How is the assessment of Autism Spectrum Disorders carried out?

Autism Spectrum Disorders (ASD) could be detected at an early age and for this it is necessary that a specialized professional with extensive experience is in charge of carrying it out, since cases have been observed of children who do not receive diagnosis before reaching a certain age.

When carrying out the assessment for Autism Spectrum Disorders (ASD), it is usual to start with an interview with the parents and the child once this has been completed, and another can also be carried out together. Once the first interviews have been carried out, various tests will be carried out to make a more precise assessment (eg cognitive development tests, attentional development tests, standardized TSA tests such as the ADI-R or the ADOS-2, etc.).

In this article we will explain in more detail how everything usually develops the autism spectrum disorder assessment process by professionals.

Features of Autism Spectrum Disorders Assessment

It is important to emphasize that the assessment of autism spectrum disorders can be quite complex and it is for this reason that the professionals who are in charge of it beforehand must be extensively trained and trained for it, being common that it starts with expert help until you have enough experience to make a proper assessment.

The diagnostic process, as well as the pre-assessment for autism spectrum disorders, typically takes several hours, it may even be necessary to extend it over several sessions if necessary in cases where the detection generates doubts for the professionals; therefore, it would be necessary to perform more diagnostic tests and thus they could provide a more accurate assessment and diagnosis.

The initial interview

Before carrying out the corresponding tests for the assessment of autism spectrum disorders, a first interview must be carried out. Therefore, it usually starts with an interview with the parents and another with the child separately.

The interview with the parents usually begins with questions related to why they came to seek professional help, as well as the analysis of any previous reports that another professional (for example, the psychologist) could have done before from the school the child attends and/or the testimony of a teacher).

Then an anamnesis would be taken by asking the parents about their child so that the professional who assesses can have a general idea about the possible problems that the child could have and how these interfere with his environment in different areas and for this we would like to ask them a series of questions about relevant aspects of the child’s life (for example, behavior at home and at school, relationships with other children of their age, hobbies, tastes, flexibility of routine or day-to-day difficulties, etc.).

With regard to the subject of hobbies and tastes, it is important to collect information especially with the aim of know if the child has very specific tastes or very restricted interestsbecause it is common for people with autism to have very limited interests and spend long hours focused on them.

Later, another anamnesis will be carried out on the child directly, collecting information similar to that which was consulted with his parents in order to be able to contrast later and thus obtain the most precise information possible. Also, as this interview unfolds, it is important pay attention to certain non-verbal details of the childsuch as eye contact when communicating with the professional performing the assessment with him and other details such as whether there are motor stereotypies (eg, constant twisting of fingers, shaking of hands, etc.), or echolalia , amongst others.

Autism Spectrum Disorder Assessment

After the initial interview with the parents and the child has been carried out, a series of tests and specific tests will be carried out for the assessment of autism spectrum disorders (for example, the cognitive development tests, the D2 test or other than they are usually used in order to carry out an assessment of your logical-mathematical, linguistic, etc. ability.

1. Cognitive development

In the process of assessing autism spectrum disorders, it is important to carry out tests to assess the cognitive development of the child, since these serve to deepen certain aspects that could have been addressed during the initial interview, and they could also help to detect other psychopathologies, if present, in addition to ASD or any possible problems or difficulties related to evolutionary development.

To carry out the assessment of cognitive development, tests would be carried out such as the Merrill Palmer scale which is used for the little ones in order to evaluate their development in a global way, being important to put particular interest in analyzing certain aspects such as symbolic play or theory of mind.

On the other hand, the Leiter International Manipulative Scale is also often used to assess nonverbal attention, as well as certain cognitive and neuropsychological skills, among others. In addition, it is common to use the Wechsler scales (eg, WPPSI, WISC) which allow an assessment of intelligence and certain cognitive abilities.

2. Assessing ASDs

Assessment using standardized tests will be one of the most important in the assessment process for autism spectrum disorders. These tests would be essentially two: the ADI-R test, which is carried out with the parents, and the ADOS-2 test, which would be the one which would be carried out with the child or the adolescent.

With the ADI-R test, an interview is carried out in order to analyze in an exhaustive way certain aspects that can be used to assess ASD, such as certain signals or indications observed by the parents or by the teachers and the psychologist of the school where your child is educated. In this test, certain relevant areas are mainly assessed: social interactions, behavior, language, communication, possible restricted and repetitive interests, etc.

In contrast, with the ADOS-2 test, the same areas would be assessed as with the ADI-R test, except that in this case the procedure would be performed with the child or adolescent. This test would focus on the objective of looking for various characteristics related to ASD cases (eg restricted and repetitive interests).

3. Assessing social development and adaptive capacities

When evaluating autism spectrum disorders, it is important to use tests that assess the child’s social development and coping skills. For that, the Vineland scale should be highlightedwhich allows for a detailed assessment of personal and social skills that are important and very useful in people’s daily lives.

On the other hand, in this area of ​​assessment, we must not forget the Australian scale, a test of 24 questions that professionals use to assess certain behaviors that are quite common in people with ASD. This would be a test that could be done with both parents and teachers of the child.

4. Assessment of communicative and language development

It is essential to carry out specific tests to analyze the development of communication and language when carrying out the whole process of assessment of autism spectrum disorders. For that, the CSBS scale is used (Communication and Symbolic Behavior Scale) which consists of a questionnaire consisting of 24 questions to be answered by parents in order to detect certain important warning signs of the child; being a test carried out with the parents of the youngest children (from 6 to 24 months).

If the child is between 18 months and 7 years old, it would be wiser to use other tests such as the Reynell III Language Development Scales. These scales are generally used to detect possible language-related problems and communication.

5. Careful development assessment

Finally, in the process of assessing autism spectrum disorders, it is also important that specific tests are performed that can be used to assess attentional development. For that, it is quite common for the D2 attention test to be useda test consisting of a timed test used to measure the child’s processing speed, the follow-up of instructions and the execution of the task ordered.

Now that we have seen what the process of assessing autism spectrum disorders consists of, we will have been able to see that it is a fairly complex process, hence the importance that it be carried out by qualified professionals. and experienced.

It should also be noted that this assessment can be supplemented with other tests to obtain a more detailed diagnosis, such as the SCL-90-R testcommonly known as the “90-symptom test”, which serves to assess the symptoms that may be present in each case since this test allows the evaluation of several dimensions (eg anti-aging, interpersonal sensitivity, phobias, etc.).

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