Educating Children with Autism (2001) / Chapter Skim
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From page 23... ...
2 Diagnosis, Assessment, and Prevalence MULTIDISCIPLINARY PERSPECTIVES The diagnosis of autism and related autistic spectrum disorders in young children is often relatively straightforward but can, at times, be challenging (Lord, 1997~. Complexities in diagnosis and evaluation relate to the range of syndrome expression in these conditions along various dimensions such as language abilities and associated mental handicap (Volkmar et al., 1997~; differential diagnosis, particularly in children younger than 3 years (Lord and Schopler, 1989~; concerns regarding labeling (Hobbs, 1975)
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From page 24... ...
Because the studies did not consider individuals with less-pronounced variants of autistic spectrum disorder, it is possible that the figures for atypical autism/pervasive developmental disorder and Asperger's disorder are underestimates. Two simple reasons explain the difference in current and historical rates: more complete diagnoses and a broader definition of autistic spectrum disorders (Fombonne, 1999~.
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From page 25... ...
were found to have autistic disorder when diagnosed at 20 and 42 months (Baron-Cohen et al., 1992; Baron-Cohen et al., 1996; Charman et al., 1998; Cox et al., 1999~. However, the CHAT was less sensitive to milder symptoms of autism; children later diagnosed with other autistic spectrum disorders did not routinely fail the CHAT at 18 months.
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From page 26... ...
is a parent or teacher rating scale for high-functioning older children on the autistic spectrum who remain undetected at schoolage. The Pervasive Developmental Disorders Screening Test-II (PDDSTII)
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An adequate assessment will involve both direct observation and interviews of parents and teachers. The range of syndrome expression in autism and autistic spectrum disorders is quite broad and spans the entire range of IQ (Volkmar et al., 1997~.
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As a result, in working with a child with an autistic spectrum disorder, considerable expertise is required of the various evaluators. Evaluators must consider the quality of the information obtained (both in terms of reliability and validity)
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From page 29... ...
In addition, various studies have documented unusual aspects even of very early communication development in autism (Ricks and Wing, 1975; Tager-Flusberg et al., 1990~. In assessing language and communication skills, parent interviews and checklists may be used, and specific assessment instruments for children with autistic spectrum disorders have been developed (Sparrow, 1997~.
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From page 30... ...
The education of physicians, nurses, and others regarding warning signs for autistic spectrum disorders is very important. After initial referral for assessment and diagnosis, consultations with other medical professionals may be indicated, depending on the context (Filipek et al., 1999; Volkmar et al., 1999)
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From page 31... ...
Social interaction requires careful attention to multiple, shifting strands of information; an ability to perceive the thoughts, feelings, and intentions of others; and coping with novel situations on a regular basis. In children with autistic spectrum disorders, social difficulties persist over time, although the nature of the social difficulties may change with age and intervention (Siegel et al., 1990~.
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