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Autism Screening for Children: Top Testing and Assessment Options

June 3, 2021

Wondering whether a child has autism might bring up a wave of different thoughts and emotions for parents. Fortunately, the process of learning more about a child and finding out whether he or she qualifies for a diagnosis of autism can be easier if parents understand the available autism testing and screening options.

Autism Testing or Screening Options

First, let’s talk about developmental screening, particularly as it relates to autism or Autism Spectrum Disorder (ASD). Developmental screening for autism can be completed by a variety of healthcare professionals. There are even some professionals who work in schools or in early childhood programs that can screen children for autism. These professionals can screen very young children through older adolescents.

Screening for Autism with a Child’s Doctor

One of the most common professionals who provides screening for autism is a primary healthcare provider - or, in other words, a child’s doctor. This could be a pediatrician or a family doctor or whoever your child sees regularly for their general healthcare needs.

Primary care providers not only monitor your child’s development over time (from birth through adulthood), they can also talk to you about how your child behaves in everyday life. Parents can also bring up any concerns they might have at wellness check-up just to make sure the doctor stays informed on how the child is functioning over time. This is helpful because the doctor can keep an eye on any potential indicators that a child may need further evaluation for autism spectrum disorder or any other concern.

Early Intervention is Key

When a child visits with their primary care provider, they are likely to be given a screening for a developmental delay as well as for autism spectrum disorder at certain times, especially in early childhood. Although not all doctors will approach screening for developmental delays or other concerns in the same way, American Academy of Pediatrics (AAP) recommends that all children receive screening for developmental delays at their well-child visits with their primary care provider, specifically at around 9 months of age, 18 months of age, and 30 months of age. Autism is recommended to be screened for at around 18 months and 24 months of age.

It is helpful to keep an eye on a child’s developmental milestones and functioning so that parents and doctors can notice if something seems concerning and hence can be more intentional and more effective at intervening if something does come up that either think is concerning for the child.

Whether the concern is about something a child doesn’t yet know how to do or if it’s about a problem behavior that’s not considered typical for the child’s age, it is important to talk to the doctor about it. For example, if a child is having a difficult time getting along with peers at age three, this should be addressed with a doctor so parents can prevent or at least minimize further difficulties that might arise later in childhood.

Early Detection of Autism or ASD

The medical and scientific fields are improving in the ability to identify autism in children as young as 18 months old. A child who is one to two years old can be evaluated and diagnosed with autism. A screening tool can be used to discover when these toddlers might be functioning in a way that could be congruent with a diagnosis of ASD or when their behaviors don’t quite match up with what is typically expected for their age as compared to other young children who do not have a diagnosis.

The earlier a child with autism is recognized as having the disorder, the better. This is for many reasons. First, the sooner parents find out that their child has autism, the sooner parents can better understand their child’s experience and they can then better help them by being mindful of their child’s ASD when intervening on things like problem behaviors or social problems, for example. Additionally, the sooner a child is diagnosed with ASD, the sooner they can access treatment services which are found to be an effective method of helping children improve their quality of life such as by teaching them important life skills, helping them navigate social experiences, helping them to learn ways to handle their own sensory needs, and so much more.

Parents know their children the best, so if there are any concerns at all, it’s critical to reach out to a professional who is competent in screening for ASD. Most often, a child’s doctor is the first step. They will ask you to report on a child’s behaviors and functioning in many different areas of development. Parents will be asked questions about any problem or challenging behaviors the child has, their ability to do typical self-care or daily living activities, about his or her interactions with others such as communication skills, or whether they understand when other people talk to them. These are just a few of the different types of things parents are routinely asked when a child is being screened for ASD.

More Benefits of Testing or Screening for Developmental or Behavioral Concerns

Another helpful thing about screening tools is that, when used in collaboration with parents, they can help parents become more aware of different developmental areas of functioning that they might consider keeping an eye on so that if their child does seem to fall behind what is developmentally expected for their age, then the parents can help address it with their child or they can reach out to a professional for guidance.

If you’re looking for assistance with autism test or diagnosis, reach out to Behavioral Innovations’ team of experienced client intake advocates who can refer you to some of the top diagnosticians in your area.

Autism Testing or Screening Tools for ASD

Let’s talk about specific screening tools that are used to assess children for the potential of autism spectrum disorder. Some screening tools might be used to assess a child’s functioning and development that focus on certain areas, such as motor skills like the ability to walk, jump, and run, or language skills such as the ability to speak or comprehend what someone else is saying.

Other screening tools focus on behaviors that may be indicative of a particular diagnosis, such as ASD. In this case, the screening tool would focus on things related to social skills, communication skills, and restricted or repetitive behaviors as well as other related concerns such as challenging behaviors or sensory issues.

One important thing to note about screening tools is that they don’t diagnose ASD. They simply identify whether a child MIGHT meet the criteria for a diagnosis of ASD. So, when a screening results in finding that a child may have some concerns related to the areas being assessed, then the child should be referred to complete additional testing.

In the case of autism screening and testing, if a child’s doctor completes a screening tool and finds that the child does have some possible concerns in their development and functioning, then the child is likely to be referred to obtain a full evaluation which is able to diagnose autism or ASD.

Examples of Screening Tools for Autism

Let’s explore a few of the available screening tools that might be used to decide whether a child should receive further evaluation for autism. Some of the most common of these screening tools include:

  • Ages and Stages Questionnaire (ASQ)
    • The ASQ screening tool addresses a variety of areas that might indicate that a child is behind his or her typically developing peers. Examples of developmental domains that are assessed or screened using the ASQ include communication skills or how a child expresses his or her thoughts, feelings, wants, and needs as well as how they responds to other people’s expressions, gross motor skills such as walking or running, fine motor skills such as picking things up with his fingers, problem-solving skills, as well as self-care and daily living skills.
  • Modified Checklist for Autism in Toddlers (M-CHAT)
    • The M-CHAT is a screening tool that is typically used for children between 16 months and 30 months old, so children who are in the toddler years. This screening assessment is designed for assessing children who may be at risk for having autism spectrum disorder.
    • Find more details about using the M-CHAT autism checklist.
  • Screening Tool for Autism in Toddlers and Young Children (STAT)
    • This screening assessment is somewhat different than many other screening tools because it involves more hands-on activities for the child to complete while many other screening tools are primarily based on interviews with parents and have less focus on observing the child.

There are a variety of other screening tools that are available to help determine if a child should receive a full evaluation or assessment for autism. If you are wondering if your child has any developmental delays or if they might have autism, you could ask your child’s primary care provider to complete a screening for ASD or for other developmental delays.

Assessments and Testing for Autism or ASD

After screening for ASD is completed, the person who provided the child with the screening will determine whether the screening results suggest that the child should be further evaluated with a more in-depth assessment or if they appear to be meeting developmental and age-appropriate expectations which would suggest that no further assessment is likely to be recommended at the time the screening is completed.

Just like screening tools, there are also several different full assessments for autism. Most of the time, when a child is assessed for autism, the professional who is providing the assessment will talk to the parent or parents of that child and they will also observe and interact with the child to get more insight into the child’s functioning and their skill set as well as about the areas that the child might need to work on.

Examples of ASD Assessment Tools

Next, we’ll briefly discuss the most common assessments for autism spectrum disorder. The most common assessments for ASD include:

  • Autism Diagnostic Observation Schedule -  Second Edition (ADOS-2)
    • The ADOS-2 is an assessment that evaluates social and communication skills and play skills in individuals who may have autism. One of the features of the ADOS is that it can be used for a large age range from toddlers to adults. It can also be used for individuals who do not have verbal communication or those who don’t speak vocally to individuals who do have more fluent vocal communication skills.
  • Autism Diagnosis Interview-Revised (ADI-R)
    • The ADI-R is an assessment tool for autism spectrum disorder that can be used for individuals from toddlers at about age 18 months old through adults. This assessment focuses on the main core symptoms of ASD including social interactions, communication skills, and restricted and repetitive behaviors.
  • Childhood Autism Rating Scale, Second Edition (CARS-2)
    • The CARS-2 is another diagnostic tool that helps to identify the presence of an autism spectrum disorder diagnosis. This assessment is used for children two years and up. This assessment can provide information about the severity level of each symptom that is identified. The CARS-2 can identify ASD from mild to moderate to severe. It is also appropriate for children who have both low and high cognitive abilities.

The process of determining whether a child qualifies as having a diagnosis of autism spectrum disorder can be overwhelming. However, it helps to understand the whole system as well as how each step in the process supports the end goals that you have for your child. Understanding the screening and assessment process can help you to be more comfortable and more aware of how the system works which can help ease some of the stress and anxiety that you may experience.

 

References:

ADOS-2: Autism Diagnostic Observation Schedule, Second Edition. Retrieved 5/21/2021 from https://www.wpspublish.com/ados-2-autism-diagnostic-observation-schedule-second-edition

CARS-2: Childhood Autism Rating Scale, Second Edition. Retrieved 5/21/2021 from https://www.wpspublish.com/cars-2-childhood-autism-rating-scale-second-edition

Screening and Diagnosis of Autism Spectrum Disorder for Healthcare Providers. Retrieved 5/21/2021 from https://www.cdc.gov/ncbddd/autism/hcp-screening.html

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