Assessment and Diagnosis
ASSESSMENTS AND DIAGNOSIS
Autism can look very different for different people at different ages. Early diagnosis can lead to early treatments, which can help to maximize the future potential of any child.
An ASD diagnosis depends on the number and pattern of typical characteristics, and the observation of specific behaviours and disabilities. It takes a multi-disciplinary team of qualified autism specialists to make a clinical diagnosis. The team typically includes: a pediatrician, a registered psychologist, a psychiatrist, and a speech-language pathologist. Many different measures and screening tools such as the DSM-IV and the M-Chat-R are used in the process to ensure accuracy.
Diagnosis can be done through the British Columbia Autism Assessment Network (BCAAN) at no cost to the family, or privately for a fee. It is so important that you request a referral from your family doctor as soon as you recognize signs of ASD in your child. If your family doctor is not hearing your concerns, try listing them in writing and providing supporting documents from teachers, Speech-Language Pathologists, or an Infant Development Program Consultant. If your family doctor is still not on board, you will want to consider seeking out a new doctor who can refer you to a specialist as soon as possible. A timely diagnosis is so important because the earlier a child is diagnosed the faster he or she can begin a treatment program, and reach his or her full potential.
Waiting list times for BCAAN’s publicly funded teams vary from region to region and time of year. Priority is given to children under six, but waiting times can vary from six months to one year and occasionally longer. This is another reason why seeking help as soon as you feel something might be wrong is so important. Parents can pay for their child to have a private diagnosis done. While there is a cost involved, getting a private diagnosis means much shorter wait times.
If you do feel that seeking a private diagnosis is right for you, there are some very important things to keep in mind: Not all private assessments are of the same quality. Currently, in BC, there is no system in place for ensuring that all private practitioners are adhering to the BC Standards and Guidelines or using the screening tools in the appropriate way. It does happen that parents pay good money and their assessment does not meet the requirements of the MCFD. You will need to consult the Ministry of Children and Family Development (MCFD) to ensure that standards are being met for your child prior to having the assessment done.
If you are interested in seeking a private diagnosis here is what we suggest: Consult and acquire reports from three professionals.
- Seek a medical evaluation from a pediatrician who, likewise, suspects signs of ASD in your child.
- Have a Clinical Psychologist perform a detailed psychological assessment, which includes the Autism Diagnostic Observation Schedule (ADOS) for the child, and the Autism Diagnostic Interview- Revised (ADI-R) for the parents. These are the most recognized instruments for assessment and diagnosis of ASD. It takes highly specialized training to perform these assessments, and not every medical professional is qualified.
- Have a Speech-Language Pathologist perform a communication assessment and produce a report detailing any significant delays or problems with speech, language and communication. These three autism specialists are essential for a successful private diagnosis.
The most important first step in all this is finding a pediatrician who is on board and hears your concerns. If your doctor is not doing everything he or she can to refer you to a pediatrician find a new family doctor or go to a walk-in clinic. Time is of the essence. Early intervention results in the best outcomes.
ADULT AUTISM ASSESSMENT
Adult autism assessments are only offered privately and for a fee. They range in price from $2000-$4000. It is important to see a clinical psychologist with experience in assessing adults as the diagnosis becomes more complex in adulthood.
Whereas some individuals will carry their diagnosis into adulthood, others may reach adulthood without a clear-cut diagnosis. In some cases, family members, such as a spouse or child, or a co-worker might be the first to point out to the adult individual that he or she may display characteristics associated with ASD. It is not uncommon for adults to seek support from our autism resource specialists about enduring issues, such as social and communication challenges, with an underlying suspicion that it could be autism. Getting a diagnosis in adulthood can be complicated, and there are many things that need to be considered before jumping to any conclusions.
If you are an adult and suspect you might have autism, consider:
- A diagnosis of autism in adulthood may allow you to access services that you otherwise could not have access to. For example, you may qualify for Community Living BC services (CLBC) or the BC disability tax credit.
- Just having a diagnosis does not automatically make you eligible for these services.
- Taking courses, reading books, taking skill-streaming curriculum could help you gain clarity.
- WorkBC offers individualized support for people with a disability, which could help you learn skills to ensure successful employment.
The truth is: it is very difficult to list out all the possibilities for adults with ASD. In fact, even CLBC does not list out their adult resources. This is because services for adults with ASD are highly individualized. It is not a one size fits all model, rather a personal journey that will take some hard decision-making and consultation.