Autism Spectrum Disorder (ASD)
ASD is not diagnosed through medical tests. An accurate diagnosis is made by a team of multidisciplinary professionals and is based on the observation of an individual’s communication, behavior, and developmental levels. However, because ASD shares behavioral characteristics with other disorders, medical tests may be ordered to rule out other possible causes for the symptoms being exhibited.
A brief observation in a single setting cannot present a true picture of an individual’s abilities and behaviors. Input from parents and other caregivers, plus the individual’s developmental history, are very important components of making an accurate diagnosis. Listed below are resources that might be useful in reaching a diagnosis. Our Autism Resource Specialists can help direct and guide families in requesting a diagnosis as well as connect them to additional options.
For children ages 3-5:
Contact Preschool Services in your county to be directed to the program that can evaluate your child for your county or school system.
For children in kindergarten through 12th grade:
Send a written request to the principal of your local school asking for an evaluation based upon the suspicion of autism.
Child psychologists, child psychiatrists, developmental pediatricians, and pediatric neurologists are able to diagnose autism.
The UNC TEACCH Autism Program provides clinical services such as diagnostic evaluations for people at any age.
The American Psychiatric Association released its Fifth Diagnostic and Statistical Manual of Mental Disorders (DSM-5) on May 22, 2013.
DSM-5 Criteria, Requirements and Level of Severity for ASD
Diagnosis requires meeting criteria across four categories:
Persistent deficits in social communication and social interaction across contexts meeting all of the following:
Restricted, repetitive patterns of behavior, interests, and activities meeting at least two of the following:
Symptoms must be present in early childhood (but may not become fully manifest until social demands exceed limited capacities)
Symptoms together limit and impair everyday functioning. Also, three levels of severity:
A new, additional diagnostic category (not under ASD) was also added to the DSM-5: Social Communication Disorder.
The DSM-5 criteria were established in an attempt to increase accuracy in diagnosis, combining overlapping symptoms into one category, loosening the 3-year-old age requirement such that for children with milder symptoms their symptoms would be allowed to become evident later in childhood, and the inclusion of a severity range (mild to high).
An additional notation in the DSM-5 criteria specifies that “individuals with a well-established DSM-IV diagnosis of autistic disorder, Asperger’s disorder, or pervasive developmental disorder not otherwise specified should be given the new diagnosis of autism spectrum disorder.” This may alleviate some concerns about people losing their diagnosis and services. A study reported by Tamara Dawkins, Allison T. Meyer, and Mary E. Van Bourgondien with Division TEACCH at the University of North Carolina suggested that the majority of children and adults with Pervasive Developmental Disorder are not likely to be affected by the changes in DSM-5.
By Alexander M. Myers, Ph.D., LP, HSP; Clinical Director, ASNC