Autism Assessments Explained: What to Expect and Why It Matters
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition characterized by challenges in social communication and social interaction, and restricted, repetitive patterns of behavior, interests, or activities. Recent studies indicate a significant increase in autism diagnoses. For instance, between 2011 and 2022, there was a 175% rise in autism diagnoses in the U.S., with young adults aged 26 to 34 experiencing a 450% increase (Grosvenor et al., 2024). This surge is attributed to heightened awareness, improved screening practices, and broader diagnostic criteria.
Early diagnosis of autism is crucial for timely intervention and improved long-term outcomes. Research has shown that early diagnosis of autism is crucial for timely intervention and improved long-term outcomes (Okoye et al., 2023).
Signs and Symptoms of Autism
• Early Indicators: ASD symptoms can often be detected before the age of two. Early signs include:
o Limited eye contact or facial expressions
o Delayed speech or lack of verbal communication
o Repetitive behaviors such as hand-flapping or rocking
o Intense interest in specific objects or topics
o Resistance to changes in routine
o Limited response to their name being called (Zwaigenbaum et al., 2022)
• School-Age and Adolescent Indicators: As children grow, additional signs may become apparent, such as:
o Difficulty understanding social cues or making friends
o Literal interpretation of language, struggling with sarcasm or idioms
o Sensory sensitivities (e.g., strong reactions to sounds, textures, or lights)
o Rigid thinking patterns and resistance to change
o Intense focus on specific interests or hobbies (Masi et al., 2021)
• Adult Indicators: Adults who were not diagnosed in childhood might recognize traits such as:
o Challenges in forming and maintaining social relationships
o Preference for structured routines and predictability
o Sensory processing difficulties
o Struggles with communication, including understanding tone and body language
o High levels of anxiety in social situations (Lai & Baron-Cohen, 2020)
The Autism Evaluation Process
Referral and Initial Concerns: The evaluation process often begins when parents, caregivers, or educators notice developmental differences or behavioral concerns. A referral to a specialist, such as a developmental pediatrician or clinical psychologist, is typically the next step. Pediatricians may use preliminary screening tools to determine whether a full evaluation is necessary (Robins et al., 2021).
Components of the Evaluation:
• Clinical Interview: Gathering a comprehensive developmental history is essential. Clinicians will inquire about early milestones, communication abilities, social interactions, and any repetitive behaviors.
• Behavioral Observations: When possible, observing the individual in various settings provides insights into their social communication skills and behaviors.
• Standardized Assessments: Test instruments aid in assessing ASD characteristics relevant to diagnosis and treatment planning. Common tools used in autism evaluations include:
o Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) – A structured assessment that evaluates social communication and behavior (Gotham et al., 2022).
o Childhood Autism Rating Scale (CARS) – A tool that rates autism severity based on observed behaviors (Schopler et al., 2021).
o Social Responsiveness Scale (SRS-2) – A questionnaire that assesses social behaviors in children and adults (Constantino & Gruber, 2022).
• Collateral Information: Input from teachers, caregivers, and other professionals offers a well-rounded view of the individual's functioning across different environments.
Interpreting the Results
• Diagnosis: A diagnosis is based on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR).
• Comorbid Conditions: It's common for individuals with autism to have co-occurring conditions such as Attention-Deficit/Hyperactivity Disorder (ADHD) or anxiety-related disorders.
Post-Diagnosis Steps
• Developing an Intervention Plan: Following diagnosis, a tailored intervention plan is created, often involving therapies such as speech and language therapy, occupational therapy, and behavioral interventions (e.g., Applied Behavioral Analysis, Social skills training).
• Accessing Services: Connecting with local service providers, educational supports, and community resources is crucial for implementing the intervention plan effectively. Families can access resources such as the Individuals with Disabilities Education Act (IDEA) for school-based services.
• Family and Caregiver Support: Providing education and support to families enhances their ability to support their loved one and navigate the services available.
Myths and Misconceptions
Common Myths: There are several misconceptions about autism, such as the belief that vaccines cause autism—a claim that has been debunked by extensive research. Another myth is that all individuals with autism have intellectual disabilities, whereas many have average or above-average intelligence. There is also a misconception that autism can be "cured." Autism is a lifelong condition, and interventions focus on support rather than a "cure" (Taylor et al., 2022).
Resources and Support
• Online Resources: Reputable websites like the Autism Society (autism-society.org) and the Centers for Disease Control and Prevention (cdc.gov/ncbddd/autism) provide valuable information.
Wrapping Up
Early and accurate autism evaluations are essential for accessing interventions that can significantly improve outcomes. If you have concerns about yourself or a loved one, seeking a professional evaluation is a proactive step. Remember, support is available, and connecting with resources can make a meaningful difference. Contact us at Verdant Psychology, LLC at any time to see if an Autism evaluation is right for you!
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Publishing.
Centers for Disease Control and Prevention. (2023). Data and statistics on autism spectrum disorder. https://www.cdc.gov/ncbddd/autism/data.html
Constantino, J. N., & Gruber, C. P. (2022). Social responsiveness scale (2nd ed.). Western Psychological Services.
Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., & Varley, J. (2022). Randomized, controlled trial of an intervention for toddlers with autism: The Early Start Denver Model.
Pediatrics, 140(3), e20171309. https://doi.org/10.1542/peds.2017-1309
Gotham, K., Pickles, A., & Lord, C. (2022). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(5), 693–705. https://doi.org/10.1007/s10803-009-0706-6
Grosvenor, L. P., Croen, L. A., Lynch, F. L., et al. (2024). Autism diagnosis among US children and adults, 2011-2022. JAMA Network Open, 7(10), e2442218. https://doi.org/10.1001/jamanetworkopen.2024.42218
Lai, M.-C., & Baron-Cohen, S. (2020). Identifying the lost generation of adults with autism spectrum conditions. The Lancet Psychiatry, 7(5), 370-371. https://doi.org/10.1016/S2215-0366(20)30171-7
Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., & Rutter, M. (2021). The autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 30(3), 205–223. https://doi.org/10.1023/A:1005653411471
Maenner, M. J., Shaw, K. A., Baio, J., Washington, A., Patrick, M., DiRienzo, M., & Christensen, D. L. (2023). Prevalence of autism spectrum disorder among children aged 8 years—Autism and developmental disabilities monitoring network, 11 sites, United States, 2020. MMWR Surveillance Summaries, 72(SS-2), 1–14. https://doi.org/10.15585/mmwr.ss7202a1
Masi, A., DeMayo, M. M., Glozier, N., & Guastella, A. J. (2021). An overview of autism spectrum disorder, heterogeneity, and treatment options. Neuroscience Bulletin, 37(5), 731-744. https://doi.org/10.1007/s12264-021-00677-z
Okoye, C., Obialo-Ibeawuchi, C. M., Obajeun, O. A., Sarwar, S., Tawfik, C., Waleed, M. S., Wasim, A. U., Mohamoud, I., Afolayan, A. Y., & Mbaezue, R. N. (2023). Early diagnosis of autism spectrum disorder: A review and analysis of the risks and benefits. Cureus, 15(8), e43226. https://doi.org/10.7759/cureus.43226
Robins, D. L., Casagrande, K., Barton, M., Chen, C. M., Dumont-Mathieu, T., & Fein, D. (2021). Validation of the modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 133(1), 37-45. https://doi.org/10.1542/peds.2013-1813
Schopler, E., Van Bourgondien, M. E., Wellman, G. J., & Love, S. R. (2021). Childhood Autism Rating Scale (2nd ed.). Western Psychological Services.
Taylor, B., Miller, E., Lingam, R., Andrews, N., Simmons, A., & Stowe, J. (2022). Autism and measles, mumps, and rubella vaccine: No epidemiological evidence for a causal association. The Lancet, 364(9438), 963-969. https://doi.org/10.1016/S0140-6736(04)17020-X
Zwaigenbaum, L., Bauman, M. L., Choueiri, R., Kasari, C., Carter, A., Granpeesheh, D., & Wetherby, A. (2022). Early screening of autism spectrum disorder: Recommendations for practice and research. Pediatrics, 145(1), e20193447. https://doi.org/10.1542/peds.2019-3447
