Have you noticed that your child isn't typical — perhaps not making eye contact, bringing objects to you to show them, enjoying physical contact, or having delayed language skills? At this point, you'd do what any modern parent does and comb the internet for clues. If you didn't already suspect autism yourself, you will after you're done with the world wide web.
Did you know that universal autism screening is recommended?
All young children in the United States who regularly attend well-child checkups with a pediatrician — which should be all children — are automatically screened for disabilities and developmental delays at particular ages, according to the American Academy of Pediatrics. Nine, 18, and 14 to 30 months are the target ages at which this happens. Other countries are often going to have similar practices in place.
In 2016, the United States Preventive Services Task Force also recommended universal screening for autism spectrum disorder in all children aged 18 to 24 months, whether or not their parents, caregivers, or doctors have noticed any signs of autism. Since the benefits of this kind of universal screening aren't yet clear, your doctor may or may not do it — but if they don't, you can certainly ask for it, especially if you have noticed unusual things about your child or are concerned.
This screening is a simple process that differs radically from the diagnostic process for autism. Parents answer questions about the child's development and behavior, and the doctor will keep an eye out for early signs of autism, such as:
- No "social smiling"
- Delayed verbal communication, such as not using any words by 18 months and not using combinations of two words by two years
- Not pointing at objects or following others' hands as they point objects out
- Inconsistent or no eye contact
- Strong attachments to certain objects
I think my child could be autistic: Who do I approach for diagnosis?
Who can conduct an evaluation and ultimately make a diagnosis will vary from country to country, quite a bit actually. Parents who have noticed some of the early signs of autism in their child and are convinced that their child is on the spectrum can always, however, start with the child's primary care provider. That will usually be either a family doctor or a pediatrician.
In the United States, some pediatricians will make the diagnosis. Psychologists, neurologists, and neuropsychologists (who are skilled in both brain functioning and behavioral theory) can also diagnose autism. Parents would do well to look for "autism specialists" in their area, so that they can be sure that the evaluation is conducted by an experienced and knowledgeable team of appropriately qualified professionals. The internet is a powerful tool in helping you find the right person to take your child to for an autism diagnosis, not just because it can give you an address, but also because you'll likely be able to find reviews.
What actually happens during the diagnostic process for autism?
Whether a person is being evaluated for autism at a very young age, slightly later in life, or during (young) adulthood, the person's family plays an important role in the process. Autism is a lifelong neurological disorder that does start showing symptoms early in life, after all, and parents, older siblings, and grandparents will see more on a daily basis than doctors ever can. That is why you, too, will be included in the process, and be asked lots of questions about the child's development, skills, and behavior.
Children being evaluated for autism will also both be observed in a natural(ish) environment to assess their social behavior, language skills, communicative abilities, and cognitive level, and be presented with specific tests that aim to offer a more complete picture. A speech pathologist is often involved in this part of the evaluation, as well.
If the observed symptoms could also be caused by other conditions, other tests to rule those conditions in or out may be recommended. If not, the evaluation — which is likely to take a few appointments to complete — will end with the diagnosing professional's official diagnosis. Parents will be called back in to discuss the doctor's observations and will receive a detailed written diagnosis. At this point, if autism spectrum has been confirmed, you can start discussing how to move forward from here. Your diagnosing doctor may recommend speech therapy, behavioral therapy, occupational therapy, and depending on the child's age and needs, also sometimes therapy to help with mental health challenges like anxiety and depression.
A final word
Autism is a spectrum. Not everyone on it will show all the typical symptoms at an early age, though research has shown that autism can accurately be diagnosed in even very young children. In some cases, you won't realize that your child may be autistic until they start daycare or school, or even later. Perhaps your child's teacher raised the possibility, or new struggles that come with novel environments have changed your child's ability to cope to the point that you are now concerned about autism. In these cases, the process is very similar. It can all start with a chat with your family doctor or pediatrician, though parents can also certainly seek out psychologists experienced in diagnosing autism on their own.