How is Autism Spectrum Disorder Diagnosed in Children?
At Moodist Hospital, autism spectrum disorder is diagnosed as a result of a detailed evaluation of the child and appropriate follow-up and management is planned for the child.
There is no biological diagnostic marker for the diagnosis of Autism Spectrum Disorder. The diagnosis is based on a careful examination of the child.
Children who meet the diagnostic criteria for autism spectrum disorder in the Diagnostic Classification of Psychiatric Disorders (DSM-5) are diagnosed with autism spectrum disorder when other disorders are excluded.
In Autism Spectrum Disorder, parents often consult a specialist when they notice that their child shows differences from typical developmental characteristics or has unusual behaviors.
Less frequently, a child with normal development may be admitted because of a subsequent loss of skills or deviations from normal development.
Autism Spectrum Disorder is diagnosed based on the history taken, psychiatric evaluation and psychometric tests.
Depending on the age and developmental level of the child, assessment procedures may vary.
When diagnosing Autism Spectrum Disorder, ethnic, cultural or socioeconomic factors are taken into account during the assessment.
Autism spectrum disorder is more difficult to diagnose in infants and very young children, and some autism symptoms (for example, stereotyped movements) may develop later.
Other psychiatric disorders are excluded before a diagnosis of Autism Spectrum Disorder is made. Autism Spectrum Disorder should be distinguished from specific developmental disorders (including language disorders), sensory disorders (especially deafness), reactive attachment disorder, obsessive-compulsive disorder, intellectual disability, selective mutism, anxiety disorders, childhood-onset schizophrenia.
Story retrieval
- Pregnancy history
- General characteristics of early developmental stages
- Age of onset, i.e. when were the symptoms of autism first noticed?
- Medical history and family history
Developmental and psychological assessment
- Assessment of intelligence level, assessment of communication skills (expressive language skills, use of non-verbal communication, use of language)
- Assessment of adaptive skills (ability to use skills to adapt to life)
Assessment of cognitive functions
The following tests can be used to evaluate cognitive functions in Autism Spectrum Disorder.
- WISC-R, Porteus, Leiter, Stanfort Binet
- Denver, AGTE
- Skill assessment battery
Psychiatric assessment and observation
Observation and examination is the most important part of the diagnosis of Autism Spectrum Disorder.
- Social relationship level (eye contact, attachment skills, social responsiveness, insight)
- Behavioral characteristics (repetitive behaviors, self-stimulation, inability to adapt to change, inappropriate hypersensitivity to the environment)
- Language and communication difficulties (echolalia, presence of communicative speech)
- Play skills (not using toys for their intended purpose, presence of symbolic/imaginary play)
Medical evaluation
In the case of a related medical condition that may be confused with or cause autism symptoms, genetic abnormalities, the presence of seizures, etc. are evaluated.
- Hearing test (ABR, BERA) (in every child with autism)
- Consultation (neurology, pediatrics, genetics) (when necessary)
- EEG, MRI/CT, chromosome analysis
How is Autism Spectrum Disorder Treated in Children?
It is often not possible to completely eliminate the symptoms of autism, the aim is to minimize the existing disability of the child and to develop the existing potential. After the diagnosis of Autism Spectrum Disorder, the patient's follow-up and treatment program should be organized quickly.
Treatment methods and supportive approaches used in Autism Spectrum Disorder include
- Psychoeducation
- Special education/behavior therapy
- Speech and language therapies
- Occupational therapies
- Cognitive behavioral therapies and individual psychotherapies (high functioning adolescents)
- Family trainings
- Occupational Therapy
- Supporting motor skills
- Medication when necessary
- Inpatient treatment in very special cases
Educational treatment approaches
- The main treatment in Autism Spectrum Disorder is educational treatment approaches.
- Educational treatments aim to improve social-communicative skills, reduce undesirable behaviors and acquire new skills.
Behavioral
- Behavioral interventions such as Applied Behavior Analysis (ABA) are the most basic educational interventions used in autism spectrum disorder.
- The ABA program includes Early Intensive Behavioral Interventions for children experiencing symptoms of autism.
- ABA techniques are effective in eliminating problematic behaviors in children with autism symptoms. ABA has been found effective in academic skills, adaptive life skills, communicative-social skills and vocational skills. Since most children with Autism Spectrum Disorder tend to learn tasks separately, studies on the generalization of these skills are important.
Contact
- Communication is the main focus of educational intervention in children with symptoms of autism.
- An individualized education plan is created taking into account the child's speaking skills.
- Children with autism who do not yet have words can be helped by using alternative communication methods such as sign language, communication boards, visual support, picture exchange and other forms of augmentative communication.
- It is aimed to develop pragmatic language skills for fluent individuals with autism.
- Many programs are used to develop social reciprocity and pragmatic language skills.
Educational
- In Autism Spectrum Disorder, an individualized education plan is prepared according to the person and the autism symptoms seen.
- Programs that have been found to be effective in children with autism symptoms are generally programs that include planned, intensive, individualized interventions with an experienced team. Educational methods that involve the participation of the family to ensure that the skills taught are generalized to life have been found to be more effective.
- When preparing an education plan for children with autism symptoms, it is important to assess the child's strengths and weaknesses. The education plan should include the aims, objectives and procedures for monitoring effectiveness.
- The curriculum used varies across programs, but includes goals to develop verbal and non-verbal communication, academic skills, social, motor and behavioral abilities.
- Parental education is also very important for children with autism symptoms.
Other Interventions
- Cognitive behavioral therapy is effective for anxiety and anger management in high-functioning youth with Autism Spectrum Disorder.
- Although there is no conclusive evidence that sensory integration therapy is beneficial in autism spectrum disorder, it can be used as an additional intervention method especially in children with sensory problems.
- In some cases, such as mood disorders, severe tantrums and aggression accompanying Autism Spectrum Disorder, inpatient treatment may be necessary.
Drug Treatments
- No medication has yet been developed to treat the core symptoms of autism.
- Medication is used to treat comorbid psychiatric conditions (e.g. anxiety, depression), aggression, self-harming behavior, hyperactivity, inattention, repetitive behaviors and sleep disorders.
- Medication can increase the ability of children with Autism Spectrum Disorder to benefit from education and other interventions.
What Happens If Autism Spectrum Disorder in Children is Not Treated?
When autism is left untreated or treatment is delayed, the benefit from educational treatments may decrease as the age increases, as the brain's capacity to recover decreases over the years. When treatment is delayed, permanent losses may occur in the person's social-communicative skills and some skills that help to sustain life.
Recommendations for Parents of Children with Autism Spectrum Disorder
Since Autism Spectrum Disorder can be diagnosed from a very early age, one of the most important things is awareness. It is important for parents to consult a specialist without wasting time when they notice deviations from normal development in their children.
When a child is diagnosed with Autism Spectrum Disorder, it can often be a challenging situation for parents and sometimes it can take a long time to accept the diagnosis. Sometimes parents may have to consult many doctors to confirm the diagnosis. This can lead to wasted psychosocial and financial resources. Especially since the early start of educational interventions is of great importance for a child with autism symptoms, it is necessary not to waste too much time at the diagnosis stage.
Although educational interventions are very important, the important thing is to reach the right education at the right time and the continuity of education. Therefore, as soon as a diagnosis is received, all resources should not be allocated to a certain thing, but should be spread over time.
In the treatment of Autism Spectrum Disorder, it is important for parents to learn certain interventions and apply them outside of class time in order to increase the benefit that the child receives from educational interventions.
Since there is no radical cure for Autism Spectrum Disorder, parents are searching for alternative treatments for their children with autism symptoms. While some of the alternative treatments do not pose a risk of harm to the child, others carry a risk of harm to the child. In scientific studies, methods such as massage, multivitamin preparations, sports, music therapy, animal therapy, acupuncture are stated as acceptable and harmless methods, while applications such as high doses of vitamin B and C, immune therapies, neurofeedback, hyperbaric oxygen therapy, gluten-free diet, chelazion do not provide any benefit in the treatment of autism and may have some negative effects.
