Diagnosis

As you may well be aware, there are still no medical tests for a diagnosis of autism (or autistic) spectrum disorder.  When a professional is trying to decide if a youngster is on the spectrum, he or she is looking for particular types and degrees of difficulty, and for particular patterns of development in each of three areas of development: social interaction; social communication; flexibility of thinking and behaviour. To get a comprehensive and reliable picture, you need information from a range of sources. Guidelines published by NICE (the National Institute of Clinical Excellence) in 2011 give recommendations about the content of the assessment. You can see these for yourself by clicking on this link:    (http://guidance.nice.org.uk/CG128/QuickRefGuide/pdf/English). As you’ll see, the core ingredients  recommended by NICE include:

  • Detailed questions about the parent’s concerns
  • A detailed developmental history, preferably using ‘an autism-specific’ tool to gather this information
  • Direct observation and assessment of specific social skills, communication skills  and behaviours, consistent with ICD 10 and DSM5 criteria (the official diagnostic criteria). Again, it recommends the use of a recognized autism-specific assessment tool

Often it is extremely helpful to have observations from other settings, and information from other sources (particularly the youngster’s school or nursery). The NICE guidelines also recommend that a doctor (typically a Paediatrician) takes a medical history and carries out a physical examination. Although ASD cannot be medically diagnosed, this is to check if the youngster has other physical conditions relevant to the diagnosis.

I am able to offer diagnostic assessments that are in full accordance with these core ingredients:

  • I am qualified and experienced in the use of the Autism Diagnostic Interview (Revised). The ADI (R) is often referred to as one of the ‘gold standard’ assessment instruments and is widely used in research. I am also qualified in the use of the Diagnostic Instrument for Social and Communication Disorders (DISCO) and the Developmental, Dimensional and Diagnostic Interview (3Di).
  • I am  trained and experienced in the use of the Autism Diagnostic Observation Schedule (ADOS). This is a battery of play based activities, tasks and discussion topics, with specific modules selected according to the language skills of the child. It is commonly used alongside the ADI-R and, again, is seen as one of the ‘gold standard’ assessment activities.
  • I have considerable experience of observing youngsters in their home and educational settings, where subtle (and sometimes not so subtle!) signs of possible ASD are apparent. This is particularly important where it is necessary to get a clearer view of a child’s interactions with peers

In my experience, it can also be useful to seek information from staff in the child’s school or nursery—and I will always try to liaise with other involved professionals, if possible. In addition,  I would always recommend that parents also seek the involvement of a paediatrician, but in most instances a sound diagnostic conclusion can be reached on the basis of assessments and observations that I’ve described above.

The different components of the assessment do not need to all take place at one time or in one setting. Practical arrangements can be tailored to suit your and your child’s needs.  The first step would always consist of discussing your concerns and getting key information about your child and any previous assessments. I can then plan the separate components of the assessment and give you a clear picture of the likely time and costs involved. Once completed, the findings of the assessment, its conclusions and any suggestions for further action will be provided in writing. Please contact me on philip.whitaker@virgin.net If you wou would like to see and hear more about the process of diagnosis and what it may mean for you and your child, you can view the podcasts below on You Tube by just clicking the links. I produced these for parents of newly diagnosed children with the aim of answering many of the questions that parents often raise in the weeks following their child’s assessment.

After diagnosis 1—making sense of ASD http://youtu.be/CMuztO0DA8Q

After diagnosis 2—understanding your child http://youtu.be/WEWe9UPxIJM

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