DIAGNOSING AUTISM: ASSESSMENT

Diagnosing Autism: Assessments and Identification

Jillian Gallant
University of New England
January 31, 2016

DIAGNOSING AUTISM: ASSESSMENTS

Diagnosing Autism: Assessments and Identification

Autism today in the US is becoming increasingly prevalent. It is estimated that 1 in 110
children born will be diagnosed with an Autism Spectrum Disorder (ASD) (Lord & Bishop,
2010). A diagnosis of ASD is likely to put financial and emotional strain on families in the quest
to find and receive services for the disorder. For this reason, it would be sensible that
assessments and diagnostic measures would be somewhat universal and more accessible.
Surprisingly, this is not so. There is a sense of disharmony among diagnostic tools and the
disorder being diagnosed.
In her paper, Amy Marie Wormald (2011) outlines and investigates ASD diagnoses and
the methods in which these diagnoses are reached. Her work turned up many different methods
and implications for testing. While frequently the tests the schools used are given in conjunction
with one another, teachers responded that often there was no set order of tests given, or a
protocol for which tests should be used. She included in her study, the use of the Childhood
Autism Rating Scale (CARS), Gilliam Aspbergers Disorder Scale (GADS), Childhood Autism
Spectrum Test (CAST), Autism Diagnostic Observation Schedule and others. It was interesting
to see that this author also found a large variance to frequency of re-testing. Many schools reevaluate after three years, others every year, every few months or almost never. While each child
and situation is unique and requires flexibility, it is interesting that there are very few protocols
regarding how many tests are given and a baseline for how frequently re-testing is required.

DIAGNOSING AUTISM: ASSESSMENTS

Lord and Bishop (2010) also find facets of ASD identification perplexing. They mention
that while there is no biological reason or marker yet identified with ASD, the definition of the
disorders are being reviewed and updated in the newest version of the DSM. These authors
highlight that the process of diagnosis is flawed in that there are issues with funding for
assessments and the assessments vary greatly because test givers are human and hold different
opinions. They identify that in order to achieve high quality testing, the administrators need to
be well trained and be thorough in their assessments. Unfortunately, funding for this quality is
almost never available and much of the costs are deferred to the family. Families often struggle
financially in order to receive not only the testing, but support services that are needed for their
child. Lord and Bishop discuss how insufficient insurance coverage leads to 9 out of 10 children
with Autism not getting the interventions they need.
These authors argue that systematic testing for ASDs is difficult because the needs of
each family are different, and that treatments need to be controlled and centered around the
family. They also discuss ABA techniques and argue that while they are effective for teaching
and offer precise data collection, these techniques do not reach goals needed for the family. This
article implies that there are many changes to be made to comprehensively assess and diagnose
ASD and to maintain goals and documentation of progress for the student involved.
A third group of authors offer some interesting points about Aspergers Disorder, a highfunctioning diagnosis of ASD, and its similarities to and confusion with giftedness. Amend,
Schuler, Beaver-Gavin and Beights (2009) discuss the traits of giftedness and the lack of
understanding surrounding them in families and schools. Given a personal experience with a
DIAGNOSING AUTISM: ASSESSMENTS

student like the one they describe in their article, I was intrigued with the diagnosis process and
the potential for pervasive behaviors in gifted students. These authors imply that a gifted learner
can be under stimulated by their educational surroundings, therefore they present behavior which
varies from the norm, creating confusion towards a diagnosis of Aspergers disorder. It is clearly
implied that this group associates many of the similarities to the frustration of the gifted student.
The inflexible environment of many schools can be a trigger for inappropriate behavior and there
are strategies to keep a gifted learner challenged and engaged appropriately in school.
This article discusses an instrument designed for differentiating between giftedness and
ASD called the Dimensional Discrepancy Model GFT + AST, the only one designed for this
differentiation. Another checklist is presented here, however, and is designed for professionals
and parents to initially decide if interventions are necessary for Aspergers Disorder or
giftedness. This checklist is appropriately called the Giftedness/Aspergers Disorder Checklist
(GADC) and looks into memory and attention, speech and language, social and emotional,
behavioral, and motor skills areas of the students presentation. The checklist is simply filled out
and the checks are evaluated by whether they are behaviors of a gifted learner or a student who
presents more similarly to Aspergers Disorder. If the checks are mostly on the side of
Aspergers Disorder, it is suggested to move ahead with a formal evaluation. The authors
provide resources for both giftedness and Aspergers Disorder.
The three articles outlined here are very different in their nature and topic, however,
together they offer a more complete picture of todays assessment and identification of ASD.

DIAGNOSING AUTISM: ASSESSMENTS

Students who are high-functioning may be gifted, be diagnosable with ASD, or both.
This is something that I feel is not often thought of prior to evaluation. While the checklist
provides a visual support to justify evaluation, it seems it may be an unnecessary step. In many
cases, formal evaluation is still needed to offer the most appropriate treatment. I do, however,
value the message of this article in that we need to be cognizant that there are other reasons
behind some of our students behaviors and that interventions may take place to positively effect
the learners without a diagnosis.
In terms of the process of diagnosis and monitoring progress, our system does seem to
have some flaws. While testing material and method needs to remain flexible to accommodate
every student, it seems that more clear baselines and expectations need to be implemented. This
is true in regards to both who does the assessments and the frequency of the testing. Families
and schools alike seem to be in a state of confusion as to whether testing is done by doctors,
mental health experts, schools, etc. because they are sometimes done by each. A family may not
know which direction to go in, and there is often a lack of communication between families,
schools and medical professionals. This confusion adds to the emotional stress of advocating
and finding appropriate support for their child as well as often paying large amounts to receive
these services. With the numbers of ASD diagnosis on the rise and changes in the definition in
the DSM to more specifically define ASD, it seems that perhaps some work in the fields of
identification, progress monitoring and administration would be relevant.

DIAGNOSING AUTISM: ASSESSMENTS

References

Amend, E., Schuler, P., Beaver-Gavin, K. & Beights, R. (2009). A Unique Challenge: Sorting
Out the Differences Between Giftedness and Aspergers Disorder. Gifted Child
Today

32(9). 57-63.

Lord, C. & Bishop, S. (2010). Autism Spectrum Disorders: Diagnosis, Prevalence, and Services
for Children and Families. Social Policy Report, 24(2). 1-27.
Wormald, A.M. (2001). Autism Spectrum Disorder: Examining Current Diagnosis Strategies and
Assessment Tools (M.A. Thesis). Retrieved from
http://files.eric.ed.gov/fulltext/ED526315.pdf.