|   Find a Doctor   |   Getting to NUH   |   Appointments   |   Contact Us   |   Newsroom   |   About NUH   |   Make a Gift

Home > Events & Health Information > Diseases & Conditions > Learning & Behavioural Problems > Autism > Frequently Asked Questions About Autism Assessment

Frequently Asked Questions About Autism Assessment

1. What is Autism or Autism Spectrum Disorder (ASD)?

2. Why does the doctor refer my child for an autism assessment?

3. At what age can autism be diagnosed?

4. How is the diagnosis of autism made? Are there any special tests the doctor can do to determine whether my child is autistic?

5. What are the tests that the paediatricians and specialists will use in the diagnosis of ASD?

6. How is a typical autism assessment like?

7. What can I do to prepare for the autism assessment session?

8. Why is it important to make the diagnosis? Can I wait till my child is much older?

 

 

1. What is Autism or Autism Spectrum Disorder (ASD)?

Autism is a neuro-developmental disorder where a child has difficulties in social interaction, reciprocal communication and a markedly restricted repertoire of activity and interests. These may be present in varying severity.

 

Back to top

 

2. Why does the doctor refer my child for an autism assessment?

The doctor may refer your child if he or she:

  • Has difficulty mixing and playing interactively with same-aged peers.
  • Has delayed speech and is also not using non-verbal communication, e.g. gestures, pointing, eye contact.
  • Has some unusual interests (e.g. interest in car logos), unusual behaviours (e.g. hand flapping, spinning body) and fixed routines and rituals.
  • If your child has difficulty in imaginative play or plays with toys in unusual manner, e.g. more interested in spinning wheels of the cars or lining up cars.

 

Please note that these are just some common behaviours and this list is not exhaustive.

 

Back to top

 

3. At what age can autism be diagnosed?

Although some children show autistic features in early infancy, it can be difficult to give a definitive diagnosis of autism before 2 to 2.5 years old.

 

In addition, some behaviours associated with autism are also frequently found in children who have developmental delay. This may make it difficult to distinguish between the two conditions in very young children. However, many children with autism can be screened for the disorder from as young as 18 months. Your doctor will determine the most suitable age for diagnosis based on the developmental status of the child.

 

Back to top

 

4. How is the diagnosis of autism made? Are there any special tests the doctor can do to determine whether my child is autistic?

At present, there are no diagnostic tests for ASD, unlike certain medical conditions where a blood test or X-ray may provide exact results.

 

Instead, the diagnosis is based on a detailed developmental history and observation of the child’s behaviours. However, autism can co-exist with certain medical conditions and your doctor may recommend blood tests, genetic tests or brain scans to rule out the presence of these other conditions.

 

Back to top

 

5. What are the tests that the paediatricians and specialists will use in the diagnosis of ASD?

A detailed medical and developmental history from the parents is obtained by the paediatrician.

 

Behavioural observations and developmental screens are also performed in the clinic. The doctor may also give out questionnaires to parents and teachers to ascertain if the child has difficulties at home or in school that may be related to autism. A physical examination will also be performed to exclude other co-existing medical conditions.

 

Next, psychological testing will involve tools developed specifically for diagnosing ASD. These include the Autism Diagnosis Interview-Revised (ADI-R), the Autism Diagnostic Observation Schedule (ADOS), Child Autism Rating Scale (CARS) and Developmental, Dimensional and Diagnostic Interview (3DI).

 

The ADI-R is a standardised, semi-structured clinical interview for caregivers. The interview can take up to 3 hours and it focuses on behaviours in three areas: quality of social interaction, communication and language, and repetitive, restricted and stereotyped interests and behaviour.

 

The ADOS is a semi-structured assessment of communication, social interaction and play or imaginative use of materials for children suspected of having ASD. The ADOS requires a 30 to 45 minutes observation period of the child’s behaviour and interaction.

 

CARS aids in evaluating the child’s body movements, adaptation to change, listening response, verbal communication and relationship to people. It is suitable for use with children over 2 years of age. The examiner observes the child and also obtains relevant information from the parents.

 

3DI is a semi-structured parent interview designed to facilitate the evaluation of suspected ASD.

 

In addition, testing of the child’s cognitive skills may be necessary and can be assessed with the Vineland Adaptive Behaviour Scales 2nd Edition (VABS-II) for younger children and standardised IQ testing for older children.

 

Back to top

 

6. How is a typical autism assessment like?

A typical autism assessment will take at least 2 hours.

 

These assessments will include a combination of detailed parental interviews and child observations using the tools mentioned above. These are usually scheduled to be completed within a day. However, depending on the child’s cooperation, interviews and observations may be scheduled on different visits. Generally, for children less than 5 years old, two assessment sessions will be booked. For children more than 5 years old, three assessment sessions will be booked.

 

Back to top

 

7. What can I do to prepare for the autism assessment session?

You can do the following:

  • Try to schedule the autism assessment to take place when your child is at his best. If your child needs to take an afternoon nap, then don’t schedule the session in the afternoon.
  • Allow the child to have plenty of rest the night before as well as a good breakfast on the day of the test.
  • Note your child’s developmental milestones (e.g. age of walking, first single words, etc.) and any unusual behaviours (e.g. spinning body, lining up objects, etc.) and how long these behaviours have lasted. All these information will be useful during the parental interview.

 

Back to top

 

8. Why is it important to make the diagnosis? Can I wait till my child is much older?

It is important to identify children with possible ASD early so that they can receive appropriate intervention and support services. Research indicates that early intervention can improve children’s developmental outcomes, including improved language, cognitive, social and motor skills.

 

The earlier a diagnosis is made, the sooner the child can participate in early intervention programmes that are specifically designed for ASD.

 

There are situations where a diagnosis may also be helpful for schoolgoing children. For example, a diagnosis allows support of the Special Needs Officer (SNO) in mainstream schools or when seeking examination accommodation.

 

Back to top

 

Our Team

We have a team of paediatricians specialising in developmental and behavioural paediatrics, psychologists, occupational therapists, speech therapists, physiotherapists, learning support educators, nurses and social workers committed to providing holistic care for children with developmental, learning and behavioural difficulties.

 

Click here to find out more about our Division of Developmental and Behavioural Paediatrics.

 


The information provided on this page is meant purely for educational purposes and may not be used as a substitute for medical diagnosis or treatment. You should seek the advice of your doctor or a qualified healthcare provider before starting any treatment or if you have any questions related to your child’s health, physical fitness or medical conditions.