Autism Spectrum Disorder

TABLE 5.2 Language and Communication Milestones in Infancy and Toddler Development
The essential diagnostic features of ASD

• Impairments across two domains of functioning:

• (1) social communication and social interaction
• (2) restricted, repetitive patterns of behavior, interests, or activities.
According to the DSM-5 deficits
• (1) social-emotional reciprocity, (2) nonverbal communicative
behaviors, and (3) developing, maintaining, and understanding social
relationships.
Restricted, Repetitive Patterns of Behavior,
Interests, or Activities
• indicated by at least two of the following symptoms:
• (1) stereotyped motor movements, use of objects, or speech;
• (2) insistence on sameness or ritualized routines;
• (3) highly restricted, fixated interests; or
• (4) hyperreactivity or hyporeactivity to sensory input
Additional specifiers for ASD
• 1. With or without intellectual impairment
• 2. With or without language impairment
• 3. Associated with a known medical or genetic condition or
environmental factor
• 4. Associated with another neurodevelopmental, mental, or behavior
disorder
• 5. Catatonia
Assessment Strategies
• 90 percent of parents express concerns by the time the child is 2 years
old
• include delayed language, development, regression or loss of skills,
not responding to verbal commands, and developmental delays
compared with siblings
• The Autism Diagnostic Interview-Revised (ADI-R; Rutter, Le Couteur, &
Lord, 2003)
• Autism Diagnostic Observation Schedule, Second Edition (ADOS-2;
Lord et al., 2012),
The Autism Diagnostic Interview-Revised
• For children and adults and contains 93 items three functional
domains:
1. Language/communication
2. Reciprocal social interactions
3. Restricted, repetitive, and stereotyped behaviors and interests
• Cover eight content areas (demographics, overview of behavior, early
development and milestones, language acquisition, current
functioning, social development and play, interests and behaviors,
and clinically relevant concerns, including aggression and self-injury).
 Autism Diagnostic Observation Schedule
ADOS
• Semi-structured, standardized clinical assessment of communication,
social interaction and play, and restricted or repetitive behaviors
• Structured activities and materials and less structured interactions
• Observed during a 45-minute to 1-hour period
• Assess standard presses for communication and social interaction
 Parent Report Instruments
• Modified Checklist for Autism in Toddlers (M-CHAT; Robins, Fein, Barton, & Green,
2001)
• Baby and Infant Screen for Children with aUtIstic Traits (BISCUIT; Matson et al.,
2009)

• Childhood Autism Rating Scale, Second Edition (CARS-2; Schopler & Van Bourgondien,
2010)

• Early Screening of Autistic Traits Questionnaire (ESAT; Dietz, Swinkels, van Daalen,
van Engeland, & Buitelaar, 2006);

• Social Communication Questionnaire (SCQ; Rutter, Bailey, Berument, Lord, & Pickles,
2003)
Related Assessment Strategies for ASD
• Necessary to obtain measures of cognitive abilities
• Expressive and receptive language functioning
• Presents with intellectual or language impairment
• Achievement testing (e.g, Woodcock-Johnson III Tests of Achievement)
• Adaptive behavior and socioemotional symptoms
• medical evaluations may consider motor function abilities, hearing, or
concomitant medical conditions
• Genetic testing, fragile X,DiGeorge, and Rett syndromes
• DNA analysis would provide diagnostic clarity