From a mile to a smile
Assessment and diagnosis of Autism
It is important to note that there is a huge difference in diagnostic criteria between DSM IV and DSM 5. In DSM IV, Autistic Disorder, Rett’s disorder, Asperger’s disorder, and Pervasive developmental disorder-not otherwise specified (PDD-NOS) are all under the umbrella of ASD. In DSM 5, instead of being divided into subcategories, these disorders fall under the umbrella of ASD. Language impairment is also no longer included in the diagnostic criteria, but has to be specified otherwise. So under the new diagnosis, your child wouldn’t be given a label of PDD-NOS or Asperger’s disorder. Despite the lack of subcategories, the differential needs still exist. That is why individualizing programmes is the key of effective treatment.
Please refer to DSM 5 for diagnostic criteria for ASD and visit Centers for Disease Control and Prevention (CDC) website for more details. If you want to know the difference between DSM IV and DSM 5, you can also check out this quick chart.
Assessment on Autism
The Prime time for autism intervention
A study carried by the US Centers for Disease Control and Prevention showed that symptoms of autism have appeared at as early as six months of age in infants.
Children with autism may be officially diagnosed as early as 18 months of age. Parents can take the age of two as a more reliable result on autism assessment. With early assessment, parents can arrange their children for treatment as soon as possible. The study pointed out that before the age of six is the prime time for intervention of autism, as the effectiveness is larger when compared with other ages. Through assessment, it is easier for parents to recognize children’s needs in order to provide early effective intervention for their children.
How do I know if my child needs an assessment?
Although each child with autism may have different symptoms, the main affected areas include:
- Defective language and communication skills
- Having problems with social skills and social interaction
- Poor cognitive and adaptive development
- Limited, repeated and rigid behaviours and interests
If parents find their children have the above characteristics, they should seek professional help and advices as soon as possible to arrange any assessment for their children.
You may contact the following centers or professionals for initial screening. They provide simple testing to screen developmental delays in your child and make recommendations for thorough assessment:
Maternal and Child Health Centre (pre-school children)
Student Health Service Centre (school age children)
Pediatric departments of hospitals
Clinical or Educational Psychologist
Pediatricians will give questionnaires to parents or interact with the child directly to observe their learning skills, language and communication skills, motor skills and behaviour. They will then recommend further assessment as soon as possible.
Assessment is the second step of diagnosis. The assessment may include some thorough parent questionnaires about child’s behaviour and development. It may also include vision and hearing test, gene test, neurological test, and other medical tests. Assessments are provided in the following sites in Hong Kong:
Child assessment centres
Child and adolescent psychiatric service of hospitals
Observing your child further
There are some signs that can indicate a child may need additional support. The conditions and impairments that are likely to affect a child’s development seriously can be noticed during routine health visits. However, some impairments may be remain undetected. Therefore, it is useful to home in on the following information when you observe a child. Also, it is crucial to bear in mind the normative development of your child’s age, such as it is typical for children under three years old to find sharing difficult.
Information that might be useful for parents:
- How much physical contact, e,g. cuddles, hand holding, your child needs at home.
- The situations where your child needs more reassurance
- How your child copes with new challenges
- How your child shows frustration
- How chatty your child is at home
- How outgoing you think your child is
- What your child enjoys doing at home
- When your child plays
- Situations that hold your child’s attention and concentration
- Your child’s play with other children outside the setting, for example with siblings.
Parents can make a checklist themselves and record down children’s behaviors with the time, duration and situation they were in.
the importance of early assessment
According to the report, early assessment of autism in children can enable children in need to receive treatment as soon as possible. The report showed that early treatment was the most effective amelioration of autism. Before the age of five is the golden period of language learning and communication. Parents can also choose different treatment methods, such as: Applied Behavioral Analysis, Occupational Therapy. Therefore, the report pointed out that children should be assessed early to avoid missing the golden period of treatment.
The researcher has conducted intensive training for 20 to 30 hours per week within 18 months. Hence, they concluded that the intensity of treatment also affects the effectiveness of treatment.
Therefore, parents should pay attention to the development of children, such as the use of simple sign language at 7 months. Parents can also use the relevant webpages for information collection.