5 FAQs About Autism Diagnosis and Screening
Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by persistent challenges with social communication and interaction, as well as restricted and repetitive patterns of behaviour, interests, or activities. It is a spectrum disorder, which means individuals with autism can have a wide range of symptoms and abilities.
Applied Behavior Analysis (ABA) therapy is a widely acknowledged and effective intervention for individuals with ASD, designed to enhance beneficial behaviours and reduce detrimental ones in order to facilitate improved social interactions, communication skills, and overall well-being.
In Singapore, about 1 in 150 children are on the autism spectrum. As parents, we are naturally inclined to understand the unique needs of our children. Moreover, it is totally understandable that we sometimes worry over their quirks, repetitive behaviours, and developmental milestones.
When it comes to autism diagnosis and screening, there are several frequently asked questions (FAQs) that are particularly important to consider. In this blog, we will answer the five most important FAQs and provide valuable insights and information for parents seeking guidance.
What are the common signs of ASD?
Some individuals with ASD may have mild difficulties, while others may require significant support in their daily lives. Autism is a lifelong condition, and early intervention and support services can play a crucial role in helping individuals with ASD reach their full potential.
Among the common symptoms or manifestations of ASD are:
- Difficulty with social communication, such as eye contact and understanding social cues
- Challenges in developing and maintaining relationships with others
- Repetitive behaviours, like hand-flapping or rocking
- Strong focus or intense interest in specific topics
- Sensory sensitivities to lights, sounds, textures, or tastes
- Delayed speech and language development or difficulty with communication
- Resistance to changes in routines or rituals
- Lack of pretend play or imaginative skills
- Difficulty understanding and expressing emotions
- Unusual posture or motor movements
When should children be screened for autism?
Autism can be diagnosed as early as 18 months, but many children are diagnosed around 5 to 7 years of age. However, some children may not be diagnosed until later in childhood or adolescence if their symptoms are less apparent. During this time, parents must observe their kids’ behaviours. Timely diagnosis and intervention are crucial in enabling individuals with autism to achieve their maximum potential.
In Singapore, children can be screened for ASD from as young as 18 months and a diagnostic assessment can be done from 31 months onwards, according to the National University Health System. The BabySibs program provides repeated screening at 12, 18, and 30 months of age for younger siblings of patients with ASD. Meanwhile, the American Academy of Pediatrics recommends that all children be screened for autism at their 18 and 24-month well-child checkup.
How is ASD diagnosed?
Developmental paediatricians, child psychiatrists, clinical psychologists and educational psychologists are part of a multidisciplinary team that conducts diagnostic evaluations for ASD. The diagnosis process typically involves gathering information from multiple sources, including parents, teachers, caregivers, and the child’s behaviour and responses. Collaboration between these professionals ensures a comprehensive evaluation, leading to a more accurate diagnosis and appropriate intervention and support services recommendations.
The Autism Diagnostic Observation Schedule (ADOS) is a standardised diagnostic test used to assess ASD. It is acknowledged by SingHealth as “the current gold standard for a behavioural observational assessment of individuals suspected of having ASD.” The ADOS-2 is the updated version of the ADOS, which includes updated norms and a new Toddler Module (T) that facilitates assessment in children ages 12 to 30 months.
The current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) governs the criteria for making an autism spectrum diagnosis, which psychologists or psychiatrists can do. It includes criteria for diagnosing ASD and provides a comprehensive framework for identifying and diagnosing individuals with autism based on specific behavioural patterns, social communication and interaction impairments, and restricted and repetitive behaviours. The DSM-5 is the standard classification of mental disorders used by mental health professionals.
While the ADOS is considered the gold standard for a clinical diagnosis of ASD, there is a shortage of people trained to administer it, and it adds cost to the diagnostic process. However, a recent study reported that there was 90% agreement between clinician diagnostic certainty and the role of the ADOS in ASD diagnosis in young children.
What happens during an autism assessment?
During an autism assessment, a team of professionals conducts a thorough evaluation to gather information about the child’s behaviour, communication, social skills, and developmental history. The typical flow of tests and activities are as follows:
- Initial interview. The assessment often begins with a consultation with the child or their parents/caregivers. This helps the professionals understand the concerns, developmental history, and observable behaviours.
- Direct observation. Professionals observe the child in various settings, such as school, home, or clinical settings. They look for specific behaviours and social interactions that may indicate autism.
- Standardised tests and questionnaires. The team may use standardised tests and questionnaires to gather additional information about the child’s communication, social, and behavioural skills. These tests provide a structured way to assess and compare their abilities to typical developmental milestones.
- Developmental and medical history. The team gathers information about the child’s developmental milestones and medical history. This includes prenatal and perinatal factors, early childhood development, and relevant medical conditions.
- Communication assessment. The psychologist assesses the child’s communication skills, including language comprehension, expressive language, and non-verbal communication.
- Social interaction assessment. The professionals evaluate the individual’s ability to interact and engage with others and their understanding of social cues and reciprocity.
- Behavioural assessment. Specialists may conduct evaluations to observe and analyse the individual’s repetitive behaviours, interests, and sensory sensitivities.
- Parent or caregiver input. Parents or caregivers are a valuable source of information and are usually interviewed or asked to fill out questionnaires about the individual’s behaviours and development.
- School or educational assessment. If applicable, the assessment team may collaborate with teachers and educators to gather information about the individual’s academic and social performance in a school setting.
- Multidisciplinary review. Once all the information is collected, the team meets to review the findings collectively. This approach ensures a comprehensive evaluation and a more accurate diagnosis.
After receiving an autism diagnosis, what is next?
Seeking professional help is the critical next step after receiving an autism diagnosis. It is crucial to find medical professionals and healthcare providers who are experienced in working with individuals with ASD, and have a strong track record of positive outcomes. Seeking out ABA therapy services can help as ABA therapy is a scientifically proven treatment that has a high success rate in improving functionality and behaviour in individuals with ASD.
ABA therapy typically involves one-on-one sessions between the individual and a trained therapist. During these sessions, the therapist uses evidence-based strategies to teach and reinforce desired behaviours while reducing challenging behaviours. An aspect of ABA therapy is involving parents and caregivers in the process. The ABA provider will offer training and support to help parents implement strategies at home and in everyday situations.
At its core, ABA therapy is rooted in the principles of behaviour analysis, a scientific discipline focused on understanding how behaviours are learned and can be modified. ABA therapy applies these principles in a structured and systematic way to teach new skills, improve existing behaviours, and reduce challenging behaviours. It’s not a one-size-fits-all approach; rather, it’s suited to the needs of each child, acknowledging their strengths and challenges.
The benefits of ABA therapy are as follows:
- Providing an individualised approach. ABA therapy is tailored to the unique needs and strengths of each child, ensuring that interventions are specifically designed to support their individual growth.
- Developing skills. ABA therapy focuses on building a wide range of skills, including communication, social interaction, academic abilities, self-care, and more.
- Improving behaviour. It effectively reduces challenging behaviours by teaching alternative, more adaptive behaviours, which in turn improves a child’s quality of life and their interactions with others.
- Giving positive reinforcement. ABA therapy employs positive reinforcement techniques to encourage desired behaviours, helping children stay motivated and engaged in their learning process.
- Tracking progress.: ABA therapy relies on data collection and analysis, enabling therapists and parents to track progress, make data-driven decisions, and adjust interventions as needed.
- Involving the parents. Parents are active participants in ABA therapy, receiving training and guidance on how to implement strategies at home, leading to consistent progress and growth.
- Building confidence. As children achieve milestones and experience success through ABA therapy, their self-confidence and self-esteem naturally increase.
- Allowing social interaction. ABA therapy helps children improve their social skills, fostering meaningful interactions and connections with peers and family members.
- Promoting independence. By breaking down skills into manageable steps, ABA therapy promotes the development of independent living skills, empowering children to become more self-sufficient.
- Enhancing communication. For children with communication challenges, ABA therapy can lead to significant improvements in verbal and nonverbal communication skills.
- Providing long-term benefits. The skills and strategies learned in ABA therapy can have a lasting impact on a child’s life, setting them up for success in school, relationships, and future endeavours.
- Giving empowerment. ABA therapy empowers children by giving them the tools they need to overcome obstacles and achieve their goals, fostering a sense of accomplishment.
Navigating ASD and Thriving!
Receiving an autism diagnosis may initially seem daunting, but it’s essential to remember that every child in the spectrum has the potential to flourish with timely intervention and the right support structures. You’re not alone on this journey; a vibrant community of parents, caregivers, professionals, and advocates is ready to stand by you.
As parents, you’re instrumental in shaping your child’s future. Our aim at AutismSTEP is to equip you with the resources and guidance necessary to nurture their growth. When we join forces and pool our knowledge, children with autism aren’t just supported—they thrive.
For insights into the most appropriate therapy for your child and to ensure you’re making the best decision for their future, please reach out for a consultation or contact us directly at +65 6456 9950.
