Diagnosing Autism
When diagnosing Autism, some of the signs we look for are poor eye contact, not responding to their name, ignoring people, ignoring instructions, echolalia. Echolalia is basically when the child just repeats everything they hear, atypical speech development. Some kids do talk, but they don't use their language to communicate with others. They just walk around labeling things or maybe they'll request but they don't actually engage in back and forth conversation. Some of them don't talk at all. They don't really have much interest in communicating with others. There are a lot of repetitive behaviors. And many of them have highly restricted interests. So they enjoy doing a few things, but when you try to get them to do something else, they resist your efforts. They also have more interest in objects or activities than in people. Most children with autism have a very low frustration tolerance and so very minor things will set them off and they'll have tantrums very frequently. It can be very difficult for them to calm down once they have a tantrum. They are just unable to manage their emotions as well as most children.
In the United States for children under the age of three, all 50 states have an early intervention program, however they all operate independently and under their own rules. In New York, for example, parents can just call the early intervention department directly. They don't need a pediatrician or some other specialists to do it for them. But if the parents don't know what to do, they can go to their pediatrician and just say, look, I think my child has some delays, I'm worried and I want to get them evaluated. The pediatrician can then tell the parents where to go to to access services and evaluations through early intervention. If the child's over three years old, usually it's done through the school district. In addition to early intervention being funded by the state and the school age program for children over the age of three, most states have a law that makes it mandatory for medical insurance to cover the treatment for autism services.
A formal diagnosis is usually provided by either a psychologist, a neurologist or a psychiatrist. Diagnosing Autism is somewhat tricky because it's not a medical diagnosis. It's not as easy as taking an X ray or a blood test or a biopsy. So it's a clinical diagnosis rather than a medical diagnosis. The tools that we use are more observational in nature, so you have the childhood autism rating scale, the ADAS. The DSM five diagnostic criteria are used as well. The way we diagnose is we observe the child directly. We try to get them to do certain activities. We see how they respond to our requests, how they engage with the different materials that we give them, the different toys, the different teaching materials, and then we also get background information from the parents. Once we have all of this information, we can then determine whether or not the child has a diagnosis of autism. There are several people who can refer the child for services. One is the child's pediatrician. If the child is a little bit older, the school district can refer the child for services. The parents can do it directly themselves. Most people working at the nursery will know how to guide the parents in getting services. The first step though is to get a diagnosis. Once the child has a formal diagnosis, it will open a lot of doors for the parents to get services for their child either free or at minimal cost. If there's no diagnosis, the parents are going to have to pay for everything in full out of their own pocket.
The team of people that work with the child consists of the parents, first and foremost, all of the therapists so that includes the ABA therapists, the occupational therapists, speech therapists. If the child requires physical therapy, then the physical therapists as well as feeding therapy if they require that and also the teachers. In fact everybody who interacts with the child needs to be part of the team and work together because consistency is very, very important.
