Pre-Diagnosis

  • Learn about the signs of autism, the diagnostic process, treatment options and much more.

    Table of Contents:

    • What is Autism?
    • What are the signs someone might have autism?
    • How is Autism Diagnosed?
    • Is There Treatment?
    • Helpful Tools and Websites
    • Learn More

    What is Autism ?

    According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social interaction, difficulties with verbal and non-verbal communication, and restricted or repetitive behaviour (CDC). As of March 2014, 1 in 68 children have been identified as having ASD with it being 4.5 times more common in boys (1 in 42) than in girls (1 in 189).

    Click here for the precise diagnostic criteria.

    What are the signs someone might have autism?

    Autism is a spectrum disorder, meaning it affects each individual differently. There is, however, some behaviour that is relatively consistent with an autism diagnosis. Please note this is not a checklist, however, if you recognize some of these signs in your child you may want to consider seeking a professional opinion.

    Communication impairment:

    • Speech may be absent or delayed
    • Poor use or understanding of gestures, such as pointing and eye contact
    • Difficulty with abstract concepts and pronouns. For example the child may reverse pronouns, saying “you” instead of “I”
    • Language may be unusual or repetitive (echolalia)
    • May take part in selective hearing, i.e., may act deaf when being spoken to but alert to other sounds
    • Conversations may be difficult for them to initiate and/or sustain
    • Make-believe is limited or absent

     

    Delays in social interaction:

    • Social cues such as eye contact, facial expressions, body language and gestures are difficult for them to use and/or understand.
    • Relationships with peers are difficult to develop or maintain; child may appear to prefer being alone
    • Sharing interest during interactions by pointing or nodding may be absent or delayed

     

    Atypical behaviours:

    • Behaviours may be done repetitively, or the child may remain preoccupied with one activity for a prolonged period of time, such as hand flapping or rocking (self-stimulating behaviour).
    • Routines and rituals may be rigidly followed. Individuals with ASD are often averse to change, and struggle with transitions, preferring set routines and familiar surroundings.
    • Attachment or preoccupation with objects or part of objects
    • The smell, touch, taste, sound or sight of certain things may cause exaggerated response.
    • Self-injurious behaviours, or an inattention to pain may be present.
    • Temper-tantrums may occur without warning.

     

    Sensory Integration:

    • Certain sensations may cause exaggerated (hyper) or muted (hypo) reaction.
    • May appear upset by certain sounds, foods, or being touched.
    • May show a visual fascination with lights or movement.


    If you suspect that someone you know has autism, regardless of his or her age, it is very important that you speak up and reach out for support. Research shows that the earlier an individual is accurately diagnosed and can start receiving intervention, the higher his or her chances of making the most developmental gains.

    If you suspect a child you know has autism, the first thing you need to do is consult a qualified specialist (QS): a pediatrician, a registered psychologist, or a psychiatrist. He or she will refer you to the British Columbia Autism Assessment Network (BC-AAN) for diagnosis and assessment.

    You may also want to consult The Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R™). This is a scientifically validated screening tool for children between 16 and 30 months of age that assesses risk for autism spectrum disorder (ASD).

    If the individual is between the age of 0-19 and your family doctor suspects he or she has autism, you will be referred to the British Columbia Autism Assessment Network (BCAAN). Diagnostic screening and assessment can only be done by a governing health care authority in your area.

    How is Autism Diagnosed?

    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. 1) Seek a medical evaluation from a pediatrician who, likewise, suspects signs of ASD in your child. 2) 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. 3) 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.

    If you have any questions or concerns about the above information, please contact one of our Information Officers at 1-888-437-0880, or email info@autismbc.ca.

    Is There Treatment?

    Yes. Scientifically validated forms of intensive early intervention, such as Applied Behavioural Analysis (ABA), have been shown to help individuals with autism acquire meaningful skills and learning techniques and ultimately reach their full potential. Significant research has been done to determine which treatment options are most effective. While early intervention models vary, here is a list of features you should look out for when determining which treatment is right for you and your family:

    • The program is carried out by a multidisciplinary team of individuals, including a physician, a speech-language pathologist, an occupational therapist.
    • The child receives structured, skills-based, therapeutic intervention for at least 25 hours per week.
    • The intervention is delivered by highly trained therapists and/or teachers.
    • Para-professionals may assist as necessary under the supervision of an autism specialist.
    • The program thoroughly engages the caregiver/s, both in decision-making and in the delivery of treatment.
    • The therapy is guided by specific and well-defined learning objectives, and the child’s progress is accurately tracked and evaluated to ensure goals are being met.
    • The intervention focuses on the unique needs of the individual with focus on the core areas affected by autism: social skills, language and communication, imitation, play skills, daily living and motor skills.
    • The program provides the child with opportunities to interact with typically developing peers, and other members in their community.
    • The therapist respects the unique needs, values and perspectives of the child and his or her family.

    If early treatment is not an option for you, please note that evidence-based effective treatments have also been shown to provide significant improvements in the condition of older children, youth and adults with ASD conditions.

    To learn more or to find resources please click here. To speak with one of our information officers contact us at info@autismbc.ca or call 1-888-437-0880.

  • What is Autism?

    According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impaired social interaction, difficulties with verbal and non-verbal communication, and restricted or repetitive behaviour (CDC). As of March 2014, 1 in 68 children have been identified as having ASD with it being 4.5 times more common in boys (1 in 42) than in girls (1 in 189).

    Click here for the precise diagnostic criteria.