Medical science is a constantly evolving branch of knowledge. There is always more to learn, more to understand, and, in terms of technologies and techniques, always more to try. It’s because of the continuing advances in medicine that things like insulin allow people with diabetes to live full lives, and that some forms of cancer are now treatable, while dangerous viruses like AIDS/HIV continue to be researched with a hope for an eventual cure.
However, treatment and advancement do not come without understanding. Diagnosis is a critical part of medical treatment, and in the case of Autism Spectrum Disorder, or ASD, it has often been one of the most challenging aspects. For decades, ASD was not even diagnosed as a distinct medical condition but was misdiagnosed as a type of schizophrenia. Even when medical experts began to suspect it was a unique condition, it was incorrectly thought to be an entirely behavioral issue, arising from poor parenting, specifically from mothers.
Today, ASD is understood to be a complex condition with many symptoms. But how is it diagnosed?
The Old Versus New
ASD diagnosis is still experiencing something of a transition as both people with ASD, and established medical experts continue to grapple with a new form of classification and diagnosis. In the 1980s, when ASD was first entered into official medical texts, like Diagnostic & Statistical Manual of Mental Disorders (DSM), it was broken down into four categories that tried, roughly, to divide ASD patients by severity, with people having Asperger’s Syndrome considered “high functioning” while those that were diagnosed with Childhood Disintegrative Disorder were considered “low functioning” and had the most severe symptoms.
In 2013, with DSM-V, the four categories were eliminated due to the difficulty in accurately categorizing and treating patients with ASD. Instead, as the name implies, Autism is now diagnosed across a spectrum of different, individual symptoms. People are no longer described as high or low functioning and classed according to a ranking of their ability. Now the specific symptoms are evaluated for individual severity, and treatments are more personalized to each individual depending on the spectrum and intensities of those symptoms.
Evaluating ASD
ASD can be noticed in children at a very early age. Even just several months after birth, before a baby is even a toddler, it is sometimes possible to see behavior that can lead to early suspicions of ASD. For any parent that is wondering whether a child’s behavior is an indication of ASD, don’t sit on that suspicion, bring the child in for an evaluation and get an experienced specialist to conduct a diagnosis.
Early intervention is one of the best ways to give ASD children a better start in life. The parents need to get an accurate assessment of a child’s behavior, and the details of the condition so that they have a better understanding of how to raise and interact with the child, without creating unnecessary barriers or limitations that could impact the quality of life.
The Criteria
Under the current DSM-V diagnoses, parents should be on the lookout for behaviors that fall into three general categories:
Social-Emotional Reciprocity
A child shows a deficit in providing normal emotional or social responses to interactions. Children that display little or no emotional reaction are one example. Or failing to respond to questions, or interact in conversation is another. An unwillingness to initiate or even engage in social interaction is another example.
Nonverbal Communication Skills
Besides speech, there are many nonverbal actions and “cues” that are considered a normal but subtle part of communication. Eye contact, for example, is something that is not usually explained to children, but is learned over the course of interaction. A child that is unwilling to look people in the eye when communicating shows a deficit in nonverbal communication that might require evaluation.
Social Interaction & Maintenance
A more general deficit is the ability to interact or maintain social connections with others successfully. Due to the difficulties in social-emotional reciprocity, and/or nonverbal communication, a child may either prefer to be alone or be unable to successfully interact with others despite a wish to do so, resulting in alienation from other children.
There are also specific behavioral elements that parents should keep an eye out for. If two of the following are present in a child’s behavior, that also merits a closer look by a medical professional:
Repetitive Movements: A child performs the same action, or says the same words repeatedly.
Adherence To Ritual: A child insists on a specific routine or order, and is extremely upset when disruption occurs.
Hyper Focus: An ability, or insistence on focusing on an activity or other preoccupation with abnormal intensity.
There may be other associated factors to consider as well, like intellectual impairment, or other mental disorders, such as schizophrenia. This is why it is critical to try not to self-diagnose, but use the guidelines above as signs to bring a child in for a proper, detailed evaluation.
