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|A B C D E F G H I J K L M N O P Q R S T U V W X Y Z|
|Overview Symptoms Treatment Prevention|
|Autistic disorder/autism spectrum; Pervasive developmental delay|
Most parents of autistic children suspect that something is wrong by the time the child is 18 months old and seek help by the time the child is 2 (though the diagnosis is usually not made until long after that). Children with autism typically have difficulties in verbal and nonverbal communication, social interactions, and pretend play. In some, aggression -- toward others or self -- may be present.
Some children with autism appear normal before age 1 or 2 and then suddenly "regress" and lose language or social skills they had previously gained. This is called the regressive type of autism.
People with autism may perform repeated body movements, show unusual attachments to objects or have unusual distress when routines are changed. Individuals may also experience sensitivities in the senses of sight, hearing, touch, smell, or taste. Such children, for example, will refuse to wear "itchy" clothes and become unduly distressed if forced because of the sensitivity of their skin. Some combination of the following areas may be affected in varying degrees:
|Signs and tests:|
Routine developmental screening should be performed for all children at all well-child visits to their pediatrician. Further evaluation is warranted if there is concern on the part of the clinician or the parents. This is particularly true whenever a child fails to meet any of the following language milestones:
These children might receive an audiologic evaluation, a blood lead test, and a screening test for autism such as the Checklist for Autism in Toddlers (CHAT) or the Autism Screening Questionnaire.
A clinician experienced in the diagnosis and treatment of autism is usually necessary for the actual diagnosis.
DIAGNOSTIC CRITERIA FOR AUTISTIC DISORDER
Because there is no biological test for autism, the diagnosis will often be based on specific criteria laid out as A, B, and C in the Diagnostic and Statistical Manual IV, as follows.
A. A total of six or more items from (1), (2), and (3), with at least two from (1) and one each from (2) and (3): :
The other pervasive developmental disorders include:
The diagnostic evaluation of autism will often include a complete physical and neurologic examination, as well as the use of a specific diagnostic instrument such as the Gilliam Autism Rating Scale, the Pervasive Developmental Disorders Screening Test-Stage 3, the Childhood Autism Rating Scale (CARS), or the Autism Diagnostic Observation Schedule-Generic. Children with known or suspected autism will often have genetic testing (looking for chromosome abnormalities) and perhaps metabolic testing.
Because autism encompasses such a broad spectrum, a brief observation in a single setting cannot predict an individual's true abilities. Ideally, a multidisciplinary team will evaluate the child. This evaluation might include a comprehensive speech-language-communication evaluation, a cognitive and adaptive behavior evaluation, a sensorimotor and occupational therapy evaluation, and neuropsychological, behavioral and academic assessments.
Sometimes people are reluctant to make the diagnosis of autism because of concerns about labeling the child. Although pigeonholing in a way that suggests limits is inappropriate due to the wide range of autistic spectrum conditions, failure to make a diagnosis can lead to failure to get the treatment and services the child needs.