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Diagnosing Autism Spectrum Disorders

Well Child Screening
A "well child" checkup should include a developmental screening test. If your child's pediatrician does not routinely check your child with such a test, ask that it be done. Your own observations and concerns about your child's development will be essential in helping to screen your child. Reviewing family videotapes, photos, and baby albums can help parents remember when each behavior was first noticed and when the child reached certain developmental milestones.
 
Several screening instruments have been developed to quickly gather information about a child's social and communicative development within medical settings. Examples of screening instruments include the following:
 
  • Checklist of Autism in Toddlers (CHAT)
  • Modified Checklist for Autism in Toddlers (M-CHAT)
  • Screening Tool for Autism in Two-Year-Olds (STAT)
  • Social Communication Questionnaire (SCQ) for children 4 years of age and older.
 
Some screening instruments rely solely on parent responses to a questionnaire, and some rely on a combination of parent report and observation. Key items on these instruments that appear to differentiate children with autism from other groups before the age of 2 include pointing and pretend play. Screening instruments do not provide individual diagnosis but serve to assess the need for referral for possible diagnosis of ASD. These screening methods may not identify children with mild ASD, such as those with high-functioning autism or Asperger syndrome.
 
During the last few years, screening instruments have been devised to screen for Asperger syndrome and higher functioning autism. The Autism Spectrum Screening Questionnaire (ASSQ), the Australian Scale for Asperger's Syndrome, and the most recent, the Childhood Asperger Syndrome Test (CAST), are some of the instruments that are reliable for identification of school-age children with Asperger syndrome or higher functioning autism. These tools concentrate on social and behavioral impairments in children without significant language delay.
 
If, following the screening process or during a routine "well child" checkup, your child's doctor sees any of the possible indicators of ASD, further evaluation is indicated.
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