Autism Spectrum Disorder, or ASD, is a neurodevelopmental diagnosis.
The word spectrum is important because autism can look very different from one person to another. Two children may both meet criteria for autism while having very different language abilities, intellectual abilities, interests, behaviors, and support needs.
What defines Autism Spectrum Disorder?
Current diagnostic criteria focus on two major areas.
The first involves persistent differences in social communication and social interaction. These may involve social-emotional reciprocity, understanding or using nonverbal communication, and developing or navigating relationships.
The second involves restricted or repetitive patterns of behavior, interests, or activities. These may include repetitive movements or language, strong preferences for routines, highly focused interests, difficulty adjusting to change, or unusual sensitivity or reduced sensitivity to sensory input.
For an ASD diagnosis, the diagnostic pattern includes difficulties across the required social-communication areas together with sufficient evidence of restricted or repetitive behaviors.
Autism is more than eye contact
Parents sometimes expect autism to have one recognizable appearance.
It does not.
A child with autism may make eye contact. A child with autism may be affectionate. A child with autism may speak in complete sentences, have friends, earn excellent grades, or show strong intellectual abilities.
The diagnosis is based on the overall developmental pattern, not one isolated behavior.
Likewise, limited eye contact by itself is not enough to diagnose autism.
What do Level 1, Level 2, and Level 3 mean?
Autism diagnoses may include a level describing the amount of support needed.
Level 1: Requiring support
Level 2: Requiring substantial support
Level 3: Requiring very substantial support
These levels are intended to describe support needs related to the core autism symptoms. They are not IQ levels, and they are not a prediction of what a child will or will not accomplish.
Support needs can also look different across areas and can change as a child develops.
How is autism diagnosed?
There is no blood test, brain scan, genetic test, questionnaire, or single behavioral test that independently diagnoses autism.
A comprehensive diagnostic evaluation considers the child’s developmental history, caregiver information, direct behavioral observation, social communication, repetitive or restricted behaviors, adaptive functioning, language, cognition when appropriate, and other possible explanations for the symptoms.
Standardized instruments can provide valuable information, but no single instrument should be used as the sole basis for an ASD diagnosis.
Can autism occur with other diagnoses?
Yes.
Autism can occur together with ADHD, anxiety disorders, language disorders, intellectual disability, learning disorders, motor difficulties, sleep concerns, and other developmental or medical conditions.
Identifying these separately can be important because not every difficulty experienced by an autistic child is automatically explained by autism.
What happened to Asperger’s Disorder?
Under current DSM diagnostic terminology, Asperger’s Disorder is no longer a separate diagnosis. Individuals who meet current criteria receive the diagnosis of Autism Spectrum Disorder, with appropriate descriptions of language, intellectual functioning, and support needs.
A diagnosis of autism should help families better understand a child’s developmental profile not reduce the child to a label.
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