Health professionals point out that it is necessary to regularly observe for the possible development. The screening may start as soon as the child begins to use cognitive skill significantly, for example from 6 months after the delivery through the school age. Your pediatrician evaluates your child by looking into his skill development. The evaluation is based on the milestones a child should reach according to his age. The doctor may interview the parents about the child’s vocabulary communication skills as well as nonverbal ones such as body language and pointing. The doctor may inquire about developments in interests, attention and social skills, compared to his siblings, cousins and friends.
For autism evaluation, doctors use a number of screening tools that are developed to effectively collect information about the child’s communicative and social development within medical settings. These instruments can be based on observation on the child, some rely entirely on questionnaire filled by parents, while others use a combination between both of them. Screening tools are mostly checklists, that cover the child’s behaviors and abilities, and the doctor will evaluate the result. During the evaluation process, doctors “score” those tools. Certain score ranges are associated with different likely diagnosis.
Health professionals validate a new screening tool by testing them on hundreds of confirmed autistic children and non-autistic children. When the new tool can accurately separate autistic and non-autistic children, the tool is considered to be useful. However, screening tool alone can’t be used for autism diagnosis. A doctor with experience in evaluating autistic children will only confirm that autism is present when:
1. The doctors have gathered information on the child’s current behavior, skill development and medical history from the parents.
2. The child has undergone all required physical examinations.
3. All disorders that mimic autism have been taken into account.
The screening tools only determine whether the child responds just like an autistic child would. It doesn’t tell us the underlying issues that cause the responses. For example, children with poor hearing may have scores that are similar with autistic children. It means additional examinations are necessary.
The following is a list of the more common screening tools that are used to evaluate children for autism. The screening tools are usually administered by pediatricians, psychologists, or neurologists.
Checklist for Autism in Toddlers
It is a simple tool used to identify autism symptoms on children at 1.5 years of age. The checklist is consisted of two sections, labeled A and B. The first section is a self-administered questionnaire for parents with some yes-or-no questions, to address development stages, for example functional play, showing (demonstrating items or skills to others), pointing, pretend play, social play, motor development, social interest and rough-and-tumble play. The second section records the clinician observation on the child. It covers basic abilities such as making towers of blocks, proto-declarative pointing, pretend play, gaze monitoring and eyes contact.
Modified Checklist for Autism in Toddlers
It is a simple parental questionnaire for parents given in regular pediatric visits. Higher degree of failure indicates a higher possibility of autism. It has 23 questions; the first 9 questions are the core of the questionnaire. The other 14 address symptoms present on the child. The test doesn’t have similar observational component like in Checklist for Autism in Toddlers.
Screening Tool for Autism in Two-Year-Olds
It is an interactive tool for evaluation autism and designed specifically to differentiate symptoms of autism with other development disorders. The test consists of 12 activities that can be completed in 20 minutes. Health professionals use the tool to sample three interaction areas including nonverbal communicative development, motor and play both reciprocal social and pretend play.
The Autism Spectrum Screening Questionnaire
It is a useful, brief screening tool for identifying autism in clinical settings. It has 27-item checklist for caretakers and parents of children with possible symptoms of autism and Asperger syndrome. It is only usable for children with mild mental retardation or normal intelligence.
Gilliam Autism Rating Scale
It is a checklist for professionals, teachers and parents to help identify and determine the autism symptoms on individuals up to 22 years old. This screening tool is based on criteria set by the American Psychiatric Association, which covers four subtests – social interaction, communication, stereotyped behaviors and an optional test.
Childhood Autism Rating Scale
It helps to evaluate the child’s ability to move, adapt to changes, listen, communicate verbally and establish relationship. It is usable for children above two years old. The doctor interviews parents to get relevant information and observe the child. The child is rated based deviations of typical behaviors, compared to other children at the same age.
Autism Diagnosis Interview-Revised
It is a structured interview with more than a hundred items and used for caregivers. It has four main factors, age-of-onset symptoms, repetitive behaviors, social interaction and child’s communication.
Autism Diagnostic Observation Schedule-Generic
It is a standardized, semi-structured assessment for imaginative use of materials, social interaction and communication to determine the presence of autism symptoms. The tool uses observational method to find socio-communicative behaviors that are usually present in abnormal and delayed children, as well as autistic children. Health professionals use specific materials and structured activities to set a baseline level in which communication skills, social interactions and other behaviors relevant to autism can be observed. The tools can also be used to evaluate adults at different chronological ages and developmental levels.