Who Should Diagnose Autism Spectrum Disorders?

It seems that everyone, including the lady at the grocery store, can spot autism when they see it. But of course, it's not that simple. Autism is not just a collection of personality traits and personal interests, and not everyone who prefers solitude and comic books is autistic. In fact, autism is a serious developmental disability, and diagnosis requires testing, evaluation, and an in-depth understanding of the disorder.

What Is an "Autism Specialist?"

Before 1994, autism wasn't diagnosed frequently. The change in diagnostic criteria (among other factors) has increased the awareness of the condition significantly. . But there are still relatively few medical professionals who are specifically trained to diagnose and/or treat autism. As a result, the people who are best qualified to diagnose children with autism are those professionals who have had the most experience in doing so, and those professionals may have a wide range of titles. These may include:

• Developmental Pediatrician
• Pediatric Neurologist
• Child Psychologist
• Child Psychiatrist

In addition to these medical professionals, there are many therapists who can take part in a multidisciplinary evaluation of your child. While these people are not medically trained, they may know as much or more about autism as a highly trained doctor -- simply because they spend so much time around autistic people. These individuals may include:

• Speech Therapist
• Occupational Therapist
• Physical Therapist
• Social Worker

How Autism Is Diagnosed

There is no simple medical test for autism, and there are many disorders that look similar to autism (sensory processing disorder, apraxia of speech, and ADHD are just a few examples). Because of this, diagnosis is based on a combination of parent interviews, non-medical tests, observation, and professional judgment. Evaluators will check on your child's developmental stage, language acquisition, imitative skills, and cognitive skills. That's why experience, in addition to training, can be critical in providing a meaningful diagnosis.

Who Should Diagnose Your Child?

With so many possible options, who is the right person to diagnose your child? The answer depends, to a large degree, upon who is available. Depending on where you live, you may find that there is a long wait to see a developmental pediatrician, while you can get in to see an experienced child psychologist almost right away. While you might be more impressed with the developmental pediatrician's credentials, you might decide that the wait is simply too long. If your child really is autistic, early intervention can be very effective—and the earlier your child starts therapy the better his outcomes are likely to be.

Another issue to consider is money. You may discover that, while a neurologist is covered by insurance, a psychologist is not. In some states, early intervention programs provide free multidisciplinary evaluations; in other states, such evaluations may be hard to access.

A word of advice from highly experienced psychologist Dr. Robert Naseef: even if your initial diagnosis comes from a psychologist, it may be worth your while to also consult an M.D. The reason is more political than medical: without an M.D. behind your child's diagnosis, says Naseef, your local school district may not provide an appropriate array of services.

Finding the Right Person to Diagnose Autism

The right person or group to diagnose your child will be trained, experienced, affordable and available in your area. To find that person (or group):

• Start with your own pediatrician. He or she may have a terrific list of names, and may even be able to help you get an appointment quickly.
• Connect with other parents. Local support groups and listserves are wonderful resources for information about professionals who are both competent and supportive.
• Check with your school district and/or regional agencies. You may find there are low-cost or free options available to you.
• Surf the web. If you live outside a major city, you may find terrific resources that your suburban sources know nothing about.
• Do your homework. Check on the recommended specialists to be sure that they really have the credentials and experience you want.