Your child will develop so quickly in the first few years of their life. But, if you are worried that your child’s development is not on track for their age, it is important to talk with their pediatrician. If autism spectrum disorder (ASD) is mentioned as a possible reason for developmental delays, ask your pediatrician about options for getting a diagnostic evaluation.
Support While You Wait
Unfortunately, many autism specific clinics are overwhelmed and have a long waiting list for evaluations. While you wait, here are some steps you can take to help support your child in the meantime:
- State programs to support development:
- If your child is under 3 years old: ask about a referral to your state’s Early Intervention (EI) program.
- If your child is 3 years or older: your school district can likely evaluate and enroll your child in their special education services.
- If your child is between 3 and 5 years old: they could be eligible to attend a developmental preschool program for children who require more support. Contact your local school district for more information.
- Outpatient therapy: your child’s pediatrician can prescribe medically necessary therapy to support development of important skills.
- Speech therapy – to learn communication skills
- Occupational therapy – to learn self-help skills
- Hearing screening: typically, your child’s hearing will be checked at each annual wellness visit. If you’re unsure, ask their pediatrician. If their screening came back abnormal, your pediatrician can refer you to a specialist such as an ENT or audiologist to check your child’s hearing.
- Engage in daily play: engage in play that your child is interested in to connect with them daily. Choose activities, objects, or people that interest your child. Additionally, consider finding a local preschool, daycare, or play group with children their age for them to be around. Children learn important life skills such as communication and self-regulation from being around other children. Just a few hours per week can make a huge positive impact!
- Educate yourself: use trusted sources to learn about autism and child development. While most children follow a similar path of learning and development, each child is different and it is important to learn about your child and what specific things they need to thrive. Look into books, podcasts, or even talking with other parents to explore the world of autism. Learning about your child’s condition and development can help you better understand them and how you can best assist them.
The Evaluation
Your pediatrician has resources and can help you decide the best place for your child to be assessed for autism. Evaluations typically involve detailed questions about your child’s health and development as well as observations of your child playing and interacting with their surroundings and other people. This is typically done by a team of professionals like psychologists, speech therapists, occupational therapists, and physicians.
The end goal of this evaluation is to understand your child and their specific needs better. To best accomplish this, you can share details like how you see your child play, interact, and communicate. You may even include input from others who interact with your child regularly such as grandparents, teachers, neighbors, and others who spend a lot of time with your child.
Some evaluations happen in one day, while others may divide the evaluation across several appointments. Your pediatrician will be familiar with the specialist they are sending you to and can answer questions you may have about what to expect.
A diagnosis is reached using all of the information gathered about your child. After the evaluation, your child will be compared to the criteria for autism along with other developmental delays and diagnoses. If your child meets the criteria, they will receive an autism diagnosis.
Other Conditions
Using the findings from your child’s medical history and physical examination, laboratory tests may be ordered to test for other possible medical or genetic conditions that could cause autism-like symptoms. If your pediatrician deems these tests appropriate for your child’s situation, they may refer you to another specialist such as a geneticist or neurologist.
Tests may include:
- Genetic testing – genetic testing, such as chromosomal microarray testing, is recommended to help identify potential reasons why your child might have ASD. Currently, up to 42% of children with ASD have a genetic abnormality that is indefinable through this genetic testing.
- Lead testing – lead testing is done regularly at certain annual wellness visits and is especially important when a child lives in a higher risk environment such as an older building or continuously put things in their mouths.
- Other tests – using the child’s medical history and physical examination, other tests such as an electroencephalograph (EEG), magnetic resonance image (MRI), or tests for metabolic disorders may be ordered. Children with ASD tend to be picky eaters, so your pediatrician may also recommend testing for evidence of an iron or vitamin deficiencies (especially vitamin D).
Tests not recommended:
Clinical evidence does not recommend any of the following tests specifically for ASD –
- Hair analysis
- Routine measurement of multiple vitamin or nutrient levels
- Intestinal permeability studies
- Stool analysis
- Urinary peptide analysis
- Measurement of mercury or other heavy metals
After the Diagnosis
- Read the evaluation report: ensure you receive a copy of the report. Usually these reports include a section with recommendations specific for your child. Discuss these recommendations with your pediatrician. They can guide you to the right resources and referrals to help your child.
- Look into additional evaluations, treatments, and support: there are other health issues that may be connected to your child’s ASD such as sleep, nutrition and gastrointestinal (feeding problems, abdominal pain, constipation, diarrhea), and behavioral health (anxiety, ADHD, irritability, and aggression). These may need additional referrals and plans to treat.
- Reflect: being diagnosed with autism does not change who your child is and, in fact, adds helpful information about how your child processes things around them. This can help you better understand your child, provide support when needed, and guide your child to their best potential!
Remember
If you ever have questions about your child’s growth, behavior, or development, don’t hesitate to discuss it with their pediatrician. Your child’s provider is always there to help!