Autism assessments: What happens after an evaluation?

Today's guest bloggers are Carol Anne McNellis, Psy.D., clinical director at Devereux PA Children's IDD Services and a member of the Devereux PA Autism Resource Team and Todd Harris, Ph.D.,  the director of Autism Services for Devereux Pennsylvania and Devereux's National Autism Consultant. This is the second of two parts.

In our last post, we discussed the recent recommendations from the U.S. Preventive Services Task Force on the benefits of screening toddlers and preschool-age children who have not raised concerns with caregivers or health care professionals for Autism Spectrum Disorder. The panel concluded that there is insufficient evidence to adequately assess the benefits and harms of routine screening for ASD in children and recommended more research to help it make a concrete determination.

However, many organizations in the field of autism, including Devereux, the Autism Science Foundation and Autism Speaks, continue to support ongoing developmental surveillance and specific autism screening at 18 months and 24 months in all children, as well as whenever a parent has any sort of concern. We had also talked about the early symptoms of autism.

Now let's learn more about assessments and what happens after a child goes through an assessment.

The "gold standard" of autism assessments is the Autism Diag­nosis Observation Schedule (ADOS-II). The ADOS is one com­ponent of a comprehensive evaluation performed by an assessment team that may include psychiatrists, developmental pediatricians, and licensed psychologists. This test diagnoses autism by evaluating a child's behavior. During the test, children are asked questions so their responses can be evaluated to determine whether they are typical for a child of that age.

An autism assessment may determine that the child does not have an ASD diagnosis. In this case, the assessment will provide recommendations that may suggest additional types of evaluations to clarify what may be causing the behaviors of concern and may also include a description of services and supports that can also be helpful to family.

If the assessment results in an autism diagnosis, the assessment team can recommend intervention services and programs. Accessing early intervention services is critical to children with autism, helping them to develop more effective methods of interacting and communicating with others before maladaptive behavior patterns become difficult to manage. In fact, the University of California released a study in 2014 that outlined how early intervention among infants – participants identified based on key behavioral signals, such as unusual visual fixations, abnormal repetitive behaviors, or difficulty maintaining face to face interaction – helped to significantly reduce symptoms.

Treatment techniques, such as Applied Behavior Analysis, are considered among the best practices in treating individuals with autism. Using principles from learning theory, ABA principles and techniques can foster basic skills such as looking and listening, as well as complex skills such as talking and understanding another person's perspective. The approach can be effective depending on the intensity of an individual's behaviors.

For the best outcomes, families should seek providers experienced in delivering autism services backed by evidence-based approaches such as ABA or cognitive-behavioral theoretical frameworks. With the right interventions and supports, individuals of all ages diagnosed with ASD, including infants and toddlers, can build their social and communication skills, minimize challenging behaviors, and live productive and satisfying lives.

Parents are encouraged to visit the following resources for more information about autism assessments and interventions:

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