The testing tools, observations of their play style, and interviews with parents or teachers are used to determine whether a child’s traits meet the diagnostic criteria ofautism spectrum disorder (ASD). These criteria are outlined in the American Psychiatric Association’s “Diagnostic and Statistical Manual for Mental Disorders” (DSM-5).
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Identifying Autism Traits
Autism traits are broadly categorized as either being social (how the person interacts and communicates both verbally and non-verbally) or behavioral, meaning how the person behaves in relation toneurotypicalnorms associated with their peers.
Social Traits
Social characteristics of autism commonly recognized in children include:
Behavioral Traits
Behavioral traits commonly recognized in autistic children include:
Can Autism Go Undetected?Autism is frequently diagnosed in children but often undetected for years in adults. This may be because they have low support needs or have simply learned to compensate for their disabilities over time. Despite being able to cope, people with undiagnosed autism are at greater risk of depression, anxiety, and isolation.
Can Autism Go Undetected?
Autism is frequently diagnosed in children but often undetected for years in adults. This may be because they have low support needs or have simply learned to compensate for their disabilities over time. Despite being able to cope, people with undiagnosed autism are at greater risk of depression, anxiety, and isolation.
Common Tests Used to Diagnose Autism
The diagnosis may involve watching the child in a structured environment, asking the parents or caregivers a battery of questions, or providing them with a series of questionnaires.
Autism Diagnostic Interview-Revised (ADI-R)
TheAutism Diagnostic Interview-Revised (ADI-R)is a structured interview with parents or caregivers to help differentiate autism from other possible causes. Intended for children who are at least 2 years old, it is considered a “gold standard” diagnostic test.
The interview takes 90 to 150 minutes to complete and involves questions that assess the child’s current and past behaviors. These include questions on communication skills, social interactions, play behaviors, and repetitive behaviors.
The ADI-R is widely accepted as a reliable diagnostic tool for autism when used in conjunction with other evaluative tests.
Social Communication Questionnaire (SCQ)
The Social Communication Questionnaire (SCQ) is a screening companion to the ADI-R. It takes around 10 minutes to complete and asks parents or caregivers questions about the child’s behavior over both the past three months and their lifetime.
In total, 40 questions are asked, each requiring a simple “yes” or “no” response. Unusual behaviors are assigned a score of 1. A total score of 15 or more suggests a higher probability of autism (although scores of 11 or above may warrant further evaluation).
As with the ADI-R, the SCQ assesses the child’s social interactions and communication skills, while establishing if there are any repetitive behaviors commonly seen with autism.
In some cases, the SCQ is used to determine whether the ADI-R is needed. At other times, the tests are performed at the same time to see if the results concur.
Modified Checklist of Autism in Toddlers, Revised (M-CHAT-R)
The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is designed specifically for children between 16 months and 30 months of age.It is a well-studied autism evaluation tool and often the first test given to determine whether further evaluation is needed.
For the M-CHAT-R, parents or caregivers are asked 20 questions about their child’s behavior, including whether the child pretends or engages in pretend play, and whether the child points to an object when interested or encouraged to do so.
The test takes around 10 to 15 minutes to complete. Based on the responses, the M-CHAT-R can determine if a child is at risk of autism or needs further evaluation.
Screening Tool for Autism in Toddlers & Young Children (STAT)
The Screening Tool for Autism in Toddlers & Young Children (STAT) is an interactive test used to screen for autism in children between 24 months and 36 months of age.
The STAT is a play-based test consisting of 12 different activities. It evaluates how a child interacts and communicates, including their ability to imitate or request and direct attention. A ball, truck, doll, bubbles, and balloons are among the tools used for the test.
The evaluator rates each activity as either “pass,” fail," or “refused.” The total score ranges from 0 (indicating a low risk of autism) to 4 (indicating a high risk of autism). A score of 2 or above warrants further evaluation.
There are many reliable tests used for autism diagnosis. You may encounter the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) or the Childhood Autism Rating Scale, Second Edition (CARS-2), in addition to the M-CHAT-R or ADI-R.Talk with your healthcare provider to ensure you understand the evaluation tool and how the results will be interpreted.
Differential Diagnoses
Autism is difficult to diagnose because there are many other conditions with symptoms similar to autism traits. Some are developmental, while others may be neurological (related to the brain and nervous system), psychiatric (related to a mental illness), or pathological (related to a disease).
To ensure a reliable diagnosis, all other possible causes must be excluded, some of which may include:
These are only some of the conditions that may be explored in thedifferential diagnosis. As a result, it can often take time to reach a definitive diagnosis, particularly if the results of the autism tests are borderline.
Summary
Autism is diagnosed based on a battery of tests that evaluate a child’s behaviors, social interactions, and communication skills. Tests such as the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) may involve interviews or questionnaires with parents or caregivers, and/or play-based activities with toddlers and children suspected of having autism.
A parent’s recognition of autism traits is key to an early diagnosis. Contact a healthcare provider trained and qualified in the diagnosis and treatment of autism for evaluation. Clinical psychologists, developmental pediatricians, and pediatric neurologists are usually trained to administer tests in children.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Screening for Autism Spectrum Disorder.Centers for Disease Control and Prevention.Signs and symptoms of autism spectrum disorder.Hodges H, Fealko C, Soares N, et al.Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation.Transl Pediatr.2020 Feb;9(Suppl 1):S55–65. doi:10.21037/tp.2019.09.09Hyman SL, Levy SE, Myers SM; COUNCIL ON CHILDREN WITH DISABILITIES, SECTION ON DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS.Identification, Evaluation, and Management of Children With Autism Spectrum Disorder.Pediatrics. 2020 Jan;145(1):e20193447. doi:10.1542/peds.2019-344Children’s Hospital of Philadelphia.Autism Diagnostic Interview - Revised (ADI-R).Randall M, Egberts KJ, Samtani A, et al.Diagnostic tests for autism spectrum disorder (ASD) in preschool children.Cochrane Database Syst Rev. 2018;7(7):CD009044. doi:10.1002/14651858.CD009044.pub2Chesnut SR, Wei T, Barnard-Brak L, Richman DM.A meta-analysis of the social communication questionnaire: screening for autism spectrum disorder.Autism.2017;21:920-8. doi:10.1177/1362361316660065Thabtah F, Peebles D.Early autism screening: a comprehensive review.Int J Environ Res Public Health.2019 Sep;16(18):3502. doi:10.3390/ijerph16183502New York University Langone Health.Diagnosing Autism Spectrum Disorder in Children.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Screening for Autism Spectrum Disorder.Centers for Disease Control and Prevention.Signs and symptoms of autism spectrum disorder.Hodges H, Fealko C, Soares N, et al.Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation.Transl Pediatr.2020 Feb;9(Suppl 1):S55–65. doi:10.21037/tp.2019.09.09Hyman SL, Levy SE, Myers SM; COUNCIL ON CHILDREN WITH DISABILITIES, SECTION ON DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS.Identification, Evaluation, and Management of Children With Autism Spectrum Disorder.Pediatrics. 2020 Jan;145(1):e20193447. doi:10.1542/peds.2019-344Children’s Hospital of Philadelphia.Autism Diagnostic Interview - Revised (ADI-R).Randall M, Egberts KJ, Samtani A, et al.Diagnostic tests for autism spectrum disorder (ASD) in preschool children.Cochrane Database Syst Rev. 2018;7(7):CD009044. doi:10.1002/14651858.CD009044.pub2Chesnut SR, Wei T, Barnard-Brak L, Richman DM.A meta-analysis of the social communication questionnaire: screening for autism spectrum disorder.Autism.2017;21:920-8. doi:10.1177/1362361316660065Thabtah F, Peebles D.Early autism screening: a comprehensive review.Int J Environ Res Public Health.2019 Sep;16(18):3502. doi:10.3390/ijerph16183502New York University Langone Health.Diagnosing Autism Spectrum Disorder in Children.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Screening for Autism Spectrum Disorder.Centers for Disease Control and Prevention.Signs and symptoms of autism spectrum disorder.Hodges H, Fealko C, Soares N, et al.Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation.Transl Pediatr.2020 Feb;9(Suppl 1):S55–65. doi:10.21037/tp.2019.09.09Hyman SL, Levy SE, Myers SM; COUNCIL ON CHILDREN WITH DISABILITIES, SECTION ON DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS.Identification, Evaluation, and Management of Children With Autism Spectrum Disorder.Pediatrics. 2020 Jan;145(1):e20193447. doi:10.1542/peds.2019-344Children’s Hospital of Philadelphia.Autism Diagnostic Interview - Revised (ADI-R).Randall M, Egberts KJ, Samtani A, et al.Diagnostic tests for autism spectrum disorder (ASD) in preschool children.Cochrane Database Syst Rev. 2018;7(7):CD009044. doi:10.1002/14651858.CD009044.pub2Chesnut SR, Wei T, Barnard-Brak L, Richman DM.A meta-analysis of the social communication questionnaire: screening for autism spectrum disorder.Autism.2017;21:920-8. doi:10.1177/1362361316660065Thabtah F, Peebles D.Early autism screening: a comprehensive review.Int J Environ Res Public Health.2019 Sep;16(18):3502. doi:10.3390/ijerph16183502New York University Langone Health.Diagnosing Autism Spectrum Disorder in Children.
Centers for Disease Control and Prevention.Screening for Autism Spectrum Disorder.
Centers for Disease Control and Prevention.Signs and symptoms of autism spectrum disorder.
Hodges H, Fealko C, Soares N, et al.Autism spectrum disorder: definition, epidemiology, causes, and clinical evaluation.Transl Pediatr.2020 Feb;9(Suppl 1):S55–65. doi:10.21037/tp.2019.09.09
Hyman SL, Levy SE, Myers SM; COUNCIL ON CHILDREN WITH DISABILITIES, SECTION ON DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS.Identification, Evaluation, and Management of Children With Autism Spectrum Disorder.Pediatrics. 2020 Jan;145(1):e20193447. doi:10.1542/peds.2019-344
Children’s Hospital of Philadelphia.Autism Diagnostic Interview - Revised (ADI-R).
Randall M, Egberts KJ, Samtani A, et al.Diagnostic tests for autism spectrum disorder (ASD) in preschool children.Cochrane Database Syst Rev. 2018;7(7):CD009044. doi:10.1002/14651858.CD009044.pub2
Chesnut SR, Wei T, Barnard-Brak L, Richman DM.A meta-analysis of the social communication questionnaire: screening for autism spectrum disorder.Autism.2017;21:920-8. doi:10.1177/1362361316660065
Thabtah F, Peebles D.Early autism screening: a comprehensive review.Int J Environ Res Public Health.2019 Sep;16(18):3502. doi:10.3390/ijerph16183502
New York University Langone Health.Diagnosing Autism Spectrum Disorder in Children.
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