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Diagnosing Autism in Children

Detecting autism can be difficult because it does not show up on any medical test, like a blood test or an MRI. Instead, doctors or psychologists look at a child’s behaviors and progress reaching developmental milestones when making a diagnosis. If a child’s parent, caretaker or pediatrician suspects autism, or if screening results point to autism, the child should be referred to a specialist for evaluation.

Diagnosing Autism

When assessing a child for autism spectrum disorder (ASD), a qualified medical doctor or psychologist will look for certain criteria related to social communication challenges and restricted, repetitive behavior. Depending on the severity of symptoms, a child with autism will receive a diagnosis of ASD level 1 (requiring support), ASD level 2 (requiring substantial support) or ASD level 3 (requiring very substantial support). These levels of autism help guide treatment as well as help caregivers and families understand the child’s needs.

Below is a brief overview of the criteria for diagnosing autism, as described in the American Psychiatric Association’s Diagnostic and Statistical Manual, 5th Edition (DSM-5). This information is not exhaustive and is not a substitute for professional evaluation.

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Social Communication or Interaction

Social symptoms of autism will be present during early childhood, but may not become obvious until the child reaches an age where social demands have increased. To be diagnosed with autism, a child must meet each of three criteria for social communication and interaction:

    1. Challenges in social-emotional reciprocity (e.g., difficulty with back-and-forth conversation, sharing interests with others, initiating social interactions, or responding when someone else initiates) 
    2. Challenges in nonverbal communication (e.g., lack of eye contact, difficulty understanding facial expressions, body language, or gestures)

Challenges in developing, maintaining, or understanding relationships. (e.g., problems understanding appropriate behaviors for different social contexts, trouble making or keeping friends, lack of interest in peers)

Restrictive, Repetitive Patterns

To meet the clinical criteria for autism a child must display at least two of the following four characteristics:

    1. Repetitive movements or speech (e.g., rocking, flapping hands, or repeating meaningless phrases)
    2. Inflexibility regarding routines, or patterns of behavior (e.g., distress over small changes, adherence to specific rituals, rigid thinking)
    3. Highly restricted interests or fixations (e.g., strong preoccupation with a certain object or topic)
    4. Hyperreactivity to sensory stimuli (e.g., extreme sensitivity or reaction to light, sound, touch, or other sensory input) or hyporeactivity (e.g., apparent indifference to pain, fascination with bright lights or other stimuli)

For specific diagnostic criteria, please refer to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th ed.

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