Evaluation and Screening for Autism
A young child’s brain developes at a fast pace, and research shows that early intervention is most effective in the first five years of life. These same studies also show that environmental experiences cause structural and neurochemical changes in the developing brain.
During these early years, the brain's nerve cells (neurons) are making millions of connections, called synapses. The formation of these synapses are affected by our environment and our experiences. If the child is not provided with developmentally-appropriate experiences and safe nurturing environments, the wrong synapses may be reinforced and positive synapses may not develop. In the early years, we can promote healthy brain development much easier than we can repair damage later in life.
Studies show that 90 percent of time, a parent’s concern about their child’s development is related to a condition and the doctor should seriously listen to that parent. Don't be afraid to speak up and voice your concerns. Parents should not accept a “wait and see” approach.
The goal of early diagnosis is to provide the child with the opportunity of early intervention. By doing so, we can positively affect this child's brain development and future opportunities for success.
Evaluation Steps in General
The first step in the evaluation process is an analysis with Dr. Robin Blitz. She reviews the patient's medical, developmental, behavioral, social skills and family history. All of this information is vital to evaluating the whole child and understanding how this child fits into this particular family, community and school.
Interviewing the child is an important part in gathering information about their feelings, perceptions and moods. It is also helpful to have input from the teachers, therapists and other healthcare professionals.
Physical and neurological examinations are also a part of the evaluation process. A developmental assessment may include a variety of standardized tests, questionnaires, observations and demonstrations.
These evaluations used are determined by the age of the child and may be formal or informal, by observing the child at play and interacting with parents and the examiner.
Screening for autism in children 3 and under
According to the American Academy of Pediatrics, it is strongly recommended that children should be screened developmentally using standardized screening tools at: their 9-month, 18-month, 24- or 30-month, and 3-year old visits at the very least.
Autism screenings specifically should be done at: 18-month and 24-month visits with your pediatrician.
If your child is younger than 3 years, contact the Arizona Early Intervention Program (AzEIP) at (602) 532-9960. A free evaluation will be conducted and could possibly qualify the child for ongoing services.
Tests to request for a referral
Hearing (OAE) test
The primary purpose of an otoacoustic emission (OAE) test is to determine cochlear status, specifically hair cell function. This information can be used to screen hearing particularly in neonates, infants, or individuals with developmental disabilities. If you are a parent that has a child who is not babbling by six months or saying a single word by one year of age, then you should request a hearing test. Even if your child passed their newborn hearing screening, you should still request the hearing test.
Parents should ask the pediatrician two things:
1) Can you refer me to a place to get a hearing test? or;
2) Do you offer a hearing screen in the office?
Some doctors can perform an OAE (Otoacoustic Emission test) right there in their office such as our general pediatrics clinic here at Phoenix Children's Hospital.
Screening for autism in children 3 and older
The American Academy of Pediatrics strongly recommends that children should be screened at well child visits using standardized screening tools from 3 years old and then annually from there on.
Some of the most common screening tools include:
- ASQ - designed for kids up to 5 years old (for a minimal cost)
- PEDS - designed for kids up to 8 years old (for a minimal cost)
- M-CHAT - designed for kids 16 months to 4-yrs. of age (free)
If your child is 3 or older, your local school district should conduct a free evaluation if the parent has concerns about their child's development.