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Diagnosing Autism

The American Academy of Pediatrics now recommends that all children should be screened for autism at their 18- and 24-month checkups. Parents usually have their hands full tending to all of the daily tasks associated with babies and toddlers, and they may not notice things that may be obvious to grandparents. Grandparents are often the first persons to notice signs of autism. We grandparents can be helpful by taking on the responsibility of knowing what those signs are and being vigilant.

The American Psychiatric Association’s most recent Diagnostic and Statistical Manual of Mental Disorders (DSM-5) presents the following criteria for an “official” autism diagnosis.

There must be “persistent deficits” in all three of the following:

✔Social-emotional reciprocity (e.g. relating appropriately to others with back and forth communication and sharing of emotions).

✔Non-verbal communication behaviors (e.g. eye contact, facial expressions, gestures).

✔Understanding and maintaining relationships (e.g. making friends, sharing play, interest in others).

AND there must be persistent deficits in at least two of the following four:

✔Repetitive motor movements (e.g. lining up objects, idiosyncratic phrases).

✔Insistence on sameness (e.g. same food, same routines).

✔Abnormally intense fixations (e.g. excessive preoccupations with specific things or topics, strong attachments to unusual objects).

✔Hypo- or hypersensitivities (e.g. indifference to pain or temperature, fascination with lights.)

The pediatrician is usually the frontline professional who monitors and evaluates a child’s health. But there is no lab test, no x-ray, no blood test, etc. that can diagnose autism, and autism includes a very wide range of symptoms. And autism can range from severe mental disabilities to a very high intellect and independent living. Three typical milestones that a pediatrician looks for are smiling by six months, mimicking sounds and facial expressions by nine months, and babbling by twelve months.

The pediatrician may ask questions such as whether there is sensitivity to light or noise or temperature, whether there is a tendency towards anger, whether there are problems with eating or sleeping, and whether there is appropriate response when you attempt to get the child’s attention.

Other professionals who may be involved to help with a diagnosis include child psychologist, speech-language pathologist, occupational therapist, developmental pediatrician, and neurologist.

If a child is suspected for autism, this team of professionals may do periodic evaluations up until the age of 5 or longer.

We grandparents can not only give love and support, but also be continually knowledgeable about the fundamental symptoms of autism and speak up when we notice suspicious things. The sooner an autism diagnosis is made, the sooner appropriate therapies can begin. And research has shown that the earlier the therapy begins the better.



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