Autism Assessment

What is an autism assessment?

Autism assessments are tools that healthcare providers use to diagnose autism spectrum disorder (ASD). The assessments are a key tool for diagnosing ASD during early childhood. But many of these tools can help adults get diagnosed, too.

Experts classify ASD as a developmental disorder because it starts in childhood. Common signs often include:

• Slower social and communication skill development: It can be harder for autistic people to communicate, make friends, form relationships and more.
• Restrictive, repetitive behavior patterns: These can make it harder for autistic people to react to everyday unexpected situations. It can also make change harder to adapt to.

When and why autism assessments happen

Pediatricians in the U.S. typically screen all children for autism during well checks. Pediatricians commonly follow guidelines from two organizations on when to screen. Those are the:

• American Academy of Pediatrics: recommends screening at 18 months and 24 months old
• U.S. National Center on Birth Defects and Developmental Disabilities: recommends screening at 9 months, 18 months, and either 24 months or 30 months old

Research shows early diagnosis and treatment can help children with autism reach their full potential.

Providers may recommend an autism assessment based on:

• What they observe during well-child visits
• Behaviors or symptoms you notice and describe
• School or child care staff describing behaviors or symptoms

Types of autism assessments

Not all autism assessments are the same. Some are simple screening tools that providers use to determine whether a child needs further testing. Others are for making a full diagnosis.

The different assessment tools usually rely on one or more of the following:

• Interviews about yourself or your child, and any symptoms you or your child might experience
• Questionnaires about yourself or your child (depending on who’s being diagnosed)
• Test materials that can highlight differences in communication or processing
• Observation time, where a healthcare provider watches your child do an activity and looks for clues or symptoms

Autism assessment screening and diagnostic tools

Screening tools include:

• Ages and Stages Questionnaire (ASQ®)
• Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (MCHAT-R/F)
• Parents’ Evaluation of Developmental Status (PEDS®)

Full autism assessment tools include:

• Autism Diagnostic Interview-Revised (ADI-R)
• Autism Diagnostic Observation Schedule-2 (ADOS-2)
• Childhood Autism Rating Scale-Second Edition (CARS-2)
• Gilliam Autism Rating Scale-Second Edition (GARS-2)
• Social Communication Questionnaire (SCQ)
• Social Responsiveness Scale-Second Edition (SRS-2)

When a provider is completing an autism assessment, they’ll probably use several of these tools and others.

One reason there are so many different assessment tools is that autism can look very different from person to person. And the tools themselves vary. Some are useful for screening by age. Others are best at uncovering specific symptoms or effects.

Related tests and assessments

Autism has links to many other conditions, so it’s common for providers to test or screen for those, too. Some of the related tests and assessments your child’s provider might recommend include:

• Vision and hearing testing
• Electroencephalogram (EEG) to check for epilepsy if your child has a history of events that could point to seizures
• Brain MRI, if your child’s provider notices differences during a physical exam, like microcephaly
• Genetic testing to make sure that autism isn’t happening because of, or along with, another condition, like fragile X syndrome
• Blood testing for lead poisoning or metabolic diseases