Prior to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders 5th Edition, APA, 2013), a cluster of Pervasive Developmental Disorders (PDD) were considered “autism spectrum disorders” (ASDs). These included Autistic Disorder, Asperger’s Disorder, and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS). However, revisions that led to the publication of the newest edition of the DSM (i.e. DSM-5), have resulted in significant changes to the criteria and categories of ASDs.
One of the most significant changes is that one umbrella term Autism Spectrum Disorder” will now replace the previously separated diagnostic labels of Autistic Disorder, Asperger’s Disorder, and PDD-NOS. Distinctions, which will influence support services and academic accommodations required by the child, will be made according to severity levels. These changes have implications for parents with children with features of and/or previous diagnoses of ASDs.
Often parents ask one of the two questions: (i) why does my child need to be evaluated and, (ii) how do you evaluate? Evaluations leading to a diagnostic label can be daunting for most people. However, an accurate and proper diagnosis is crucial for understanding your child’s current functioning and, level of challenges. Rather, it is also imperative in assisting psychologists, medical doctors and educators, identify individualized treatments, strategies, educational placements and academic accommodations that aim at assisting your child develop to his/her fullest potential, whilst continuously challenging him/her to develop further.
This understanding then naturally leads to the latter question: how will you assess my child? Diagnosing ASD can be challenging, since there is no medical/blood test available for diagnostic purposes. Doctors and psychologists look at the child’s behavior and development to make a diagnosis. Children can be screened at 12 months of age, with a reliable diagnosis by a trained professional being possible after 2 years of age. An ASD assessment is two-fold: comprising of developmental screening to ensure that development has been age appropriate and, comprehensive diagnostic evaluation which is often carried out by either Developmental Pediatricians, Child Neurologists, Child/Clinical Psychologists or Psychiatrists.
Comprehensive diagnostic evaluations comprehensive of both observing the child in various setting and, objective tools assessing the triad of challenges (i.e. Language/Communication Delays, Play/Social Delays and Restricted and Rigid Behaviors) seen among individuals with ASD. Specialized diagnostic tools such as ADOS-2 (Autism Diagnostic Observation Schedule – Second Edition), ADI-R (Autism Diagnostic Interview – Revised) and PEP-3 (Psycho Educational Profile – Third Edition) are used in formal evaluations. A thorough assessment will also rule out other conditions which can contribute to difficulties related to ASD.
Written by Dr Sanveen Kang-Sadhnani