Expert: James Michael Roan - 9/4/2008

Question
Hi James.

I have a son who will be 3 in Nov.  He is different than my previous 3 children were at his age. I think he is showing many signs of autism BUT at the same time he is progressing but at a slow pace. My question is, how does one determine if the child is actually autistic and where do I go to get  an accurate diagnosis? I know the pediatrician is a start, but not the person to diagnose this.

thanks much.

Answer
Hi Bella;

The best way to approach this is for you to complete the M-CHAT and score it. If there is any risk noted for autism, we can take it from there. You can also use it to defend your need, or not, for a full evaluation by a team of autism professionals. Your pediatrician will recognize the universally accepted M-CHAT and use its results as a basis for a referral to a team of professionals. The M-CHAT is a screener for children "at-ris" of autism and is not a "test" for autism.

M-CHAT: http://www.utmem.edu/pediatrics/general/clinical/m-chat.pdf

Scoring: http://psychlops.psy.uconn.edu/ED/downloads/M-CHATscoring.pdf

If you live in the U.S., you can find a Children's Hospital with an autism team or a local university. Also, psychologists specializing in autism can assess as well. Please remember, that a diagnosis by itself is virtually useless. You want the psych or team to assess all areas associated with an autism spectrum disorder: IQ, executive functions (including attention), receptive and expressive language including nonverbal communication (gestures, etc.), social communication, social development, social /emotional development, autism-specific instruments (ADOS, ADI-R, GARS, etc.), adaptive behavior, and sensory processing.

If you live in the U.S., while you are waiting for an evaluation, call the special education department at the school district in which you live and make a referral for an evaluation. If he qualifies, he will receive communication and other interventions services for which he qualifies. This assessment and services are at school district expense.

Here are some red flags for autism. Use these to support your need for a full evaluation:

6-12 Month Markers:

•   Infrequent eye contact
•   Failure to orient to name
•   Does not smile in response to smiles from others
•   Social and emotional passivity
•   Fixation on objects

By 12 Months:

•   Poor or no eye contact
•   Failure to orient to name
•   Poor imitation
•   No babbling by 12 months
•   No gesturing by 12 months

By 16 Months:

•   No single words by 16 months
•   No pointing to objects or events of interest in an effort to share

By 24 Months:

•   No spontaneous two-word phrases
•   Loss of any language or social skills at any age

Kind regards,
James