Administration of Tests

According to the American Academy of Pediatrics (AAP), every child should be screened for autism during regular visits to a pediatrician. Through regular testing, a child with autism can be identified in the early years. There are a number of developmental screening tools, such as the Modified Checklist for Autism in Toddlers (M-CHAT) and the Ages and Stages Questionnaire, that help to evaluate a child’s behavior.

If autism is diagnosed at an early stage and effective intervention is implemented, the child will be able to develop to his or her maximum potential. If a developmental disorder or delay is observed in a child, more tests will be conducted to confirm that the symptoms are due to Autism Spectrum Disorder (ASD) and not any other medical condition similar to autism, such as a language delay, a hearing loss or an intellectual disability. If the child’s doctor is not specifically trained or experienced in developmental disorders, the doctor will refer the child to a specialist, for example, a speech therapist or child psychiatrist.

Behavioral Tests

There are many types of strategies and questionnaires that will help a doctor to identify the particular kind of developmental delay a child is experiencing. These include:

Medical History

The parents are interviewed to establish the child’s medical history.  Parents are asked about the child’s development, such as gesturing abilities, speech skills, and so forth. For instance, a small child with ASD may be capable of pointing at things he or she wants; however, the child probably will not make sure that the parent is also looking at that thing to which they are pointing.

Autism Diagnostic Guidelines

Autism diagnostic guidelines have been established by the American Academy of Child and Adolescent Psychiatry (AACAP). Doctors use the guidelines to assess behaviors that are associated with various conditions in the autism spectrum. The guidelines are designed for children who are age three years and older.

Other Behavioral Questionnaires

Besides the diagnostic guidelines of the AACAP, there are numerous other diagnostic questionnaires that focus on the behavior of children below the age of three.

Clinical Observations

A child who has developmental delays is observed by the doctor in different settings. The doctor will ask the parents if some behaviors of the child are common in those situations.

Developmental and Intelligence Tests

The AACAP also recommends tests that determine if the child’s thinking and decision-making abilities are affected by developmental delays.

Physical Examinations and Lab Tests

These tests are performed to find out if there is a physical ailment that may be causing the symptoms in a child. The tests are as follows:

Physical Examination

The child’s height, weight, and head circumference are measured to check the child’s growth pattern.

Auditory Tests

Auditory function tests determine whether hearing disabilities are causing delays in the development of the child’s social and language skills.

Lead Poisoning Tests

Pica is a condition in which a child may crave non-edible substances such as dirt. A child with developmental delays may continue eating and putting non-edible things in his or her mouth even after other children have outgrown it. This can lead to lead poisoning, which affects brain development.

Genetic Testing

For a child diagnosed with autism, doctors today usually recommend chromosomal microarray, which finds small missing or extra pieces of the chromosomes, and a DNA test for fragile X syndrome, a common inherited cause of intellectual disability (American College of Medical Genetics and Genomics, 2013). These tests are offered whether or not anyone else in the family has a disability.

Electroencephalograph (EEG)

If a child experiences seizures or shows symptoms of developmental regression, an EEG test is warranted.

Magnetic Resonance Imaging (MRI)

An MRI may be performed to examine the physical structures of the brain for abnormalities or damage.

References: Chris Plouche' Johnson, MD, MEd and Scott M. Myers, MD. (2007). "Identification and Evaluation of Children with Autism Spectrum Disorders". Elk Grove Village, IL: American Academy of Pediatrics.
Schaefer, G. B., & Mendelsohn, N. J. (2013). Clinical genetics evaluation in identifying the etiology of autism spectrum disorders: 2013 guideline revisions. Genetics in Medicine, 15(5), 399–407.

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