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diagnosis
The criteria for the diagnosis of autism include three primary areas of difficulty:
- impaired social interaction
- qualitative impairments in communication
- restricted interests or play, and repetitive and/or stereotyped
behaviors
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The diagnosis of autism involves a comprehensive evaluation of the child's skills and abilities in all areas, as well as a focused assessment of the areas that are of most concern, including social relatedness, communication skills, play skills, and sensory processing. The diagnosis is made, generally by a medical or mental health professional, by integrating information from all areas that are assessed. Autism is not a mental illness, but mental health, as well as medical, professionals have the training and experience to make a formal diagnosis that involves determining the significance of certain behaviors. Because the diagnosis of autism involves consideration of many different areas of behavior and performance, it is often more effective and easier for families to have the evaluation conducted at an agency where multidisciplinary teams can evaluate all areas of functioning and communicate their findings to each other before a final diagnosis is made. Very young children should receive a multidisciplinary developmental evaluation. Parents should express any concerns they may have about how their child will react in a new environment before the evaluation, so the clinicians can talk with the parents about what the setting will be like and can plan appropriately for the child's visit.
The evaluation should include:
- a psychological evaluation to determine the child's cognitive
ability level. Sometimes specialized evaluation tools, such
as the PEP (TEACCH), are used. Tools that evaluate only
nonverbal ability are also available
- a comprehensive speech and language evaluation
- an occupational therapy evaluation that includes assessment of their motor skills and sensory processing skills
- a medical evaluation
- the results of these evaluations are then integrated with
behavioral observations and parent reports. There are some
standardized tools to assist clinicians with behavioral
observations, such as the CARS.
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Some issues that need to be addressed in determining a diagnosis include
whether or how the child initiates or shows interest in social interactions,
responds to social interactions, uses nonverbal communication skills,
engages in restricted play and rigid behaviors, engages in sensory
seeking or avoiding behaviors, and has difficulty with self regulation
(includes both under and over arousal). Checklists of problematic
behaviors, while helpful in screening for autism, are not sufficient,
because often the quality of the child's interaction is key as opposed
to whether a particular behavior is observed. For example, many children
with autism do make eye contact, especially with familiar people.
However, often what is observed is that the eye contact is less frequent
than would be expected, or it is not used to effectively communicate
with others. Young children express these behaviors in different ways
than older children, and so it is critical that an evaluation of a
young child be conducted by experienced professionals who possess
backgrounds in working with the younger population.
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Disabilities 
