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Diagnosing autism spectrum disorder

  • By Dr. Arijit Ghosh

Major signs and symptoms include restricted or repetitive activities, behaviours, and interests. All these result in impaired social and occupational functions and responses.

Autism spectrum disorder is not a curable disorder. Early diagnosis is important to provide adequate supportive measures to the affected child. It enables to provide aid to the affected child so that he or she can adapt to the surroundings and lead the life of a normal child.

Visit to the doctor

The doctor evaluates the child for any sign of developmental delay during periodic evaluation at an early part of childhood. If any sign of autism is detected, the child is referred to a group of specialist doctors consisting of child psychologist and paediatric neurologist for proper examination and assessment of the child.

Examination of the child

No medical test is available to diagnose autism spectrum disorder. The diagnosis is made by observation alone.

  1. The specialists observe the social interactions, behaviour, and communication skills of the child and ask questions to the parents regarding these aspects.
  2. The language, speech, and developmental levels are observed by the specialists.
  3. Social interactions and communication skills of the child are assessed through structured methods.

However, the following medical tests may be done to rule out other possible disorders with similar presenting features:

  1. Physical examination - weight, height, and head circumference of the child are measured to evaluate the growth pattern.
  2. Hearing tests - These are done to determine hearing abnormalities that may cause impaired social interactions and communication skills.
  3. Chromosomal analysis - It is done to rule out presence of any genetic disorders

Evaluation

Once the above-mentioned observations are made, the child is assessed as per the criteria of Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The assessment is done in two aspects - impairment of social interactions and communication skills and restricted or repetitive behaviours.

The social interactions and communication skills are assessed by the following methods:

  1. Response of the child in social settings: Positive findings of autism are decreased ability to share experiences or emotions with others, inability to engage in normal conversation and difficulty in initiation of social responses.
  2. Response to nonverbal communication methods: Positive findings of autism are difficulty in making eye contacts, difficulty in understanding nonverbal cues, and lack of facial expressions.
  3. Other positive findings of autism include lack of interest in others, difficulty in imaginative play, etc.

The restricted or repetitive behaviours are assessed by the following methods:

  1. Repeated external movements or use of objects - mimicking sounds, repeating phrases verbatim without proper understanding.
  2. Following rigid routines - need to take same route every day, extreme distress at small changes.
  3. Interest in topics with abnormal focus or intensity - limited or narrow areas of interest, strong attachment to unusual objects.

Once the diagnosis of autism spectrum disorder is confirmed, the child is provided with all the necessary supportive measures. Early detection and proper intervention helps the child to lead a normal life.


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