01 Feb Autism Testing
Parents of young children typically become alarmed with the developmental delays and unique behavior in their toddlers. Examples include delayed speech, not responding to their name, obsessions with specific toys or repetitive movement such as hand-flapping. Sometimes they review these symptoms with the pediatrician. Pediatricians vary dramatically in their awareness of autism. Some may give the parent a “wait and see” answer, whereby others begin a more formal screening process such as using the M-CHAT. When parents get a response tantamount to denial, from others, it is imperative that they become proactive and search for a full evaluation. Make sure the doctor or doctors have expertise in autism. Experts include developmental pediatricians (specialized pediatricians), clinical and child psychologists or neurologists.
Parents of school-age children become concerned with poor eye contact, difficulty reading subtle social signals and preoccupied play, such as with Thomas the Tank. Sometimes it is not play but a topic that seems obsessive, like nonstop talk about Star Wars, even if the parent has given signals that they are no longer interested. The number one symptom of autism is lack of social reciprocity. Roughly translated, this means that the child stays in their “own world” thereby not connecting and communicating with people.
Autism testing is a minimum of a three-session process. The best determinant of any diagnosis is history. A good psychologist will take a thorough history including that of the parents. Research data is beginning to show that parents with a cold or factual-type personality (the stereotyped engineer personality) have a higher probability of giving rise to children with autism. The same is also true for parents with a history of ADHD. Birth issues can also come into play, such as low birth weight.
Babies later diagnosed with autism have poor eye contact, reduced responsive smiling and diminished babbling. The doctor continues with specific inquiries about the youngster’s play and social interactions. Speech development and sensory issues also are important .
Dr. Eisenberg uses the gold standard of autism testing, which is the Autism Diagnostic Observation Schedule – 2. The Autism Diagnostic Observation Schedule – 2 is considered the gold standard of autism testing. The Autism Diagnostic Observation Schedule – 2 quantifies social interaction. Much of it involves play with action figures or the description of presumably exciting picture stories. Most children enjoy the ADOS because it’s a play based test. Here the doctor is looking for social reciprocity between his figures and the child’s or perhaps eye contact or shared pleasure (called joint attention). Despite the fact that it looks like play, the Autism Diagnostic Observation Schedule – 2 has a very sophisticated scoring system, which gives very clear indication of the existence of autism. Parents’ opinions and observations are also encouraged, often through formal polling by a questionnaire such as the Social Responsiveness Scale, 2.
Developmental attainment is also important. Sometimes an autistic child has better self-care skills than those in social or communication areas. Here, instruments like the Vineland are used. Should Dr. Eisenberg question the youngster’s ability to understand the world around him, an IQ test is recommended. In that half of the IQ test is nonverbal, often we can get a better sense of the child’s potentials because speech is not required. This will give us an eyeball to the future because when more sophisticated speech does develop we will better understand the youngster’s thinking and intellectual abilities.
Hence, in good autism testing, history, observations and testing are combined and a meaningful, no-nonsense presentation is made to the parents in a final session, called the feedback session. Here the youngster’s strengths and weaknesses are explained, as well as treatment recommendations for education and therapies. Parents will also be taught as to how to communicate with their children. For instance, children on the spectrum do not respond as well to language as to other approaches. Most parents tell the doctor that they leave the feedback session with a sense of relief, as well as clear direction for the future.