Diagnosing autism spectrum disorder


So Autism Spectrum Disorder is this really broad disorder where the affected

person has trouble communicating and interacting with other people.

And they also have this

sort of restrictive

and repetitive behavior where they can be

really restrictive with their interests,

maybe only showing interest

in one or two activities

and repetitive with their behaviors

or maybe the routines

that they need in place.

And while we’re not entirely sure yet

what causes Autism Spectrum Disorder,

we do have a few clues that we’ve kind of

picked up over the years that are helping

us try to figure out what the cause is.

So we know that if kids

have a family member,

someone who they share

some of their DNA with,

also known as a blood relative,

if one of their family members

has Autism Spectrum Disorder,

well they have a higher chance of

also having Autism Spectrum Disorder.

And we also know that boys are more likely

than girls to develop

Autism Spectrum Disorder.

So both of these suggest to us that maybe

genetics is playing part of a role in the

development of Autism Spectrum Disorder.

And we also know that

the older the parents

are when they have their kid, the higher

the chances that the kid will

have Autism Spectrum Disorder.

And that kind of points to

a genetic cause as well.

So those are some of the clues we have,

but we’re still trying to

figure out the whole puzzle

when it comes to the cause

of Autism Spectrum Disorder.

So if we suspect that a kid might

have Autism Spectrum Disorder,

how might we go about confirming

or diagnosing Autism Spectrum Disorder?

Well, for Autism Spectrum Disorder there

really isn’t a test like

a blood test or a scan

or anything like that that we

can use to make the diagnosis.

So what we have to do instead is really

look for the signs of

Autism Spectrum Disorder.

The trouble with

communicating and interacting

and the restrictive and

repetitive behaviors.

So you can imagine that diagnosing

Autism Spectrum Disorder

can be a little tricky,

and that sometimes it can

take quite a while for

a diagnosis to be made.

So to help us with diagnosing

Autism Spectrum Disorder,

there’s actually a really useful manual

sort of like a guidebook

that we use called the

Diagnostic and Statistical

Manual of Mental Disorders,

or what we often shorten to the DSM.

So let’s actually pull

up what we would find

if we cracked open the DSM and checked out

the criteria for diagnosing

Autism Spectrum Disorder.

Now something that I should mention here

is that the most current

version of the DSM

which is the fifth edition, so the DSM 5.

Well when it came out a few years ago,

there were actually some big changes

made to Autism Spectrum Disorder.

So in the DSM 4, the

older version of the DSM,

there were several different

Autism Spectrum Disorders

including Autistic Disorder,

Asperger’s Disorder,

Childhood Disintegrative Disorder,

and Pervasive Developmental Disorder

and now in the DSM 5

all of these different

Autism Spectrum Disorders have kind of

been merged into one spectrum disorder.

Autism Spectrum Disorder,

and this was done because kids with

these different disorders, they really do

fall along a spectrum, and the hope

was to make diagnosing a

child a bit more accurate.

So now in the DSM 5 there’s just one

Autism Spectrum Disorder

and kids will fall

in different places along this spectrum.

Okay, so the current requirements

for diagnosing Autism Spectrum Disorder

are split up into two main categories

and these categories, they’re actually

the main signs of Autism

Spectrum Disorder.

So the first category that

we would find in the DSM

is persistent deficits in social

communication and interaction.

And this just basically

means that the child’s

social development is not quite

tracking along the way it should be.

So a child would have to display issues

with their social interactions in order

for us to consider diagnosing them

with Autism Spectrum Disorder.

And there are actually a few specific ways

that a child would need to show this,

this deficit in social

communication and interaction.

So the first one here is deficits in

social and emotional reciprocity.

Now reciprocity is when two people do

something for each other,

so in a social situation

this is kind of the back and

forth flow of a conversation

where we respond to each

other in similar ways.

So maybe someone smiles at

you and says good morning.

Well, you would likely do the same.

You would return their smile and say

good morning back to them as well.

And when you do that, you’re returning,

you’re reciprocating their emotions

and their social gestures.

So having trouble with

understanding and using

this sort of social and

emotional reciprocity

is one of the communication

deficits that we would

need to see in someone in order to

diagnose Autism Spectrum Disorder.

And it’s not simply because

they don’t want to say hi.

I’m sure everyone’s got someone

they’re not stoked to say hi to,

but it’s because the

reciprocation it doesn’t

really occur to them as a

social requirement, if you will.

Now another sign that we would need

to see in order to diagnose

Autism Spectrum Disorder

is some sort of deficit in developing

and maintaining relationships.

And here we’re talking about relationships

with peers, with people

around the same age.

Because it’s actually not uncommon

for kids with Autism Spectrum Disorder

to befriend people who are

younger or older than them,

but then still struggle with building

relationships with people their own age.

And the last sign that

we would need to see

under this social

communication and interaction

category here is some sort of

deficit in nonverbal communication.

So this means that the person would

have trouble understanding and using

things like hand gestures and eye contact

and facial expressions

when they’re communicating.

So that’s the fist

category that would need

to be checked off before

you would consider

diagnosing someone with

Autism Spectrum Disorder.

And that makes sense, right?

Because trouble with social communication

and interaction is one of the main signs

that we see in someone with

Autism Spectrum Disorder.

So there’s one more

main category that also

needs to be checked off before we can

officially make a diagnosis

of Autism Spectrum Disorder.

And as you might have guessed,

this category is one

of the other main signs

of Autism Spectrum Disorder, and that’s

restrictive and repetitive

behavior and interests.

So you might remember that for a kid

with Autism Spectrum

Disorder, there are a few

different ways that they might show this,

this restrictive and repetitive

behavior and interests.

So they might have

really fixated interests.

Maybe they’re only really

interested in one or two

activities and they show

no interest in any others.

They might be really

strict about following

routines or rituals, or maybe they

really struggle with change.

They might have repetitive

sounds or movements

or behaviors that they perform.

Or maybe they react to stimulation

like bright lights or

loud sounds a bit more

or a bit less than what we would expect.

So these are the two main categories that

we would need to check off in order

to diagnose Autism Spectrum Disorder.

And there are two little things

that I should also mention that the DSM

requires from a kid in order

to make that diagnosis.

So one is that all of these behaviors,

they start coming on when the

kid is in early childhood.

And the other is that these behaviors,

they interfere with the kid’s daily life.

All right, so now we know what we need

to see in order to diagnose a kid

with Autism Spectrum Disorder.

So how do we go about

looking for these signs?

Well what we really rely on is asking

the parents questions and

talking to and playing

with the kid to see if we can pick up

on any of these signs here.

Now these questions,

they’ll vary quite a bit

depending on how old the kid is.

So maybe if the child is a toddler,

let’s say they’re between the age

of six months old to two years old.

Well, to look for this deficit in social

communication and interaction,

we might ask the parents if

their child makes eye contact

or smiles and laughs with the parent.

Or maybe we’ll ask if the child tries

to show or share toys with the parent.

If the kid was a bit older, we might

ask the parent how the kid is doing

with making friends at school.

And if we wanted to look

for this restrictive,

repetitive behavior, we

might ask how the kid

handles change or unexpected situations

like a different bed time

routine or going on a trip.

Maybe we’ll ask the parents

to see if their child

has any particular habits

that they like to repeat

like lining up toys in a special way,

or if they’ve noticed that

any environmental stimuli

like a car honking or a light flashing

really tends to bother their kid.

Now, while these are

the diagnostic criteria,

part of diagnosing

Autism Spectrum Disorder

also involves ruling out disorders

that can look like

Autism Spectrum Disorder.

So for example, intellectual disability,

which is when someone

has trouble functioning

in many areas of their

life, like communication,

taking care of themselves at school

with their academics, well,

intellectual disability

can actually kind of look the same

as Autism Spectrum Disorder,

especially when the kid is young.

It’s hard to decide if a kid’s trouble

with communication and interaction

is due to Autism Spectrum Disorder,

or due to an intellectual disability.

So, part of diagnosing

Autism Spectrum Disorder

involves trying to really make sure

that the trouble that the kid is having

fits this picture here of

Autism Spectrum Disorder

rather than the picture of another

disorder like intellectual disability.

And to make things a little

trickier, it’s actually

not uncommon for kids with

Autism Spectrum Disorder

to also have an intellectual disability.

So this means that they

would meet the criteria

for both Autism Spectrum Disorder

and intellectual disability.

This doesn’t mean that all children

with Autism Spectrum Disorder

have intellectual disability, not at all.

Often, there’s no intellectual

impairment at all,

but this just highlights that sometimes,

especially when the kid is really young

and still growing and developing,

it can be a little tricky to figure out

exactly what’s behind their struggles

with communication and interaction.

So it may take a few years

to make a final diagnosis,

but diagnosing Autism Spectrum Disorder

really comes down to observing the child’s

social behaviors and habits for some time.