WHAT DO I NEED TO KNOW ABOUT AUTISM SPECTRUM DISORDER (ASD)?
To meet diagnostic criteria for Autism Spectrum Disorder (ASD) according to DSM-5, a person must have persistent deficits in social communication and social interaction, in nonverbal communicative behaviors used for social interaction, and deficits in developing, maintaining, and understanding relationships, and a pattern of restricted, repetitive patterns of behavior, interests, or activities across multiple contexts.
What Are Deficits In Social Communication and Social Interaction?
According to the DSM-V these include deficits in social-emotional reciprocity, ranging from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions. It also includes deficits in developing, maintaining, and understanding relationships, ranging from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.
What Are Deficits in Nonverbal Communication?
According to the DSM-V these deficits range from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
What Are Restricted Interests and Repetitive Behaviors?
According to the DSM-V restricted, repetitive patterns of behavior, interests, or activities, include stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypes, lining up toys or flipping objects, echolalia, idiosyncratic phrases), insistence on sameness, inflexible adherence to routines, or ritualized patterns of verbal or nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat same food every day).It also includes highly restricted, fixated interests that are abnormal in intensity or hyper- or hyporeactivity to sensory input or unusual interest in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).
What Do The Severity Levels Mean?
Severity is based on social integration and communication impairments and restricted, repetitive patterns of behavior. Severity is described in 3 levels.
Level 3 – Requires very substantial support
Level 2 – Requires substantial support
Level 1 – Requires minimal support
What Happened to Asperger’s Disorder?
The DSM-V combined Asperger Syndrome(which would now technically be labeled Level 1 Severity Autism), Pervasive Developmental Disorder (PDD-NOS) and Childhood Disintegrative Disorder into a single label of Autism Spectrum Disorder.
Can An Adult Be Diagnosed With Autism?
Absolutely. Symptoms must be present in the early developmental period but may not become fully noticeable until social demands exceed limited capacities. They may also be masked by intellectual capabilities or environmental factors that either limit exposure or provide the individual with protective factors to compensate for symptoms. As time goes on social, occupational, or other important areas of current functioning are impacted and the individual may begin to look for a root cause.
Why And When Should Children Get Tested?
With autism it is so important to have an early diagnosis so that treatment can start early. By the age of 2 if early milestones are delayed such as speech and language, social skills, and gross and fine motor skills, it is important to schedule a full evaluation to see what is causing the delay. You want to use the services of a psychologist who specializes in testing for autism. Give us a call at 561-769-9437 and schedule an evaluation as soon as possible.
Why Get Tested For Autism As An Adult?
Many adults have spent their lives wondering why they have difficulty interacting with other people. They may miss social cues, misunderstand what other people are trying to say, and struggle with emotional regulation. They may become fixated on things and have trouble transitioning away from them. They start to notice that their unusual behaviors are affecting them personally, interpersonally, socially, academically, and professionally, and they want to better understand what the reason for it is. If that sounds familiar a proper diagnosis can help you to start to make the changes you need to meet your full potential.
What Is The Cost Of Testing?
That depends. If you have insurance, testing may be paid partially or in full by your insurance carrier. Kelly can give you that information when you call her at 561-769-9437. If you are paying privately the initial and follow-up sessions are 150 dollars and the testing is 1000 dollars unless extended testing is required. Kelly can discuss that with you when you give her a call.
What Is The Best Way To Diagnose Autism In Children And Adults?
Although you can speak to your doctor or pediatrician about your symptoms, it is important to get a full evaluation by a psychologist that specializes in psychoeducational assessments for ASD, because many other disorders present with similar symptoms. The evaluation will vary depending on the age of the individual. Younger children will be given the CARS, MIGDAS Diagnostic and Parent Survey to assess for autism, the BASC to assess for attentional capacity, executive and adaptive functioning, and other similar constructs, and the Bayleys-4 to assess cognitive abilities, language skills, and gross and fine motor skills. Children over 4 will be given an intelligence test such as the RIAS, an achievement test such as the WJ-V, a memory test such as the WRAML-2 that also measures attentional capacity, the MIGDAS Diagnostic and Parent Interview and the GARS to assess for autism, and the BRIEF and CAT-C to measure executive functioning and attentional capacity. Other measure may be added or eliminated based on the symptoms of the child. Adults will be given the MIGDAS Diagnostic Interview, the GARS, BRIEF, ASRS Attention Scale, an intelligence test such as the RIAS, an achievement test such as the WJ-V, a memory and attention test such as the WRAML-2, and the NAB Screening test to check neuropsychological functioning. Again, additional tests may be added based on symptoms discussed in the initial session.
What Is The Process?
The first step is to give us a call at 561-769-9437 and set up an initial consultation, a date for the evaluation, and a follow-up appointment. If you have insurance, we will run your insurance and let you know if they will cover the testing and how much your patient responsibility is. Kelly our testing coordinator and behavioral specialist will send you paperwork through our portal for you to fill out. Some of it is just the typical paperwork and some of the forms ask more about the current symptoms you or your child are exhibiting.
On our initial call we will discuss your concerns and I will gather the information I need to decide what tests should be utilized and what specific symptoms we are looking for.
The testing appointment can be done in your home but if location or mobility are issues we can do the testing through Zoom for adolescents and adults. The testing usually takes between 3 and 5 hours depending on the age and the number of tests that need to be administered.
At the follow-up appointment we will discuss the results and you will receive a follow-up report that can be shared with your other medical providers, schools, and workplaces.
Are There Other Things To Rule Out When An Individual Is Experiencing Symptoms Of ASD?
Both mental health and medical diseases may mimic ASD, such as sleep disorders, thyroid disorders, and seizure disorders so it is important to speak to your physician to rule out those and other possible medical conditions. Our testing will be able to assess whether ADHD, learning disabilities, anxiety or mood disorders are present and if further evaluation is needed. In older adult’s some changes that mimic autism may reveal age-related cognitive impairment or dementia which would need additional follow-up by a neurologist.
What If It’s More Than ADHD And I’ve Only Asked For ASD Testing?
In our initial meeting we will discuss all of the symptoms you or your child are having to decide what testing we will do. We are prepared to give you an accurate diagnosis and have the skills and the testing materials needed to do that.
What Happens If My Child Is Diagnosed with Autism?
If your child is diagnosed with ASD they will be eligible for an IEP plan which is a legal document with goals, modifications and accommodations that the school needs to strictly adhere to. If they have additional deficits such as learning disabilities or ADHD or other impairments such as a speech and language deficit, or the need for occupational or physical therapy, they may qualify for additional services. Only the school can create an IEP so you will bring the report to the ESE contact at the school, and they will set up a School Based Support Team Meeting where they will discuss goals, accommodations, and modifications that can be made to meet their needs.
Why Is It Important To Test Before College
Many people feel like if they have gotten through high school why look for services now, but that is far from the truth. The additional challenges of college may exacerbate symptoms of ASD. With a diagnosis of ASD you can get accommodations for both assignments and tests in class as well as for standardized tests such as the MCAT. LSAT, GRE, SAT, and ACT.
What If I Am Diagnosed With ASD As An Adult?
That depends on why you are doing the testing. The report is yours to share as you choose. Some people just want answers they have long been waiting for. Others want accommodations at work to help them to achieve success. Others are going back to school or are in school and need accommodations for classes and tests. Others are doing the testing as part of a request for disability or following an accident or medical incident. Whatever your reason we will help you to navigate the process and will provide you a list of necessary accommodations and modifications to help you to meet with success.
Accommodations Verses Modifications
Accommodations change the environment in some way to help you or your child to more effectively utilize it. Some examples of accommodations include preferential seating, audiobooks, ability to take breaks, and speech to text technology. We will include an extensive list of possible accommodations to meet you or your child’s needs in the final report. A modification describes a change in the curriculum. Modifications are made for individuals with disabilities who are unable to comprehend the content. This can include shortening assignments or presenting them in a way that makes them more accessible to the individual. These will be included in your final report as needed.
If My Child Is Diagnosed What Treatments Are There?
Behavioral Approaches- focus on changing behaviors by better understanding why they happen. The most common is Applied Behavior Analysis (ABA). ABA therapy can be done in a center or at your home and the purpose is to encourage desired behaviors and discourage undesired behaviors.
Developmental Approaches focus on improving specific developmental skills, such as speech and language skills or physical skills, or a broader range of interconnected developmental abilities. They include speech and language therapy, occupational therapy, physical therapy, and sensory integration therapy.
Educational Approaches-focus on providing teachers with ways to adjust the classroom structure and improve academic and other outcomes. This is where the accommodations and modifications come in. This can include social relational skill training to increase motivation, interest, and abilities to participate in shared social interactions.
Pharmacological Approaches- There are no specific medications to treat ASD but medication can be used to help manage high energy levels, inability to focus, or self-harming behavior, such as head banging or hand biting. Medication can also help manage co-occurring psychological conditions, such as anxiety or depression, in addition to medical conditions such as seizures, sleep problems, or stomach or other gastrointestinal problems. Special diets, herbal supplements, and chiropractic care may also be suggested.
Psychological Approaches- Cognitive Behavioral Therapy(CBT) can be used to help individuals change how they react to situations. Family and parenting counseling can also be useful to help families to adjust to the needs of the ASD individual. Other treatments might include animal therapy, arts therapy, mindfulness, or relaxation therapies.
Additional Help And Resources
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