How is the evaluation of Autism Spectrum Disorders?

Autism spectrum disorders (ASD) could be detected at an early age and for this it is necessary for a specialized professional with extensive experience to be in charge of carrying it out, since cases have been observed of children who do not receive a diagnosis until reaching a certain age.

When carrying out the evaluation of autism spectrum disorders (ASD), it is usual to begin with an interview with the parents and the child who has been overcome, and another joint interview is also carried out. Once the initial interviews have been carried out, it is when different tests would be carried out to make a more precise evaluation (for example, tests on cognitive development, evaluation of attentional development, standardized tests of ASD such as the ADI-R or the ADOS-2, etc).

In this article we will explain in more detail how the entire evaluation process for autism spectrum disorders is usually carried out by professionals.

Characteristics of the evaluation of Autism Spectrum Disorders

It is important to point out that the evaluation of autism spectrum disorders can become quite complex and that is why the professionals who are in charge of it should previously be extensively trained and trained for it, and it is common for it to begin with the help of a expert until you have enough experience to be able to make a correct assessment.

The diagnostic process, together with the previous evaluation of autism spectrum disorders, usually lasts several hours , and it may even be necessary to extend it over several sessions if necessary in those cases in which the detection generates doubts for the professionals; therefore, more diagnostic tests would need to be performed and thus could provide a more accurate evaluation and diagnosis.

The initial interview

Before carrying out the corresponding tests for the evaluation of autism spectrum disorders, an initial interview must be carried out. Therefore, it is usual to start with an interview with the parents and another with the child separately .

The interview with the parents usually begins with questions related to the reasons why they have come seeking professional help, in addition to analyzing the possible previous reports that another professional could have previously made (for example, the psychologist of the school the child attends and/or the testimony of a teacher).

Then, an anamnesis would be carried out, asking the parents about their child so that the professional who evaluates could get a general idea about the possible problems that the child could have and how these interfere with their environment in different areas and for this, a series of questions should be asked about relevant aspects of the child's life (for example, behavior at home and at school, relationship with other children of their age, hobbies, tastes, routine flexibility or day-to-day difficulties, etc.).

Regarding the topic of hobbies and tastes, it is important to collect information especially in order to know if the child has very specific tastes or very restricted interests , since it is common for people with autism to have very restricted interests and spend long hours focused on them.

Subsequently, another anamnesis will be carried out on the child directly, collecting information similar to that which was consulted from their parents in order to be able to contrast it later and thus obtain the most precise information possible. In addition, while this interview is taking place, it is important to pay attention to certain nonverbal details of the child , such as eye contact while communicating with the professional who is conducting the evaluation with him and other details such as whether there are motor stereotypes ( eg, constant finger twisting, hand shaking, etc.), or echolalia, among others.

Assessment of autism spectrum disorders

Once the initial interview with the parents and the child has been carried out, a series of tests and specific tests for the evaluation of autism spectrum disorders will be carried out (for example, tests of cognitive development, the D2 test or others that They are usually used in order to carry out an evaluation of their logical-mathematical, linguistic capacity, etc.).

1. Cognitive development

In the process of evaluating autism spectrum disorders, it is important that tests are carried out to assess the cognitive development of the child, since these serve to delve into certain aspects that could have been dealt with in the initial interview and could also help detect other psychopathologies, if any, in addition to ASD or any possible problem or difficulty related to evolutionary development.

To carry out the evaluation of cognitive development, tests such as the Merril Palmer Scale would be carried out, which is used with the smallest in order to evaluate their development in a global way, being important to pay special attention to analyze some aspects such as symbolic play or the theory of mind.

On the other hand, the Leiter International Manipulative Scale is also frequently used, which allows an evaluation of non-verbal attention, as well as certain cognitive and neuropsychological abilities, among others. In addition, the Wechsler Scales (eg, WPPSI, WISC) are commonly used to assess intelligence and certain cognitive abilities.

2. The evaluation of the TEA

Evaluation through standardized tests will be one of the most important in the evaluation process for autism spectrum disorders. These tests would basically be two: the ADI-R test, which is carried out with the parents, and the ADOS-2 test, which would be the one that would be carried out with the child or adolescent.

With the ADI-R test, an interview is carried out with the aim of exhaustively analyzing certain aspects that could be used to evaluate ASD, such as certain signs or indications observed by parents or even by teachers and the school psychologist. where his son goes. In this test, some relevant areas are mainly evaluated: social interactions, behavior, language, communication, possible restricted and repetitive interests, etc.

On the other hand, with the ADOS-2 test, the same areas would be evaluated as with the ADI-R test, only in this case the procedure would be carried out with the child or adolescent. This test would be focused on the objective of looking for various characteristics related to ASD cases (eg, restricted and repetitive interests).

3. Assessment of social development and adaptive skills

When carrying out the evaluation of autism spectrum disorders, it is important to resort to the use of tests that evaluate the social development and also the adaptive abilities of the child. For this, the Vineland Scale should be highlighted , which is used to carry out a detailed evaluation of personal and social skills that are important and very useful in people's daily lives.

On the other hand, within this evaluation area, we must not forget the Australian Scale, a 24-question test that professionals use in order to evaluate certain behaviors that are quite frequent in people with ASD. This would be a test that could be carried out with both the child's parents and teachers.

4. Assessment of communication and language development

It is essential to carry out specific tests to analyze communication and language development when carrying out the entire evaluation process for autism spectrum disorders. For this, the CSBS Scale (Communication and Symbolic Behavior Scale) is used, which consists of a questionnaire made up of 24 questions that parents should answer in order to detect some important warning signs of the child; being a test that is carried out with the parents of the youngest children (from 6 to 24 months of age).

In the event that the child was between 18 months and 7 years of age, it would be more advisable to resort to other tests such as the Reynell III Scales of Language Development. These scales are often used to detect possible problems related to language and communication.

5. The evaluation of attentional development

Finally, in the process of evaluating autism spectrum disorders, it is also important to carry out specific tests that can be used to assess attentional development. To do this, it is quite common to use the D2 Attentional Test , a test that is made up of a test against the clock that serves to measure the child's processing speed, the following of instructions and also the execution of the task that has been ordered.

Now that we have seen what the evaluation process for autism spectrum disorders consists of, we will have been able to observe that it is a fairly complex process and hence the importance of it being carried out by qualified and experienced professionals.

It should be noted that this evaluation can also be completed with other tests that allow a more detailed diagnosis, such as the SCL-90-R test , commonly known as the "90 symptoms test", which is used to make an evaluation of symptoms that could be present in each case since this test allows evaluating several dimensions (eg, anti-aging, interpersonal sensitivity, phobias, etc.).