Who diagnoses autism and how.

april 6 2008

A diagnosis of autism has a lot of implications for a child and its parents.

Some people claim to be able to "see" if a child is autistic.

Autism though can be easily mixed up with other developmental or communication problems, so an expert needs always to be involved.

So it's not up to a schoolteacher, nor to the family physician to make the diagnosis.

Because autism is a neurobiological disorder defined in the DSM, the Diagnostic and Statistical Manual of Mental Disorders, a psychiatrist is the expert one needs.
Not all psychiatrists however are trained to deal with children, so one should look for a child and developmental psychiatrist. If possible one who is wellknown for accurate diagnoses of autism spectrum disorders.

Some people think it's not very important that a well defined diagnosis is made for a young child.
They say young children change a lot and maybe these children even outgrow their diagnosis.
As I wrote before: autism is a disorder for life.

A carefull diagnosis is important, because the treatment of a child depends on it, and which means that the development of the child depends on it.

In some states children with PDD-NOS won't get proper treatment, because PDD-NOS is considered of less influence on the child's life than for instance classical autism.
So even experts are inclined to diagnose a child with classical autism, to get help for the family.
It's a disgrace that policy-makers don't know enough to make proper decisions about the help children should get. Or that they won't trust experts.


I've had some questions from parents about the time the diagnosic process costs.

Each diagnostic process should include:

• an anamnesis, that's a family history. It's important to know which illnesses and disorders are in the family, because some might point in a certain direction, or might be overlooked at a young age.
• the history of the child. Some disorders lead to the same symptoms as autism, but are not autism at all.
• the experiences of the parents. Parents see their child develop from day to day. They know their child as no one else.
• the observations of teachers and others. Sometimes familymembers or friends see things the parents are not able to see.
• questionnaires. They're very helpfull to discuss each and every subject that's needed to pick up signals. People can remember active, but also by recognition. These list are great for that.
• observation. Expert observation of the child is always important. It's up to the expert where he likes to see a child. Some are OK with a classroom, others prefer playtherapy or videos at the family home.

Some experts also want a physical exam, bloodwork and even scans.
That's because they want to exclude other issues (vitamin deficiency, gluten intolerance, brain damage, etc ) before making a clear statement about autism.

I'll write about the symptoms of autism at another time.


.