DSM-IV Criteria for a Diagnosis of Autism
Frequently Asked Questions About The Diagnosis of Autism

How is Autism Diagnosed?

Presently, there is not a medical test for autism; a diagnosis is based on observed behavior and educational and psychological testing.

As the symptoms of autism vary, so do the routes to obtaining a diagnosis. A parent may have raised questions with a pediatrician. Some children are identified as having developmental delays before obtaining a diagnosis of autism and may already receive some

Unfortunately, parents' concerns are sometimes not taken seriously by their doctor and a diagnosis is delayed. Autism Speaks and other autism related organizations are working hard to educate parents and physicians so that children with autism are identified as early as possible. From birth to at least 36 months of age, every child should be screened for developmental milestones during routine well visits. If concerns about a child's development are raised, their doctor should refer the child to Early Intervention and a specialist for a developmental evaluation. Hearing and lead exposure screenings should be performed and an autism-specific screening tool, such as the Modified Checklist of Autism in Toddlers (MCHAT) should be used.

The MCHAT, is a list of simple questions about your child. The answers determine whether he or she should be referred to a specialist, usually a Developmental Pediatrician, a Neurologist, a Psychiatrist or a Psychologist, for further evaluation.

There are other screening tools available, some geared towards older children or specific Autism Spectrum Disorders.

Your child may have been diagnosed by one of the professionals mentioned above. In some cases, a team of specialists may have evaluated your child and provided recommendations for treatment. The team may have included an Audiologist, to rule out hearing loss, a Speech & Language Therapist, to determine language skills and needs, and an Occupational Therapist to evaluate physical and motor skills. If this was not the case for your child, you will want to make sure further evaluations are conducted so that you can learn as much as possible about your child's strengths and needs.

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DSM-IV criteria for a diagnosis of Autism

I. A total of six (or more) items from heading (A), (B), and (C), with at least two from (A), and one each from (B) and (C):

(A) Qualitative impairment in social interaction, as manifested by at least two of the following:

• Marked impairments in the use of multiple nonverbal behaviors such as eye-to- eye gaze, facial expression, body posture, and gestures to regulate social interaction.
• Failure to develop peer relationships appropriate to developmental level.
• A lack of spontaneous seeking to share enjoyment, interests, or achievements with other people, (e.g., by a lack of showing, bringing, or pointing out objects of interest to other people).
• A lack of social or emotional reciprocity.

(B) Qualitative impairments in communication as manifested by at least one of the following:

• Delay in or total lack of, the development of spoken language (not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime).
• In individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others.
• Stereotyped and repetitive use of language or idiosyncratic language.
• Lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.

(C) Restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least two of the following:

• Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus.
• Apparently inflexible adherence to specific, nonfunctional routines or rituals.
• Stereotyped and repetitive motor mannerisms (e.g. Hand or finger flapping or twisting, or complex whole-body movements).
• Persistent preoccupation with parts of objects.

II. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:

(A) Social interaction.
(B) Language is used in social communication.
(C) Symbolic or imaginative play.

III. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder. Source: Diagnostic and Statistical Manual of Mental Disorders; Fourth Edition

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Frequently Asked Questions About The Diagnosis of Autism

Catherine Lord, Director of the University of Michigan Autism and Communication Disorders Center, answers questions about Autism Spectrum diagnoses.
Click here for the PDF file.