| Assessing Autism Spectrum Disorders Bright Tots educational toy store offering baby toys toddler toys games & videos. |
|
Initial detection of autistic spectrum disorders (ASD) is a two-step process: developmental
surveillance and screening that begins at infancy with the child’s primary care provider.
Developmental surveillance is the routine monitoring and tracking of specific developmental
milestones at well-child visits. This includes the gathering of information through reliable
standardized instruments combined with parent and professional observations and tracking
developmental progress, compared with children of similar age. All professionals responsible for
the care of the child should perform routinedevelopmental surveillance to identify children with
atypical development.
Evaluation
Major advancements in the sciences of early identification and treatment of ASD have increased
public awareness and focused more attention on this class of neuro-developmental disorders. It
has been clearly demonstrated that ASD are identifiable and relatively stable in very young
children. Evaluations, the identification of risk factors for a disorder using specific tests. By
screening the population of children from birth through age 5 for ASD, seeks to identify those
children most at risk of developing an ASD and/ or developmental delay.
surveillance and screening that begins at infancy with the child’s primary care provider.
Developmental surveillance is the routine monitoring and tracking of specific developmental
milestones at well-child visits. This includes the gathering of information through reliable
standardized instruments combined with parent and professional observations and tracking
developmental progress, compared with children of similar age. All professionals responsible for
the care of the child should perform routinedevelopmental surveillance to identify children with
atypical development.
Evaluation
Major advancements in the sciences of early identification and treatment of ASD have increased
public awareness and focused more attention on this class of neuro-developmental disorders. It
has been clearly demonstrated that ASD are identifiable and relatively stable in very young
children. Evaluations, the identification of risk factors for a disorder using specific tests. By
screening the population of children from birth through age 5 for ASD, seeks to identify those
children most at risk of developing an ASD and/ or developmental delay.
| Assessing Autism Spectrum Disorders |
Historically, it has been difficult to reliably detect ASD before the age of 3. In part, this is due to lack of awareness of health care
providers about the presentation of ASD in young children (including their more limited skill development, particularly in language,
cognitive, social behaviors). For example, it would be difficult to judge developmental deviation in peer relationships in children of
18 months, an age at which these skills would not be expected to have developed.
Identifying Behaviors Before Age 2
Advances have been made in identifying behavior indicators as well as atypical development in children less than 2 years of age who
are later diagnosed with ASD. It has been demonstrated that autism can be reliably diagnosed by an experienced clinician in children
between the ages of 24 and 30 months. Since ASD early intervention services are dependent upon early detection and formal
diagnosis, it is imperative that young children be screened for ASD, identified as being at risk and referred for comprehensive
evaluation and assessment in an efficient and timely manner.
Recently, researchers have begun to focus on the developmental precursors of communication, language and social development in
the first two years of life. Children with disorders on the autistic spectrum consistently seem to demonstrate deficits in
social-cognitive and social-communicative behaviors early in life.
providers about the presentation of ASD in young children (including their more limited skill development, particularly in language,
cognitive, social behaviors). For example, it would be difficult to judge developmental deviation in peer relationships in children of
18 months, an age at which these skills would not be expected to have developed.
Identifying Behaviors Before Age 2
Advances have been made in identifying behavior indicators as well as atypical development in children less than 2 years of age who
are later diagnosed with ASD. It has been demonstrated that autism can be reliably diagnosed by an experienced clinician in children
between the ages of 24 and 30 months. Since ASD early intervention services are dependent upon early detection and formal
diagnosis, it is imperative that young children be screened for ASD, identified as being at risk and referred for comprehensive
evaluation and assessment in an efficient and timely manner.
Recently, researchers have begun to focus on the developmental precursors of communication, language and social development in
the first two years of life. Children with disorders on the autistic spectrum consistently seem to demonstrate deficits in
social-cognitive and social-communicative behaviors early in life.
These include failures of joint attention, nonverbal and pre-verbal communication, social
reciprocity, affective understanding and imitation.
The majority of parents report atypical behaviors in their young children with autism
during the first two years of life. Parents of children with autism noted several features
that were markedly deficient in their child during the first two years of life. These
included: poor eye contact and poor coordination of eye gaze with vocalization or
gesture, no pointing to or showing of objects and an inability to follow another’s focus
of attention through eye gaze or gesture. Children with autism also displayed less pre-
verbal babbling and no reciprocity in vocalizing and imitation. They also attended less to
voice and had difficulty understand and using nonverbal gestures.
The detection of young children with developmental and behavioral problems can be
difficult due to the variety of disorders and their manifestations at different ages. This is
particularly apparent in young children with ASD whose communicative and social
difficulties are often poorly understood and are therefore frequently attributed to normal
variations in typical development. Many studies have demonstrated that early detection
reciprocity, affective understanding and imitation.
The majority of parents report atypical behaviors in their young children with autism
during the first two years of life. Parents of children with autism noted several features
that were markedly deficient in their child during the first two years of life. These
included: poor eye contact and poor coordination of eye gaze with vocalization or
gesture, no pointing to or showing of objects and an inability to follow another’s focus
of attention through eye gaze or gesture. Children with autism also displayed less pre-
verbal babbling and no reciprocity in vocalizing and imitation. They also attended less to
voice and had difficulty understand and using nonverbal gestures.
The detection of young children with developmental and behavioral problems can be
difficult due to the variety of disorders and their manifestations at different ages. This is
particularly apparent in young children with ASD whose communicative and social
difficulties are often poorly understood and are therefore frequently attributed to normal
variations in typical development. Many studies have demonstrated that early detection
and early therapeutic intervention are associated with the best developmental, behavioral and adaptive outcomes.
Early Diagnosis
Most parents of children with autism expressed concerns regarding their child’s development before 18 months of age. Until
recently, a considerable gap existed between the time parents first reported concerns and subsequent referral and definitive
diagnosis. A lengthy referral and diagnostic process contributes to considerable parental anxiety, places unneeded stress on parents
and families and squanders valuable intervention time. Research has supported the notion of parental accuracy with regard to
developmental concerns with their child. With the documented efficacy of early intervention in achieving optimal outcomes for
young children and their families, it is imperative that all concerns be taken seriously and addressed appropriately.
Parents’ concerns about their child’s development and behaviors are discussed at every health care provider contact, including well
and ill child visits. Some noteworthy clinical sings, or “red flags,” exist that can help identify children at risk for developmental
delay and/or ASD within a routine office or other health facility visit. These indicators typically are tracked through routine
developmental surveillance procedures, which should occur at all well-child visits. The most powerful indicators is degree of
language development. Any child not using single words by 16 months of age or some two-word phrases by 2 years of age should
be further evaluated. Children who do not use gesture (i.e., pointing, waving, etc) or who cannot follow nonverbal communication
by 12 months should also be referred. Finally, any loss of skills at any age is a serious red flag and warrants immediate referral to
an appropriate diagnostic team.
Developmental Concerns
Primary care providers are generally the first point of contact for parents with concerns and questions regarding their child’s
development. Parents expect their pediatricians and family physicians to offer guidance regarding developmental issues; if no help is
forthcoming, these parents may turn to other sources. Well-child visits are the logical time and place for developmental surveillance
and screening for specific disorders to occur.
Studies have shown that even when parents bring up developmental concerns, some PCPs respond by waiting to see if the delays
will resolve spontaneously or by discounting parental observations. They may be unaware of the degree of accuracy often
associated with parental concerns regarding their child’s development. While a small number of children do “catch up” without
formal intervention and achieve developmental milestones somewhat later than same-age peers, this is the exception. A significant
number of youngsters require early intervention either on a transient ongoing basis to function within their family and community
environment.
Presently, children are being referred for evaluation regarding suspicion of ASD at earlier ages. Although many trained professionals
are able to make a definitive diagnosis at a young age, the stability of diagnosis within the spectrum may fluctuate. This is often the
case with children who are very young (2 years and under) and for those at extreme ends of the spectrum. It is not uncommon for
a child to meet diagnostic criteria for autistic disorder at age 2 and then be described at age 3 or 4 as PDD-NOS. Symptoms and
behaviors may change considerably with intervention, particularly as language and social skills progress. Because symptoms change
over time, a young child with an early diagnosis of ASD should be reexamined at least annually to confirm the diagnosis and plan
treatment.
Specific Domains
Developmental and behavioral history of the child and current functioning are important in diagnosing ASD. Developmental
information such as developmental milestones, motor skills, eating and sleeping patterns etc. are critical in the evaluation process.
The following are some specific domains in the diagnostic criteria.
∙ First concerns about the child’s development.
∙ Characteristics of the infant’s temperament.
∙ Social-emotional milestones. This includes engagement in typical baby games (pat-a-cake, peek-a-boo), eye contact during
feeding and games, shared attention, greetings and similar significant events. It is sometimes helpful to provide a reference point (i.
e., first birthday) to aid with recall.
∙ Sensory abnormalities. It is important for the clinician to provide examples to help discriminate atypical patterns from typical
development patterns. For example, arm flapping and jumping are common in many pre-verbal children. For example, children
respond to exciting stimuli such as the currently poplar children’s characters, Barney and Elmo.
∙ Feeding and sleep problems or patterns.
∙ Fine and gross motor development and milestones.
∙ Atypical interests and activities.
∙ Interest in other children and/or siblings.
∙ Patterns of attachment to care givers.
∙ Ability to use nonverbal communicative means such as gesture and facial expression.
∙ Communication, including both verbal and nonverbal intent.
∙ Preferred activities and play.
∙ Other notable characteristics such as loss of skills or deterioration of behavior.
Early Diagnosis
Most parents of children with autism expressed concerns regarding their child’s development before 18 months of age. Until
recently, a considerable gap existed between the time parents first reported concerns and subsequent referral and definitive
diagnosis. A lengthy referral and diagnostic process contributes to considerable parental anxiety, places unneeded stress on parents
and families and squanders valuable intervention time. Research has supported the notion of parental accuracy with regard to
developmental concerns with their child. With the documented efficacy of early intervention in achieving optimal outcomes for
young children and their families, it is imperative that all concerns be taken seriously and addressed appropriately.
Parents’ concerns about their child’s development and behaviors are discussed at every health care provider contact, including well
and ill child visits. Some noteworthy clinical sings, or “red flags,” exist that can help identify children at risk for developmental
delay and/or ASD within a routine office or other health facility visit. These indicators typically are tracked through routine
developmental surveillance procedures, which should occur at all well-child visits. The most powerful indicators is degree of
language development. Any child not using single words by 16 months of age or some two-word phrases by 2 years of age should
be further evaluated. Children who do not use gesture (i.e., pointing, waving, etc) or who cannot follow nonverbal communication
by 12 months should also be referred. Finally, any loss of skills at any age is a serious red flag and warrants immediate referral to
an appropriate diagnostic team.
Developmental Concerns
Primary care providers are generally the first point of contact for parents with concerns and questions regarding their child’s
development. Parents expect their pediatricians and family physicians to offer guidance regarding developmental issues; if no help is
forthcoming, these parents may turn to other sources. Well-child visits are the logical time and place for developmental surveillance
and screening for specific disorders to occur.
Studies have shown that even when parents bring up developmental concerns, some PCPs respond by waiting to see if the delays
will resolve spontaneously or by discounting parental observations. They may be unaware of the degree of accuracy often
associated with parental concerns regarding their child’s development. While a small number of children do “catch up” without
formal intervention and achieve developmental milestones somewhat later than same-age peers, this is the exception. A significant
number of youngsters require early intervention either on a transient ongoing basis to function within their family and community
environment.
Presently, children are being referred for evaluation regarding suspicion of ASD at earlier ages. Although many trained professionals
are able to make a definitive diagnosis at a young age, the stability of diagnosis within the spectrum may fluctuate. This is often the
case with children who are very young (2 years and under) and for those at extreme ends of the spectrum. It is not uncommon for
a child to meet diagnostic criteria for autistic disorder at age 2 and then be described at age 3 or 4 as PDD-NOS. Symptoms and
behaviors may change considerably with intervention, particularly as language and social skills progress. Because symptoms change
over time, a young child with an early diagnosis of ASD should be reexamined at least annually to confirm the diagnosis and plan
treatment.
Specific Domains
Developmental and behavioral history of the child and current functioning are important in diagnosing ASD. Developmental
information such as developmental milestones, motor skills, eating and sleeping patterns etc. are critical in the evaluation process.
The following are some specific domains in the diagnostic criteria.
∙ First concerns about the child’s development.
∙ Characteristics of the infant’s temperament.
∙ Social-emotional milestones. This includes engagement in typical baby games (pat-a-cake, peek-a-boo), eye contact during
feeding and games, shared attention, greetings and similar significant events. It is sometimes helpful to provide a reference point (i.
e., first birthday) to aid with recall.
∙ Sensory abnormalities. It is important for the clinician to provide examples to help discriminate atypical patterns from typical
development patterns. For example, arm flapping and jumping are common in many pre-verbal children. For example, children
respond to exciting stimuli such as the currently poplar children’s characters, Barney and Elmo.
∙ Feeding and sleep problems or patterns.
∙ Fine and gross motor development and milestones.
∙ Atypical interests and activities.
∙ Interest in other children and/or siblings.
∙ Patterns of attachment to care givers.
∙ Ability to use nonverbal communicative means such as gesture and facial expression.
∙ Communication, including both verbal and nonverbal intent.
∙ Preferred activities and play.
∙ Other notable characteristics such as loss of skills or deterioration of behavior.
| ________________________________________________________________________________________________________________________ Copyright © 2004 Bright Tots® Inc. - Educational Toys & Resource Guide to Child Development - All rights reserved. ________________________________________________________________________________________________________________________ |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
 | |  | |  |
|
 |
 |
 |
 |
 |
 |
|
 |
 |
 |
 |
 |
| ||||||||||
Custom Search
Custom Search