Currently the
only available assessment process to
reliably diagnose Autism Spectrum
Disorders is based around two specific
tests. First, a clinical interview to obtain a detailed and
relevant developmental history, and second, the administration of a
series of structured activities aimed at evaluating presenting
symptoms.
To
comply with this process, the "golden standard" in Autism diagnosis
involves the administration of two well established and researched assessment instruments, the Autism Diagnostic Interview-Revised (ADI-R) and
the Autism Diagnostic Observation Schedule (ADOS). Both
tests are administered by trained professionals, such as clinical
psychologists, child psychiatrists and paediatricians.
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DEVELOPMENTAL HISTORY
A
child's developmental history is
an
important starting point to evaluate the presence of ASDs.
Therefore, information gathering involves a detailed clinical interview
with the parents or caregivers, most often
using the Autism Diagnostic Interview-Revised (ADI-R). The interview
responses are scored with the aid of a specifically designed
algorithm. The ADI-R algorithm for autism is consistent with both
the ICD-10 and DSM-IV diagnostic
criteria.
When available, additional information is
obtained from other sources, such as speech pathology reports,
teachers' reports and other family
members.
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EVALUATION OF PRESENTING
SYMPTOMS
Due to its chronic nature, children with ASDs
present with characteristic symptoms in most circumstances. To
evaluate the symptoms and to differentiate them from other disorders
(e.g., intellectual disability, genetic disorders) clinicians rely
on the Autism Diagnostic Observation Schedule (ADOS).
The ADOS is the most widely
used psychological test to evaluate
communication, social interaction, play and imaginative skills
for children and adults suspected of having autism or other
pervasive developmental disorders (PDD). The ADOS
contains four separate tests, differentiated by
children's and adults' developmental and language levels. It
can be administered to children with no expressive or
receptive language use to children and adults with fluent
verbal skills.
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OBSERVATION
When possible,
the assessment of ASDs includes an observation of the
child in his or her natural environment, such as day care
centre, school or home. Observation in natural settings
is particularly important when no information is available
about early
development.
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