Is it Autism?

 

What are the Early Signs of Autism?

The criteria for diagnosing autism include (1) challenges with social communication and interaction and (2) restricted or repetitive behaviors or interests. It is important to note that most children with autism engage in just some, but not all, of the behaviors listed. The Centers for Disease Control and Prevention has a list of the signs of autism that can be found here.

Additionally, the American Academy of Pediatrics has a similar list, “What are the Early Signs of Autism?” that includes examples of how to tell the difference between a child with autism and a typically developing child.  Autism Navigator developed the Baby Navigator Lookbook: 16 Early Signs of Autism by 16 Months.

Kennedy Krieger Institute has developed a free 9-minute video tutorial to improve recognition of the early signs of ASD. The tutorial consists of six video clips comparing toddlers who show no signs of autism to toddlers who show early signs of autism.

 
 
 

If I Suspect Autism, what do I do next?

If you suspect autism, there are several options for next steps. It is often helpful to pursue multiple pathways at the same time. This includes seeking out an Early Intervention or educational evaluation (via Strong Start or Early Stages, respectively) and seeking out an evaluation within the medical setting. Talk to your child’s primary care provider about these options. If your child’s primary care provider has told you to “wait and see,” but you feel uneasy about that advice, you can self-refer to these resources.

Early Intervention/Educational Evaluations

Guided by the Individuals with Disabilities Education Act (IDEA) Part C and Part B, Strong Start and Early Stages are freely available to all families within the District of Columbia. These programs provide an evaluation of the following areas of development: communication; physical, including vision and hearing; cognitive; social-emotional; and adaptive skills. Following the evaluation, it will be determined if the child is eligible for (able to obtain) early intervention/special education services, feedback will be provided to families, and intervention plans will be developed if the child is eligible.

  • For children birth to 2 years, 10 months, Strong Start provides services via an Individualized Family Service Plan (IFSP) if there is a 25% delay in one of the five areas of development. Strong Start will identify “developmental delays or disabilities” but will not provide an ASD educational classification or diagnosis. Even though they do not diagnose or classify children as having ASD, they do provide important intervention services that many children with ASD need, such as speech therapy, occupational therapy, and applied behavior analysis.

  • For children 2 years, 8 months to 5 years, 10 months, Early Stages’ evaluations are used to determine if a child meets criteria for one of the 14 IDEA-specified disabilities (including Autism). These evaluations inform the development of an Individualized Education Plan (IEP). Evaluation could result in an educational classification of ASD, but Early Stages will not provide a medical diagnosis of ASD. Early Stages will create and recommend IEP services. IEP services are implemented in a DC public school setting (DC Public School or DC Public Charter School).

Evaluations of Autism within the Medical Setting

Children can receive a comprehensive autism evaluation in the medical setting by a medical provider (e.g., pediatrician, psychologist, or another medical specialist). These evaluations are usually covered by your child’s health insurance. Providers use your description of your child’s development, developmental history, observations, and assessments to determine if your child meets the DSM—5 diagnostic criteria for ASD. If your child meets these criteria, the provider will give your child a medical diagnosis of ASD.

 
 

What are the Differences Between a Medical Diagnosis and an Educational Classification of Autism?

Usually made by a medical provider in a healthcare setting using DSM—5 diagnostic criteria, a medical diagnosis of autism will not always lead to eligibility for early intervention/special education services. A medical diagnosis of autism can be helpful to make sure a child has additional access to services through their health insurance plan. A medical provider may be able to recommend therapies and other services that the child can benefit from that are not a part of the IFSP or IEP.  The medical provider will discuss with you the recommended support through early intervention or school. 

For children 2 years, 8 months of age and older, an educational classification of autism identifies autism as a disability under IDEA and determines eligibility for special education services. An educational classification of ASD can be helpful to make sure a child has access to needed support in school.

 
 

Why is it important to pursue both a Medical Diagnosis and an Educational Classification of Autism?

By pursuing both a medical diagnosis and an educational classification of ASD, families can have better access to services in school and in the community and may be able to support their child’s development more comprehensively. 

How do I Access Early Intervention/Educational Evaluations?

Your child’s primary care provider may refer you or you can self-refer to Strong Start or Early Intervention.

Please note that the early intervention/special education evaluation process will only begin after a parent/guardian has provided written consent.

 
 

Where Can I get my Child Evaluated for a Medical Diagnosis of Autism?

You can call your insurance provider and/or ask your child’s health provider to help you find a health care provider who can diagnose autism. To get you started, below is a list of clinics (in alphabetical order) that evaluate autism:

DC Metro Area:

Baltimore Area:

Parent Tips on How to Access Autism Evaluations:

  • Waitlists are long for medical evaluations (3 months-2 years), but do not get discouraged.

  • Call multiple clinics and submit paperwork, you can always call to cancel once you get an appointment.

  • Medical evaluation and early intervention/educational evaluations can happen at the same time, and it is often a good idea to pursue both at the same time.

  • Ask questions if you do not understand.

  • Work with your medical provider to arrange further diagnostic evaluations if needed.

If you need support in accessing or navigating these services, contact: 

The American Academy of Pediatrics has created a resource, “If Autism is Suspected, What Next?” which provides information on what happens during an autism evaluation, as well as a list of medical tests that are not recommended.

What should I do after an evaluation?

Parents should keep records of conversations and communications with providers and agencies. The Center for Parents Information and Resources created this Sample Record Keeping Worksheet. Parents should get a copy of the evaluation and share this with their child’s health and education providers.

Check out this blog post entitled “The First Three Things to Do When Your Child is Diagnosed with Autism” to help get you started.