Why so many different evaluations? Screenings versus evaluations

Parents can be confused at the wide variety of evaluations for autism. Currently there is no set standard for autism screenings and evaluations. As a result there are many different screenings and diagnoses discussed by medical professionals.

There's a mental health bible, the DSM-IV TR, that is considered 'the' medical definition of autism. Based on the DSM definition of autism several different diagnostic tests have been developed.

Autism Screenings

Some tests for autism are simple screenings of a few behaviors and delays, such as M-CHAT, that suggest further testing.  These screenings though only indicate that a child may have autism.  The screens though are usually easy to do, take 10 minutes, and are inexpensive. Unfortunately, the autism screenings also have a lot of false positives: children who might have autism,  need further evaluations, but in the end don’t have autism but instead may have another medical condition.

Autism Diagnoses

The more careful evaluations for autism result in an autism diagnosis.  These more difficult and expensive evaluations can use one doctor or a whole team examining the child in a variety of settings.  Genetics tests, brain wave measurements, social and behavioral questionnaires, blood tests, IQ tests, hearing tests, vision tests, can all be performed to make sure a child doesn’t have another disorder besides autism, or even along with autism. All of these other medical conditions that can look like autism, then, make an autism diagnosis very difficult.

Around the U.S., an autism diagnosis is most frequently done by an individual clinical psychologist, developmental pediatrician, neurologist, or psychiatrist, according to the IAN survey by the Kennedy Krieger Institute. Only 11% of the time is a diagnosis given by a team of school professionals.

Other conditions that can look like autism or are associated with autism include fragile X syndrome, epilepsy, extreme child abuse, mental retardation, hearing or vision problems, language delays, sensory disintegration, depression, and other mental illnesses. Or, these difficulties can be happening at the same time a child suffers from autism.

A thorough autism diagnosis, while expensive and time-consuming, tries to make sure another medical problem hasn't been missed.