Interesting changes to the diagnosis of Autism
The diagnostic categories for Autism changed in 2014. Previously Autistic Disorder fell under the umbrella term, Pervasive Developmental Disorder (PDD). PDD included a variety of different disorders including Autistic Disorder and Asperger’s Syndrome (among others). Since 2014, the umbrella term has become Autism Spectrum Disorder (ASD), and the other disorders (e.g., Asperger’s Syndrome) no longer exist as diagnoses on their own but now fall under ASD. There have also been some changes in the diagnostic criteria for ASD. ASD is on the rise Between 2012 and 2014 the official prevalence of ASD rose by 30%, from 1 in 88 to 1 in 68 children. In 2015, a government parent survey suggested 1 in 45 children in the US had ASD. This increase cannot only be explained by better awareness. The exact cause of ASD is still unknown. Research shows a strong genetic component to ASD but something in the environment is triggering the genetic predisposition in more individuals than before. Studies have identified correlations between ASD and environmental risk factors such as the mother (or father’s) prenatal exposure to food or environmental toxins; infections, illness, or certain medications taken by mothers while pregnant; preterm deliveries; and even the older age of parents. There is also a higher prevalence in boys than girls with one girl versus five boys diagnosed with ASD. There are a number of theories that have arisen to explain this discrepancy, one of which is that girls with ASD present differently from boys and may be less understood or misdiagnosed. Further research is being conducted into these differences. Signs and Symptoms of ASD Symptoms of ASD fall on a spectrum (or continuum) because there are varying combinations and severity of symptoms. It is possible to have a relatively mild or severe form of the condition (or anywhere in between). This is why no two individuals with ASD are alike.
The following list of symptoms includes some of the signs to look out for:
Deficits in social communication and social interaction
Individuals with ASD display deficits in ALL of the following areas:
Restricted, repetitive patterns of behavior, interests, or activities
Individuals with ASD display at least two of the following:
For a diagnosis to be made the individual should display a combination of the above symptoms (may vary from mild to severe) and they should cause significant impairment. They should be seen in the child’s early years, however in some individuals they become more apparent as social demands increase. In some adolescents or adults, the severity of symptoms can be masked somewhat by learned strategies. ASD is not an intellectual disorder. Some individuals have normal to above average intellectual functioning, however, for many there can be an accompanying intellectual impairment. Similarly, many individuals with ASD do not display a delay in language and can even have advanced vocabulary. Nevertheless, for many there is accompanying language impairment. Some speak late and others don’t develop language at all. ASD can also be accompanied by other medical (e.g., seizure disorders); genetic conditions (e.g., syndromes); or neurodevelopmental, mental, or behavioral disorders (e.g., Attention-Deficit Hyperactivity Disorder, Anxiety Disorders, Mood Disorders etc.).
Getting a diagnosis of ASD
The diagnosis of ASD is usually made by a professional such as a Paediatric Neurologist, Specialist Psychiatrist, or Clinical Psychologist (with a special interest in neurodevelopmental disorders). There are no neurological or medical tests that diagnose ASD although these should be done to rule out other neurological abnormalities or associated conditions. ASD is a diagnosis that is made based on the clinical presentation of the individual. There are assessments and checklists that can be used to assist the professional in making the diagnosis. Developmental assessments are also useful to inform interventions and track progress over time. Intellectual tests can be helpful for informing how a child is likely to cope with mainstream schooling. It is important to note that these tests are often not a true reflection of an ASD child’s intellectual capacity and should be interpreted with caution. Getting a diagnosis provides so much more than a label. It informs intervention, helps to highlight and draw on specific strengths and weaknesses, informs educators on how best to teach or support the child, and most importantly, provides a platform from which parents can better understand the way their child thinks and sees the world. As a result, parents and professionals can better support the child in achieving their true potential.