Autism Testing: Your questions answered by Dr. Casey Ferri, Psy.D., M.S.

Autism Testing: Your questions answered by Dr. Casey Ferri, Psy.D., M.S.

What is Autism Spectrum Disorder?

Autism Spectrum Disorder (ASD) is a developmental disorder that is most commonly identified at an early developmental age, or once social demands become more prominent within a child's life. Given the range of the spectrum from mild to severe, many adults may go through life feeling out of place, wondering if they qualify for a diagnosis. 

What should I be asking myself to determine if I or someone I know may have Autism?

If you're not sure of the symptoms of autism (and I will map them out more in-depth below), you may want to consider the following questions: 

For children considering ASD testing: 

  • Did your child struggle to reach developmental milestones (speech, crawling, walking) at a typical rate?

  • Does your child exhibit atypical social behaviors (avoids eye contact, prefers to play alone, does not respond to their name or facial expression)?

  • Does your child display any repetitive habits, fixations, or unusual routines?

  • Does your child have difficulty coordinating body movements?

  • Does your child display any particular sensory interests or dislikes?

For adults seeking ASD testing: 

  • Do you often feel you do not fit in with others or feel “different”?

  • Do you struggle in interpersonal relationships?

  • Do you have difficulty appropriately participating in conversations?

  • Do you like things done a specific way or have rigid interests?

  • Do you find that you need specific instructions to understand what others expect of you?

What are the DSM diagnostic criteria for Autism Spectrum Disorder? 

In simple terms, to receive a diagnosis of Autism, a child or adult must display deficits in the following two categories which disrupt social, emotional, and cognitive development: 

  1. Persistent deficits in social communication and social interaction across multiple contexts 

  2. Restricted, repetitive patterns of behaviors, interests, or activities in at least two instances

Diagnosis is broken down into three possible severity levels: Level 1, “Requiring Support”, Level 2, “Requiring Substantial support, and Level 3 "Requiring very substantial support”

Full DSM-V diagnostic criteria can be found here.

Do online tests for autism work?

If the questions above sound like you, you may have considered taking an online test to assess for Autism Spectrum Disorder. These “screening measures” have become increasingly popular and while online tests can provide insight into behaviors as well as some insight, it is important to recognize that they are self-assessment tools that often consist of questionnaires or checklists that assess common autism-related traits and behaviors and are in no way a valid substitute for a professional evaluation and diagnosis! 

Online tests for autism can provide a preliminary indication or raise awareness about potential symptoms, but they cannot provide a definitive diagnosis. Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition that requires a comprehensive evaluation by a qualified healthcare professional, such as a psychologist, or psychiatrist, for an accurate diagnosis.

Given the strict criteria and the level of observation and evaluation it takes to support an Autism Spectrum diagnosis, there is no way an online tool could be definitive in determining an accurate outcome. 

So in short, no, online tests are not sufficient indicators for autism in my professional opinion. 

I think I or my child may have symptoms of Autism. Should I consider getting an Autism Evaluation through a school or receiving an evaluation from a doctor?

The evaluation process for autism can vary depending on whether it is conducted by a school or a private clinician. It's important to note that while school evaluations can provide valuable information within an educational context, they are not always sufficient for a comprehensive diagnosis or to provide a detailed understanding of an individual's strengths and challenges. Private evaluations, conducted by qualified professionals, offer a more in-depth assessment and can provide a broader perspective on the individual's needs. 

Here are some key differences:

  • Diagnosis Vs. Eligibility
    • School evaluations: Evaluations primarily focus on determining eligibility for special education services and developing an Individualized Education Program (IEP) or a 504 plan. The goal is to identify educational needs and develop appropriate interventions within the school setting. The Individuals with Disabilities Education Act  (IDEA) has defined 14 eligibility categories for IEPs, one of which is Autism. Schools cannot give your child a diagnosis of autism; they do not have the authority to do so. Instead, they evaluate children to determine if they fit the eligibility criteria for any of the specific categories.
    • Private evaluations: Provide a broader, more comprehensive diagnosis and understanding of autism for various purposes, including accessing therapies, seeking medical interventions, or obtaining accommodations both inside and outside of the school setting. These more detail-oriented evaluations will assess multiple domains, including social communication, sensory processing, cognitive abilities, and adaptive functioning, to provide a comprehensive picture of the individual's strengths and challenges.
  • The Team

    • School evaluations: School evaluations typically involve a multidisciplinary team within the educational system, which may include school psychologists, special education teachers, speech-language pathologists, and other relevant professionals. 

    • Private evaluations: Often conducted by clinicians specializing in neurodevelopmental disorders, such as psychologists or psychiatrists, who have expertise in diagnosing and assessing autism.

  • Evaluation Tools

    • School evaluations: Use standardized assessment tools that are specifically designed for educational purposes, focusing on identifying academic and functional needs. 

    • Private evaluations: Utilize a wider range of assessment tools, including standardized measures, clinical interviews, observations, and parent or caregiver input, to gather information about the individual's developmental history, social interactions, communication skills, and other relevant areas.

How is autism tested for adults and children? 

At Heritage Counseling a typical Autism Evaluation for children or adults consists of:

  • 4-5 sessions, each 3-5 hours in nature. 

  • Each appointment consists of 30 minutes of observation to start, one or two independently, one with each parent or guardian, one with a stranger, and at times one with a sibling. Utilization of two in-depth ASD evaluations:

    • ADI-R: A diagnostic interview that seeks to develop an understanding of developmental, health, social, communication, and play, both past and present.

    • ADOS: An observation schedule that consists of multiple structured presses which challenge the individual being tested in multiple scenarios and is later coded. 

  • Intelligence (IQ) testing, achievement testing, behavioral testing, adaptive functioning, language, visual, gross motor, and fine motor all included in the evaluation. 

    • These additional tests serve two functions, 1. further support an autism diagnosis and provide valuable insight into additional strengths and weaknesses as well as ways to best support the client moving forward, and 2. If an autism diagnosis is not supported, provide further answers into social, emotional, and developmental functioning to a client who is clearly struggling in one of those areas given the need for an evaluation. 

Once receiving a diagnosis of Autism Spectrum Disorder, what will treatment look like?

The treatment plans for individuals who are diagnosed with autism, whether adults or children are typically individualized and tailored to the specific needs and challenges of the person. The treatment approach may involve a combination of various interventions and therapies. Ongoing monitoring, evaluation, and adjustment to the treatment plan are typically necessary to address changing needs over time. The following are commonly used approaches to treatment plans for individuals diagnosed with Autism Spectrum Disorder:

Cognitive Behavioral Therapy (CBT): Addresses specific challenges related to cognitive processes, emotions, and behaviors through multiple approaches. 

  • Cognitive restructuring: Helps individuals reframe thoughts and develop more adaptive thinking styles regarding social interactions, sensory experiences, and self-perception.

  • Emotional regulation: Individuals with autism face challenges with understanding and regulating emotions. CBT will assist in recognizing and labeling emotions, developing strategies to manage intense emotions, and promoting appropriate self-regulation.

  • Problem-Solving Skills: CBT uses proving solving skills to develop strategies to address everyday challenges. This may include breaking down complex tasks into manageable pieces, developing alternative solutions and displaying cognitive flexibility, and evaluating outcomes of different strategies.

  • Social Skills Training: Focuses on teaching specific social behaviors, understanding social cues, and improving social interactions overall. It may involve role-playing, modeling, and providing feedback.

  • Anxiety and Stress Management: Many individuals with autism experience anxiety or high levels of stress in certain situations. CBT can help identify triggers for anxiety or stress, develop relaxation techniques and learn coping skills to manage big feelings effectively. 

  • Generalization of skills: CBT aims to facilitate the generalization of skills learned in therapy to real-life situations across the lifespan. This involves practicing and applying the strategies and techniques learned in therapy sessions to various contexts and settings.

Behavioral Therapies: Applied Behavioral Analysis (ABA) is a widely recognized and evidence-based therapy for autism. It focuses on increasing desired behaviors and reducing challenging behaviors through systematic reinforcement and shaping techniques. ABA is often provided at home, or at a private facility. 

Speech and language therapy: Many individuals with autism experience difficulties in communication. Speech and language therapy aims to improve communication skills, including language development, speech clarity, social communication, and pragmatic language skills. 

Occupational Therapy: Occupational therapy addresses challenges related to sensory processing, motor skills, and daily living activities. It helps individuals develop skills necessary for independent functioning and enhances their ability to participate in daily activities. 

Educational Support: For children, special education services and individualized Educational programs (IEPs) can provide tailored support within the school setting. For adults, continuing education and vocational training programs may be beneficial in developing skills for employment and independent living.

Medication: In some cases, mediation may be prescribed to manage specific symptoms associated with autism, such as anxiety, attention difficulties, or aggression. Medication decisions should be made in consultation with a qualified healthcare professional.

Next Steps 

If you suspect that you or someone you know may have autism, it is important to consult with a healthcare professional who specializes in diagnosing and treating autism. They will conduct a thorough assessment, which may include interviews, observations, and other standardized tests, to make an accurate diagnosis.

Heritage Counseling & Consulting is currently offering a 30-Minute free consultation to discuss what Autism Spectrum Disorder testing includes and will determine if the client is a good candidate for testing moving forward. Please call 214-363-2345 to schedule.