March 2024 Special Needs Living Magazine

Diagnosing Autism: What Families Need to Know

BY DR. KRISTINE TURKO, BCBA, COBA

We have all sought the support of a medical professional for a diagnosis, whether it be a diagnosis of a respiratory infection, strep throat, or a broken bone. We have expectations for the processes associated with a medical diagnosis. We make an appointment, see the doctor shortly after, are tested, and wait for the results. Usually not pleasant, but a tolerable nuisance. The process of diagnosing someone with autism is usually not straightforward or pleasant. The uncertainty associated with the process can cause stress and anxiety, and it is difficult to know where to go to seek help. Know that if you are going through the autism diagnosis process you are not alone!

It is important to note, before we jump into the process, that there are two types of diagnoses for Autism Spectrum Disorder or ASD: the medical diagnosis and the educational diagnosis. The medical diagnosis is made by a psychiatrist, clinical psychologist, or developmentalbehavioral pediatrician. More often than not, more than one person is involved in the diagnostic process. The educational diagnosis (i.e., determination of educational eligibility) is made by a school psychologist. Why two diagnoses, you ask? They each serve their own very important purpose.

A medical diagnosis of autism is made when a clinician determines that the patient demonstrates deficits in three unique areas of social communication and interaction. The three areas are: impaired socialemotional reciprocity, impaired nonverbal communication, and repetitive and stereotyped patterns of behavior or interests. These areas are assessed using diagnostic tools like the Autism Diagnosis Interview-Revised (ADI-R), the Autism Diagnostic Observation Schedule (ADOS), and the Childhood Autism Rating Scale (CARS). Each assessment typically takes between 30-60 minutes and requires a followup visit after the clinician compiles the results. Medical diagnosis is important, as it opens the door to many types of interventions that can improve communication and social skills like behavior therapy, speech therapy, occupational therapy, and counseling.

While a medical diagnosis determines eligibility for some interventions, it does not guarantee that a child will qualify for special education services in school. Educational services are granted when qualified professionals (e.g., school psychologist) provide an educational diagnosis. In addition to identifying autism as a disability, the educational diagnosis determines the need for special education services. The critical component here is whether the disability interferes with learning in a way that requires special services so that the student can make adequate academic progress. This means that every child with a medical diagnosis of autism does not qualify for special education services. If a child is found ineligible for special education services, parents can inquire about alternative accommodations to ensure that the student has access to equitable learning environments.

It is common for families to pursue both medical and educational diagnoses for autism. The medical diagnosis is critical for gaining access to intervention outside of school. An educational diagnosis is critical if your child struggles with academics and behavior in the classroom. Both assessments can be done simultaneously. Patience is key in the process. Know that you can ask for help. Medical advocates are typically made available through the site at which the assessment is conducted. Parent advocates are available through school districts. If you are feeling alienated, there are resources online that can help.

Here are a few that are reliable:

https://www.cdc.gov/ncbddd/ autism/index.html

https://autismsociety.org/ screening-diagnosis/

https://www.apa.org/topics/autismspectrum-disorder/diagnosing