source:
Lamb JA, Parr JR, Bailey AJ, et al.
Autism: in search of susceptibility genes.
Neuromolecular Medicine. 2002; 2: 11-28.
 
 
 
 
 
6 To learn more, see Medical causes of autism.

The American Academy of Pediatrics and the American Academy of Neurology recommend that your doctor looks for signs of autism at your child's regular checkups, starting when your child is a baby.
 
 
 
 
 
Source:
American Academy of Pediatrics.
Screening guidelines.
January 2009. Available at http://www.firstsigns.org/screening/guidelines.htm (accessed on 23 April 2009).
 
 
 
 
 
7
 
 
 
 
 
Source:
American Academy of Neurology and Child Neurology Society.
Practice parameter: screening and diagnosis of autism.
Available at http://www.guidelines.gov (accessed on 21 April 2009).
 
 
 
 
 
8

The American Academy of Neurology also recommends that you have your child checked if they:
 
 
 
 
 
Source:
American Academy of Pediatrics.
Screening guidelines.
January 2009. Available at http://www.firstsigns.org/screening/guidelines.htm (accessed on 23 April 2009).
 
 
 
 
 
7
 
 
 
 
 
Source:
American Academy of Neurology and Child Neurology Society.
Practice parameter: screening and diagnosis of autism.
Available at http://www.guidelines.gov (accessed on 21 April 2009).
 
 
 
 
 
8

  • Don't babble by 12 months
  • Don't gesture (for example, point or wave bye-bye) by 12 months
  • Don't use single words by 16 months
  • Don't say phrases of two words (by themselves, not just copying you) by 24 months
  • Lose speaking or social skills at any age.
ALARM campaign
The American Academy of Pediatrics has a campaign called ALARM for doctors.
 
 
 
 
 
Source:
American Academy of Pediatrics.
Autism ALARM.
October 2007. Available at http://www.medicalhomeinfo.org (accessed on 22 April 2009).
 
 
 
 
 
9 It aims to make them more aware of autism.

  • A stands for autism.
  • L stands for listen to parents. This is because many children have signs of autism before they are 18 months old.
  • A stands for act early. This means starting treatment as soon as you can.
  • R stands for refer. This means that doctors can send you or your child quickly to other professionals for tests, treatment and other help.
  • M stands for monitor. This means making sure that your child gets the tests or treatment they need.
Autism and the law
Autism is a kind of disability. This means that your child has problems doing some of the basic things that they need to do to get by in life. It also means that there are services and programs to make sure your child can get the special help they need.

In the United States, the law says that children with disabilities must get an education that is free and suited to them.
 
 
 
 
 
Source:
U.S. Department of Health and Human Services.
National child care information center.
Available at http://www.nccic.org (accessed on 22 April 2009).
 
 
 
 
 
10 This law is called the Individuals with Disabilities Education Act (IDEA for short).

From birth until 3 years, your child can get early programs to help. These programs are run by your state.

After 3 years, your child can get educational services through your school system. Each child has their own written program. It's called an individual education program (IEP for short). It is agreed on by you (the parents) and your school district.

Ask your doctor about the programs and services that you can get for your child.

Your child's health care team
If your child has autism, a lot of different professionals will be involved in caring for and treating them. They work together as a team. Each one helps in a certain way.

For example, teachers or
 
 
 
 
 
psychologist
A psychologist is trained to study the human mind and human behaviour. A clinical psychologist provides mental health care in hospitals, clinics, schools or to private patients.
 
 
 
 
 
psychologists may give your child tests to help work out the best program for them. And special therapists may help your child with speaking.

To learn more, see Autism professionals.

Sources for the information on this page:
  1. Howlin P.Autism and intellectual disability: diagnostic and treatment issues.Journal of the Royal Society of Medicine. 2000; 93: 351-355.
  2. World Health Organization.The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research.1993. Available at http://www.who.int/classifications/icd/en (accessed on 21 April 2009).
  3. American Psychiatric Association.Diagnostic and statistical manual of mental disorders.4th edition. APA, Washington, U.S.A.; 1994.
  4. Baird G, Cass H, Slonims V.Diagnosis of autism.BMJ. 2003; 327: 488-493.
  5. Lord C, Risi S, Lambrecht L, et al.The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism.Journal of Autism and Developmental Disorders. 2000; 30: 205-223.
  6. Lamb JA, Parr JR, Bailey AJ, et al.Autism: in search of susceptibility genes.Neuromolecular Medicine. 2002; 2: 11-28.
  7. American Academy of Pediatrics.Screening guidelines.January 2009. Available at http://www.firstsigns.org/screening/guidelines.htm (accessed on 23 April 2009).
  8. American Academy of Neurology and Child Neurology Society.Practice parameter: screening and diagnosis of autism.Available at http://www.guidelines.gov (accessed on 21 April 2009).
  9. American Academy of Pediatrics.Autism ALARM.October 2007. Available at http://www.medicalhomeinfo.org (accessed on 22 April 2009).
  10. U.S. Department of Health and Human Services.National child care information center.Available at http://www.nccic.org (accessed on 22 April 2009).
This information was last updated on Oct 19, 2009
BMJ Group
This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment.
© BMJ Publishing Group Limited 2010. All rights reserved.
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