The American Psychiatric Association’s Diagnostic and Statistical Manual, Fifth Edition (DSM-5) changes the concept of autism; The previous categories – Autistic disorder, Asperger syndrome, Childhood Disintegrative disorder, and Pervasive Developmental Disorder-not otherwise specified (PDD-NOS), are now best understood as being part of a continuum of ‘Autistic Spectrum Disorders’.
What the current criteria for diagnosing Autism?
The DSM-5 criteria for autism covers two categories:
- Persistent deficits in social communication/ interaction
- Restricted, repetitive patterns of behaviour
Several ‘screening tools’ help identify children with autistic spectrum disorders. They vary in quality and complexity and should only be used by trained specialists. It is important to note that diagnosing autism requires the assessment of more than one professional and observation of the child in more than one setting. Standardised assessment tools, such as ADI/ ADOS, may help with assessment. The tools are usually administered by trained developmental paediatrician.
Are there any other investigations needed to exclude other causes of Autism?
Your paediatrician or developmental paediatrician may refer you to paediatric neurologist for further neurological evaluation or investigations after your child’s diagnosis.
The appointment with the Paediatric Neurologist will involve a detailed evaluation by our Dr Yeo, including medical history, physical examination, and neurological assessment (looking for neurocutaneous stigmata, hearing/ visual impairment, and specific genetic disorders, such as Rett’s syndrome, Fragile X and Tuberous Sclerosis.)
Dr Yeo may offer blood tests looking at some general health markers (such as a haemoglobin or blood count, Vitamin D level) and other tests that look for conditions known to be associated with autism (such as muscle enzyme for muscle disorder). Dr Yeo may request an Electroencephalogram (EEG) to analyse your child’s brain wave signals/ pattern. If indicated, Dr Yeo may suggest micro-arrays, a genetic test examining differences between the child’s genetic material and the rest of the population’s, and other specific genetic testings, such as Fragile X syndrome and MECP2 mutation genetic testings.
Please click ‘Blood Tests & Metabolic Testing’ and ‘Genetic Testing’ for details.
