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Tests and diagnosis
By Mayo Clinic staffYour child's doctor will look for signs of developmental delays at regular checkups. If your child shows some signs of autism, you may be referred to a specialist who treats children with autism. This specialist, working with a team of professionals, can perform a formal evaluation.
Because autism varies widely in severity, making a diagnosis may be difficult. There isn't a specific medical test to determine the disorder. Instead, an autism specialist may:
- Observe your child and ask how your child's social skills, language skills and behavior have developed and changed over time
- Give your child developmental tests covering speech, language, developmental level, and social and behavioral issues
- Present structured social and communication interactions to your child and score the performance
Signs of autism often appear early in development when there are obvious delays in language skills and social interactions. Diagnosis is usually made before age 3. Early diagnosis and intervention is most helpful and can improve skill and language development.
Diagnostic criteria for autism
For your child to be diagnosed with autism, he or she must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.
To be diagnosed with autism, your child must have six or more of the following symptoms, and two or more of those symptoms must fall under the social skills category.
Social skills
- Has difficulty with nonverbal behaviors, such as making eye contact, making facial expressions or using gestures
- Has difficulty forming friendships with peers and seems to prefer playing alone
- Doesn't share experiences or emotions with other people, such as sharing achievements or pointing out objects or other interests
- Appears unaware of others' feelings
Communication skills
- Doesn't speak or has delayed speech and doesn't make an attempt to communicate with gestures or miming
- Can't start a conversation or keep one going
- May repeat words or phrases verbatim, but doesn't understand how to use them
- Doesn't play make-believe or doesn't imitate the behavior of adults when playing
Behavior
- Develops interests in objects or topics that are abnormal in intensity, detail or focus
- Performs repetitive movements, such as rocking, spinning or hand-flapping
- Becomes disturbed at the slightest change in routines or rituals
- May be fascinated by parts of an object, such as the spinning wheels of a toy car
- Autism overview: What are some of the possible signs of autism? Eunice Kennedy Shriver National Institute of Child Health & Human Development. http://www.nichd.nih.gov/publications/pubs/autism/overview/signsOfAutism.cfm. Accessed Aug. 3, 2012.
- Autism fact sheet. National Autism Association. http://nationalautismassociation.org/resources/autism-fact-sheet/. Accessed Aug. 3, 2012.
- LaBlanc LS, et al. Behavioral interventions for children with autism spectrum disorders. Pediatric Clinics of North America. 2012;59:147.
- Autistic disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Aug. 3, 2012.
- Huffman LC, et al. Management of symptoms in children with autism spectrum disorders: A comprehensive review of pharmacologic and complementary-alternative medicine treatment. Journal of Developmental & Behavioral Pediatrics. 2011;32:56.
- Learn the signs — Act early. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/actearly/concerned.html. Accessed Aug. 3, 2012.
- James S, et al. Omega-3 fatty acids supplementation for autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007992.pub2/abstract. Accessed July 2, 2012.
- A parent's guide to autism spectrum disorder. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/a-parents-guide-to-autism-spectrum-disorder/what-are-the-symptoms-of-asd.shtml. Accessed Aug. 3, 2012.
- Augustyn M. Terminology, epidemiology, and pathogenesis of autism spectrum disorders. http://www.uptodate.com/index. Accessed Aug. 3, 2012.
- AskMayoExpert. What advice can a primary care provider give to parents who inquire about autism spectrum disorder (ASD) treatments that have no scientific evidence of efficacy and may be harmful. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Cheuk DKL, et al. Acupuncture for autism spectrum disorders (ASD). Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007992.pub2/abstract. Accessed July 2, 2012.
- American Academy of Pediatrics policy statement. Sensory integration therapies for children with developmental and behavioral disorders. Pediatrics. 2012;129:1186.
- Autism spectrum disorders (ASDs). Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/autism/topics.html. Accessed Aug. 3, 2012.
- Autism fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/autism/detail_autism.htm. Accessed Aug. 3, 2012.
- Whiteside SP (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 18, 2012.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 19, 2012.
- Chelation: Therapy or "therapy"? National Capital Poison Center. http://www.poison.org/current/chelation%20therapy.htm. Accessed Sept. 20, 2012.
- Antshel KM, et al. Advances in understanding and treating ADHD. BMC Medicine. 2011;9:72.
- Filipek PA, et al. Reaffirmed 2010. Practice parameter: Screening and diagnosis of autism. Neurology. 2000;55:468.
- Schultz MG (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 21, 2012.
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