Getting Started: Obtaining a Diagnosis

Individuals or parents who are interested in investigating an autism spectrum disorder (ASD) diagnosis need to find a provider who is familiar with autism, “typical” development, and someone who can take into account the cultural values and needs of their family.

For insurance purposes, a medical diagnosis must come from a medical provider (MD, PsyD, etc). The process of evaluating for ASD is complex and cannot be reduced to a single score from a single test.

One Source is Not Enough

Freeman, Cronin, and Candela (2002) highlight that “rating scales were not designed to be used in isolation to make a diagnosis. They are useful to the clinician but are only one source of qualitative information for a comprehensive clinical assessment” (p. 148). It is crucial that the diagnostic report and diagnostic decision should include information from multiple sources.

These sources include, but are not limited to:

Interviews with family members

Information from the individual’s school such as the Full and Individual Evaluation (FIE), classroom observations, teacher interviews, etc.

If the individual receives private therapy (speech therapy, occupational therapy, physical therapy, etc), information from the therapist(s) providing services should be included. This includes: a copy of the most recent evaluation report, recent progress notes, observations, and potential interviews

Medical Provider

The medical provider must gather information from their own observations and interactions with the individual as well. This often includes an evaluation that provides descriptive information and outcomes based on the results of the evaluation.

Tools of the Medical Trade

Below are some of the tools that may be used by a medical provider. The autism screening and diagnostic/identification tools included are the most widely used instruments available in both practice and research.

Please Note: The list in the tab below is not exhaustive and may change as information and research change.

• Tools

  DescAsperger Syndrome Diagnostic Scale (ASDS)
  Autism Diagnostic Interview-Revised (ADI-R)
  Autism Diagnostic Observation Schedule- Second Edition (ADOS-2)
  Autism Observation Scale for Infants (AOSI)
  Autism Screening Instrument for Educational Planning – Third Edition (ASEIP-3) and the Autism Behavior Checklist (ABC)
  Autism-Spectrum Quotient (AQ)
  Autism Spectrum Rating Scales (ASRS)
  Checklist for Autism Spectrum Disorder (CASD)
  Childhood Autism Rating Scale- Second Edition (CARS-2)
  Childhood Autism Spectrum Test (CAST)
  Development Behavior Checklist – Autism Screening Algorithm (DBC-ASA) and Early Screen (DBC-ES)
  Early Screening of Autistic Traits (ESAT)
  Gilliam Asperger’s Disorder Scale (GADS)
  Gilliam Autism Rating Scale – Third Edition (GARS-3)
  Modified Checklist for Autism in Toddlers, Revised with Follow-up (MCHAT-R/F)
  Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS-2)
  Parent’s Observations of Social Interactions (POSI)
  Screening Tool for Autism in Toddlers and Young Children (STAT)
  Social Communication Questionnaire (SCQ)
  Social Responsiveness Scale – Second Edition (SRS-2).
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Understanding the History

ASD is classified as a “Neurodevelopmental Disorder” by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; American Psychiatric Association, 2013); therefore, accurate assessment and reporting must include a thorough developmental history. The assessment report, also known as a diagnostic report, should contain enough information for others (educators, family members, therapists, insurance providers, etc.) to understand how a diagnosis of autism was determined.

This includes providing information on the evaluations that were conducted and examples of behaviors that helped determine scores and or diagnosis. Parents can expect to be asked about the following when a provider is gathering information about their child’s developmental history:

• Birth History

• Family History (Immediate & Extended)

  Pervasive Developmental Disorders
  Genetic or Medical Disorders
  Learning Disorders

  Emotional/Behavioral Disorders
  

• Medical History

  Medical Conditions (e.g., seizures, allergies, asthma, head injury/trauma)
  Hospitalization
  Sensory Differences
  Medication
  Hearing/Vision
  Previous Evaluations/Other Diagnoses
  

• Developmental Milestones

  Language/Communication
  Social
  Motor
  History of Regression or Interruption of Development
  History of Interventions

Your Next Steps

A medical diagnosis is based on the diagnostic criteria for ASD as identified in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The specific criteria and a FAQ on DSM-5 and Autism can be found on the Autism Speaks website using this link: https://www.autismspeaks.org/autism-diagnosis-criteria-dsm-5.

If you have questions about diagnostic testing and the steps you need to take in obtaining one, please contact us. Our team is highly trained in autism testing and supporting and collaborating with families. We are here to help you learn, process, and take each step one day at a time.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).Arlington, VA: American Psychiatric Publishing.

Freeman, B. J., Cronin, P., & Candela, P. (2002). Asperger syndrome or autistic disorder? The diagnostic dilemma. Focus on Autism and Other Developmental Disabilities, 17(3), 145–151.