Autism Diagnosis Checklist Signs of Autism
There are two major diagnostic classification systems in current use, the International Classification of Diseases, version 10 (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders 4th edition (DSM-IV ).
They have similar symptom criteria for diagnosis based on three general impairments, with the following behaviours, which are out of line with their mental age:
1. Social
Delayed or abnormal social development.
2. Language and communication
Delayed or abnormal language and communication both verbal and non-verbal.
3. Thought and behavior
Rigidity of thought and behavior and lack of imagination. Displays ritualistic behavior, reliance on routines, impairment of imaginative play.
DSM-IV is diagnostic criteria used in the United States and many other parts
of the world.
ICD-10 is the most commonly used ASD classification system in the UK and Europe,
although many research studies also use DSM-IV or other criteria.
The diagnostic criteria for ASD continue to develop as more research is done
and understanding improves, and they are likely to change with future revisions.
Timing of Diagnosis
In children under 2 years of age typical ASD symptoms may not be noticeable. However,
absence of such behaviours should not totally rule out the possibility of diagnosis.
However, regardless of the age of the child, if there is a suspicion of autistic tendencies then early referral can make a difference.
Another form of diagnosis assessment is the Checklist for Autism in Toddlers (CHAT ) which was designed to identify 18 month old children at risk of ASD.
Here are some general guidelines derived from CHAT that can be used by parents as an informal way to assess a child
General Developmental Warnings of Possible ASD in Pre-School children
Delay or absence of spoken word
Looks through people; not aware of others
Not responsive to other’s facial expressions/ feelings
Lack of pretend play; little or no imagination
Does not show typical interest in peers or play near peers purposefully
Lack of turn-taking in games
Unable to share pleasure
Non-verbal communication delays or impairment
Does not point at an object to direct another person to look at it
Lack of gaze monitoring
Lack of initiation of activity or social play
Unusual or repetitive hand and finger mannerisms
Unusual reactions or lack of reaction to sensory stimuli
Signs of Possible ASD in school-age Children
Communication impairments
Abnormalities in language development including muteness
Odd or inappropriate prosody (the acoustic properties of speech) i.e. pitch/ tone
Persistent echolalia
Reference to self as “you”, “she” or “he” beyond three years
Unusual vocabulary for child’s age/social group
Limited use of language for communication and/or tendency to talk freely only about specific topics
Social impairment
Inability to join in play with other children or inappropriate attempts at joint play (may manifest as aggressive or disruptive behavior)
Lack of awareness of classroom “norms” (criticising teachers, unwillingness to co-operate in classroom activities, inability to appreciate or follow current trends and fads and fit in with the crowd)
Easily overwhelmed by social and other stimulation
Failure to relate normally to adults (too intense/ no relationship)
Showing extreme reaction to invasion of personal space and resistance to being hurried
Impairments of interests, activities and/or behaviours
Lack of flexible cooperative imaginative play/creativity
Difficulty in organising self in relation to unstructured space (e.g. hugging the perimeter of playground, halls)
Inability to cope with change or unstructured situations, even ones that other children enjoy (school trips, teachers being away etc)
Other factors
Any other evidence of odd behaviours including unusual responses to sensory stimuli
Signs of Possible ASD in adolescents
General Picture
Long standing difficulties in social behaviours, communication and coping with change, which are more obvious at times of transition (e.g. change of school, leaving school)
Significant discrepancy between academic ability and “social” intelligence, most difficulties in unstructured social situations, e.g. in school breaks
Socially “naive”, lack common sense, not as independent as peers
Language, non-verbal skills and social communication
Problems with communication even if they have a wide vocabulary and normal use of grammar. May be unduly quiet, may talk at others rather than hold a “to and fro” conversation, or may provide excessive information on topics of their own interest.
Unable to adapt their style of communication
to social situations e.g. may sound like “a little professor” (overly formal), or be inappropriately familiar
May have speech peculiarities including “flat”, unmodulated speech, repetitiveness
May take things literally and fail to understand sarcasm or metaphor
Unusual use and timing of non-verbal interaction (eg eye contact, gesture and facial expression)
Social Problems
Difficulty making and maintaining peer friendships though may find it easier with adults or younger children
Can appear unaware or uninterested in peer group “norms”, may be alienated by behaviours which transgress “unwritten rules”
May lack awareness of personal space, or be intolerant of intrusions on own space
Rigidity in thinking and behavior
Preference for highly specific, narrow interest or hobbies, or may enjoy collecting, numbering or listing
Strong preference for familiar routines, may have repetitive behaviours or intrusive rituals
Problems using imagination e.g. writing, future planning
May have unusual reactions to sensory stimuli e.g. sounds, tastes, smell, touch, hot or cold.