Children with developmental disorders are referred routinely to specialists and other clinicians for diagnostic testing. Diagnostic tests and other clinical evaluations help to determine the nature, scope, and intensity of each child’s unique abilities and deficits. This section will explore the types of diagnostic testing recommended for children with autism spectrum disorders.

As stated in the Practice Parameter for the Screening and Diagnosis of Autism, “Although educators, parents, and other health care professionals identify signs and symptoms characteristic of autism, a clinician experienced in the diagnosis and treatment of autism is usually necessary for autism spectrum disorder (ASD) is not a one-time procedure; it is a complex process.

The practice parameter outlines the following types of evaluations:

• Surveillance and screening
  (See Screening Guidelines)
• Diagnosis
  It is recommended that the formal diagnosis of autism is made by a physician or clinician who has extensive experience with, or specializes in, ASD, such as a pediatric neurologist, a developmental pediatrician, a child psychologist or child psychiatrist. See Specialists for more information.
• Medical and neurologic evaluation
  This includes “a perinatal and developmental history” as well as a “physical and neurologic examination.” This can be performed by an experienced physician, a developmental pediatrician, or a pediatric neurologist.
• Evaluation and monitoring of autism
  As part of a team or multidisciplinary approach, specialists are called upon to evaluate and monitor a child after diagnosis. See Specialists for more information.
• Speech, language, and communication evaluation
  A comprehensive speech-language-communication evaluation should be performed on all children who fail language developmental screening procedures. These evaluations should be conducted by an experienced speech-language pathologist.
• Cognitive and adaptive behavior evaluations
  Tests such as the Vineland Adaptive Behavior Scales and the Scales of Independent Behavior “should be performed in all children with autism by a psychologist or other trained professional.” These evaluations “provide an overall index of ability” including social, verbal, and non-verbal skills.
• Sensorimotor and occupational therapy evaluations
  Depending on the presenting needs of a child, a physical therapist or occupational therapist may assess a range of skills, including: fine motor, gross motor, and sensory processing. For children thought to have sensory integrative dysfunction, the Sensory Integration and Praxis tests may be required.
• Neuropsychological, behavioral, and academic assessments
  These assessments may be performed by a psychologist or other experienced clinician. A child’s behavior, cognitive abilities, and social skills are core elements of these evaluations. An “assessment of family resources” is also important in order to determine if additional supports or resources may be needed.

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