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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 in treating children with autism. This specialist, working with a team of professionals, can perform a formal evaluation for the disorder.
Because autism varies widely in severity, making a diagnosis may be difficult. There isn't a specific medical test to pinpoint the disorder. Instead, an autism specialist will observe your child and talk to you about how your child's social skills, language skills and behavior have developed and changed over time. To help reach a diagnosis, your child may undergo a number of developmental tests covering speech, language and psychological issues.
Although the signs of autism often appear by 18 months, the diagnosis sometimes isn't made until age 2 or 3, when there may be more obvious delays in language development and social interactions. Early diagnosis is important because early intervention — preferably before age 3 — appears to be the most helpful.
Diagnostic criteria for autism
For your child to be diagnosed with autism, he or she must meet the symptom criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and 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
- Starts talking later than age 2 and has other developmental delays by 30 months, 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 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
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- Golnik AE, et al. Complementary alternative medicine for children with autism: A physician survey. Journal of Autism and Developmental Disorders. 2009;39:996.
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- If you're concerned — Act early. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/actearly/concerned.html. Accessed April 8, 2010.
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