Current practice guidelines suggest that there should be a comprehensive assessment involving structured observations of the child's behavior extensive parental interviews testing of cognition, speech and language, hearing, vision, and motor function a physical examination and a collection of medical and family history information ( Millward et al., 2008 Nye and Brice, 2005 Reichow et al., 2010, 2013). Several sets of practice guidelines are now available to provide guidance on screening and diagnosis ( McClure, 2014). At each step of the diagnostic process, financial and cultural barriers can delay the identification of ASD, especially for socioeconomically disadvantaged children ( Magaña et al., 2013). Once a referral has been made, families can face wait times of 6 to 12 months or longer for the first available appointment. The process of obtaining a diagnosis of ASD often requires a referral from a pediatrician or other primary care provider to a clinical center or care provider experienced in ASD diagnosis. Concerns about individuals losing services prompted the addition of a “grandfather clause” in DSM-5 granting continued diagnostic assignment to cases previously diagnosed under DSM-IV.Īlthough experienced clinicians can diagnose ASD by the age of 2 years in many affected children, and while the diagnosis of ASD can usually be made very clearly by age 3, population-based studies in the United States have shown the median age at first diagnosis of ASD to be older than 5 years ( Maenner et al., 2013 Shattuck et al., 2009). DSM-5 criteria require that a child has persistent impairment in social communications and interactions across multiple contexts as well as restricted or repetitive patterns of behavior, interests, or activities that symptoms should present in early childhood and cause significant functional impairments and that the impairments are not better explained by intellectual disability ( APA, 2013).ĭSM-5 introduced major change by eliminating subcategories and providing an overall approach to the diagnosis of ASD ( Volkmar et al., 2014a). The current version of the DSM introduced in 2013, DSM-5, is the first edition of the DSM to use the term “autism spectrum disorder.” This version does not distinguish subtypes such as “autistic disorder” or “Asperger syndrome,” and the diagnostic criteria specified in the DSM-5 for ASD are somewhat narrower than used previously. ASD was not officially recognized until DSM-III, the third edition of the Diagnostic and Statistical Manual of Mental Disorders, in 1980 ( APA, 1980 Kanner, 1943). The diagnosis of ASD is typically made during childhood, based on comprehensive behavioral evaluations by specialists in child psychiatry or psychology or by those in behavioral and developmental pediatrics.
Autism, or autism spectrum disorder (ASD), first described in 1943 ( Kanner, 1943), is a neurodevelopmental disorder characterized by impairments in social interaction and communication, along with repetitive or stereotyped patterns of behaviors and often restricted interests.