Screening and Diagnosis

There are no medical markers for screening or diagnosis of Autism Spectrum Disorder(ASD). There are no medical tests, like a blood test or MRI to screen for the condition.Doctors observe the child’s behavior, responses note overall development and then make recommendations or diagnose. Autism may become noticeable as early as 15 to 18 months. However, children do not receive a final diagnosis until they are around 3 years of age. Children below the age three years are usually screened for the possibility of Autism instead of a diagnosis of Autism. The purpose of the screening is to start the training and therapies. Adapt the home environment and enhance parenting style to enable the child to learn. Early identification and intervention can enable a more natural way of learning in the child.

Some people are not diagnosed until much later, especially if they speak. They may even receive a diagnosis when they are adolescents or adults. Delay may mean that people with Autism might not get the early help and support they need.

Diagnosis is important but can be reviewed from time to time. Diagnosis allows all those associated with a child to make accommodation at home and school. The family has time to plan for any necessary therapies and training. Families also have to make provisions financially and plan for future support systems.

How is the child screened?

Most screening tools involve questions for parents regarding the child’s developmental history and present state. It can also involve observation of the child’s play, communication and social responses.

How is the child diagnosed?

As mentioned earlier there are no biological markers for the diagnosis of Autism. Therefore diagnosis is done through observation of the child , questioning parents about developmental history of the child. The professional may also ask questions about the child responses and behaviors in different situations. Professionals usually use diagnostic tools to identify Autism.

Screening tools for autism used in India include:

Modified Checklist for Autism in Toddlers (M-CHAT): This is a widely used toolfor screening autism spectrum disorder in young children. It consists of a series of questions answered by parents or caregivers about the child’s behavior.
Social Communication Questionnaire (SCQ): The SCQ is another screening toolthat assesses communication skills and social functioning in individualssuspected of having autism. It is available in different versions for different age groups.
Autism Spectrum Quotient (AQ): The AQ is a self-administered questionnaire designed to measure autistic traits in adults. It assesses various aspects of social skills, attention to detail, and imagination.
Developmental Behaviour Checklist (DBC): Although not specific to autism, the DBC is often used as a screening tool for various developmental disorders,including autism. It assesses a wide range of behaviors and emotional functioning.
Indian Scale for Assessment of Autism (ISAA): Developed specifically for use in India, the ISAA is a screening tool designed to assess autism spectrum disorder in children aged 2-9 years. It takes into account cultural and linguistic factors relevant to the Indian context.
Autism Diagnostic Observation Schedule (ADOS): While not a screening tool perse, the ADOS is a structured observation assessment commonly used in diagnostic evaluations of autism. It provides a standardized way of observing and coding social and communication behaviors.

It’s important to note that these tools are often used as part of a comprehensive assessment process conducted by healthcare professionals, including psychologists, pediatricians, and developmental specialists, to determine whether further evaluation for autism spectrum disorder is warranted.

Here are some commonly used diagnostic tools

Autism Diagnostic Observation Schedule (ADOS): ADOS is a standardized
assessment tool used worldwide to diagnose ASD. It involves direct observation
of the individual’s behavior, communication, and social interaction.
Autism Diagnostic Interview-Revised (ADI-R): ADI-R is a semi-structured parent interview used to gather information about the individual&’s behavior and development from early childhood.
Childhood Autism Rating Scale (CARS): CARS is a behavioral rating scale used to assess the severity of autism symptoms in children.
Social Communication Questionnaire (SCQ): SCQ is a screening tool used to assess social communication skills and detect the presence of ASD traits.
Vineland Adaptive Behavior Scales (VABS): VABS is a tool used to assess adaptive functioning across different domains, including communication, daily living skills, socialization, and motor skills.
Developmental and Behavioral Pediatrics: Many pediatricians in India are trained to recognize early signs of developmental disorders, including ASD, during routine check-ups. They may use developmental screening tools such as the Modified Checklist for Autism in Toddlers (M-CHAT) or Ages and Stages Questionnaires (ASQ).