Diagnosing Autism Spectrum Disorder (ASD)

By Alex Utley, M.S., BCBA, LABA

[This column was published in the West Springfield Republican on September 29, 2022.]

Autism spectrum disorder (ASD) is a neurodevelopmental disability. The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) describes two primary impacted areas: social communication and interaction and restrictive, repetitive behaviors. These impacts must be present early in development but may not be evident until later as a child’s social environment changes and becomes more complex. Therefore, many people are not formally diagnosed with ASD until they are older. 
 
Worries about differences in communication are often among the first concerns parents raise when they bring their child in for an autism assessment. Delayed language development may be an early indicator of Attention-Deficit/Hyperactivity Disorder (ADHD) and other speech and language disorders. It can also be one of the first indicators of autism. 

The cause of ASD is not yet fully understood, and there is no definitive medical test or assessment for it. There are, however, many different factors that may make an ASD diagnosis more likely, including environmental, biological, and genetic factors. ASD is currently diagnosed by professionals such as pediatricians, neurologists, psychiatrists, or psychologists who ask questions about the person’s developmental history, engage in direct observations, and conduct assessments of the individual.
 
When determining whether or not a child meets the criteria for ASD, professionals will also gather information on social interactions, communication, and behavior, including repetitive or intense interests and atypical mannerisms. In addition to impacted communication (e.g., repetitive vocalizations, echoing others’ speech, etc.), other early signs that a child might have ASD include:

 

• differences in eye contact
• not responding to sounds, voice, or own name
• limited use of gestures (such as pointing or waving goodbye)
• atypical play interests (e.g., no pretend play with toys, lining up blocks, spinning the wheels on cars)
• infrequent attempts to direct another person’s attention by showing or pointing to interesting things
• repetitive motor mannerisms (e.g., walking on tip toes or flapping hands) 
• sensitivity to the environment or sensory input (e.g., loud noises, clothing textures, visual fascination with light or movement)
• loss of skills or interests over time

 
Almost all of these behaviors are related to verbal and nonverbal communication and involve the way children interact with their parents, siblings, and other children. For this reason, it is important to discuss any social-communication difficulties your child may be experiencing with a pediatrician. However, it is important to remember that there are many possible explanations for your child’s developmental differences. 

Signs of ASD in older children might include difficulty making friends, appearing uncomfortable in social interactions, and having difficulty understanding social cues and emotions. Although the presence of these traits may suggest the need for further evaluation, these traits may be present for a variety of other reasons, such as learning to navigate the complex social world of adolescence.
 
If you have any concerns about your child’s development, consider consulting a service provider, such as your child’s pediatrician or a psychologist. Early assessment and intervention have been shown to be effective in supporting those on the spectrum at home, in school, and in their communities. Parents are often the best advocates for their children in seeking and obtaining services and resources. The National Autism Center at May Institute and other organizations such as the Autism Society of America may provide helpful information and resources to help parents get started.

Alex Utley, M.S., BCBA, LABA,  is a postdoctoral Fellow at May Institute who works in the Western Massachusetts Home-based and School Consultation programs.

About May Institute
May Institute is a nonprofit organization that is a national leader in the field of applied behavior analysis and evidence-based interventions, serving autistic individuals and individuals with other developmental disabilities, brain injury, neurobehavioral disorders, and other special needs. Founded 70 years ago, we provide a wide range of exceptional educational and rehabilitative services across the lifespan. For more information, call 800.778.7601 or visit www.mayinstitute.org.