Autism Spectrum Disorder

Evaluation in Autism Spectrum Disorder

Autism is the most common neurological disorder encountered today and is accepted to affect one in every 150 children. In addition, the prevalence of autism in boys is three to four times higher than in girls.

Most individuals with autism appear physically normal. Tests that can be used to make a definitive diagnosis of autism have not yet been developed, nor are there any tests that can reveal the differences between subgroups of autistic disorders. Blood tests, X-rays, brain scans, electroencephalograms and other physical examinations do not provide sufficient information to prove or disprove the existence of autistic spectrum disorder. There is currently insufficient information about what causes autism.

Diagnosis is made based on behavioral patterns that have existed since the early stages of life.

The most commonly used diagnostic criteria for autism are those accepted by the DSM IV (American Psychiatric Association), ICD (International Classification of Diseases) and WHO (World Health Organization), and these criteria are accepted by experts in research on autism.

DSM-IV-TR Diagnostic Criteria for Pervasive Developmental Disorders

There must be a total of six (or more) items from items (1), (2) and (3), at least two from item (1) and one each from items (2) and (3):

Qualitative Deterioration in Social Interaction as Manifested by the Presence of at Least Two of the Following:

• Significant impairment in many nonverbal behaviors such as hand and arm movements, body positions, facial expressions, and eye contact for social interaction
• Failure to develop developmentally appropriate relationships with peers
• Failure to spontaneously seek out other people for fun, or to share interests or achievements (e.g., failure to show, bring, or indicate objects of interest)
• Failure to respond socially or emotionally

Qualitative Deterioration in Communication Manifested by the Presence of at Least One of the Following:

• Delayed or absent development of spoken language (not accompanied by attempts to substitute for it with other means of communication such as hand, arm, or facial movements)
• A marked impairment in initiating or sustaining conversations with others in individuals with adequate speech
• Using stereotyped or repetitive or idiosyncratic language
• Failure to spontaneously engage in a variety of imaginative or socially imitative games appropriate to developmental level

Restricted, stereotyped, and repetitive patterns of behavior, interests, and activities as manifested by at least one of the following:

1. Abnormal in level of interest or focus, fixation on one or more stereotyped and restricted patterns of interest
2. Specific, dysfunctional, rigid adherence to routine routines or rituals with little or no flexibility
3. Stereotyped and repetitive motor mannerisms (e.g., finger snapping, hand flapping or twisting, or complex whole-body movements)
4. Persistent preoccupation with parts of objects
5. Delays or unusual functioning before age 3 in at least one of the following areas: (1) Social interaction, (2) language used in social communication, or (3) symbolic or imaginative play
6. The disturbance is not better explained by Rett Disorder or Childhood Disintegrative Disorder

How and by Whom Is Autism Diagnosed?

In our country, the specialists who can diagnose autism are child psychiatrists and child neurologists. The diagnosis is made by specialists observing the child, performing developmental tests, and asking parents questions about the child's development.

Early diagnosis is important for the start of education as soon as possible.

Immediately after a child is diagnosed with autism, the step of planning the education program should be taken. The treatment of autism is continuous and intensive education.

The earlier a child with autism starts receiving special education, the faster he/she can progress. Autistic children should be given special education for at least 15 hours a week, preferably 35-40 hours, with education programs specially prepared for autistic children.

In addition, various psychiatric medications are used to reduce behavioral problems such as hyperactivity, temper tantrums, and obsessions in autistic children and to increase their attention.