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Parents Ask: What Should We Look for in an Evaluation for Autism?

“We’ve been told our child should get evaluated for autism. How do we get a good evaluation?”

This week’s “Got Questions?” answer is from autism therapist and diagnostician Donna Murray, senior director of the Autism Speaks Autism Treatment Network (AS-ATN).

Thank you for your question. It’s one we hear often.

It’s important to obtain an evaluation by healthcare professionals who are experienced in identifying autism spectrum disorder (ASD) across a range of ages and symptom severity. As with any healthcare issue, you want experience. Ideally, I recommend finding someone who has evaluated hundreds of individuals, not just a few here and there.

Why are so much expertise and experience important?

The diagnostic challenge
Diagnosing ASD is challenging. There’s no blood test or other simple medical test for making the diagnosis. Nor is there any one behavior or other characteristic that indicates autism. Rather, we look for a broad but specific group of symptoms. This requires direct observation combined with an expert examination and assessment as well as reports from parents, teachers or other caregivers.

In addition, autism symptoms exist across a spectrum. They must be differentiated from similar symptoms associated with other developmental disorders. Often, the crucial difference is in the degree that certain symptoms are present.

Making a diagnosis can be especially challenging when it involves individuals on either end of the autism spectrum: those with broad developmental problems and those who are highly functioning despite having autism-related challenges.

Selecting a diagnostic team
Qualified and experienced providers can be found in a number of medical and mental health fields. If you’re seeking an evaluation, you want a provider who understands typical development, developmental disorders, as well as specific autism symptoms.

At specialized autism centers such as those in the AS-ATN, a diagnostic team evaluates each child. (Click here to find the AS-ATN center nearest you. Click here to search for other diagnostic centers using the Autism Speaks Resource Guide.)

Ideally, the team should include a medical specialist such as a developmental pediatrician, psychiatrist or neurologist. In addition, it should include a psychologist with expertise in diagnosing autism, a speech-language pathologist and possibly an occupational therapist.

- The physician’s exam should focus on possible medical and/or genetic issues associated with your child’s symptoms.

- The psychologist administers developmental and cognitive tests.

- The speech-language pathologist evaluates communication and social skills.

- The occupational therapist can further evaluate sensory and motor issues.

Following the diagnostic evaluation, the team should provide the family with comprehensive feedback, including a written report that fully explains all test results. This feedback session and report should be presented in understandable language.

If there’s anything you don’t understand, you should feel comfortable asking for explanations. It’s vital that you come away with an understanding of the entire diagnostic process. With this information, you will be positioned to obtain the necessary services and interventions for your child.

Beyond the evaluation: intervention guidance
Your feedback session and written report should not stop with your child’s diagnosis. It should also lay out the next steps in your journey. If your child receives an ASD diagnosis, for example, the report should include comprehensive recommendations for the therapists and/or teachers who will be a part of the intervention program.

When a diagnostic team isn’t available
Unfortunately, autism clinics with highly trained diagnostic teams aren’t available in every community. You may need to consult with your primary care physician for a recommendation in your area. As part of its mission, the AS-ATN is working to share best practices for autism diagnosis and care with doctors and other healthcare providers across North America.

As mentioned, you can also search for local diagnostic services through this website’s resource guide. If you’d like personal help, please don’t hesitate to call the Autism Speaks Autism Response Team at 888-228-4762 (en Español 888-772-9050) or email familyservices@autismspeaks.org.

While you’re waiting
Finally, while you’re waiting for your child's evaluation, you may want to download Autism Speaks First Concern to Action Tool Kit. (Follow the link for a free download.) Also see, "Five Things to Do While Waiting for an Evaluation."

Thanks again for your question. Best wishes to you and your child.

Got more questions? Send them to GotQuestions@autismspeaks.org. 
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