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Printable Handouts
Navigable Slide Index
- Introduction
- Diagnosis
- Difference between diagnosis and assessment?
- Pros and cons of diagnosis
- Most widely used diagnostic instruments
- Autism Diagnostic Observation Schedule
- ADOS (Lord et al., 2000)
- Autism Diagnostic Interview-Revised
- Childhood Autism Rating Scale
- Chlebowski: ROC curves for AD on the CARS
- Chlebowski: ROC curves for ASD on the CARS
- Four diagnostic instruments for PDD
- Agreement results
- Controversial issues in diagnosis
- Early diagnosis: conclusions
- Other particularly useful scales
- Some clinical considerations
- How blunt should you be?
- Some blocks to communication
- Communicating about prognosis
- Providing resources
- Screening
- Why add screening to pediatric surveillance?
- Negative symptoms in young children
- Barriers to general and autism-specific screening
- AAP recommendations
- Open questions in autism-specific screening
- What is the best age for autism specific screening
- What is the best age for autism screening?
- The 18 and 24 month screens equally effective?
- Screening for autism in toddlers
- Positive predictive value of MCHAT
- Ethnic disparities in screening practices?
- Factors that influence best screening methods
- Parent report vs. observation
- Red flags for ASD in toddlers
- Early autism-specific screens
- MCHAT-revised
- The special case of siblings
- Highly recommended literature
- Screening: conclusions
- Screens for older children (1)
- Screens for older children (2)
- Screens for older children (3)
- Comparison of Asperger's instruments
- Is diagnosis reliable with mental age below 1 year?
- Autism observation scale for infants
- Autism spectrum disorders and low mental age
- Mean developmental progress between age 2&4
- DSM-5
- Major changes in autism from DSM-4 to DSM-5
- Objections to DSM-5 Autism
- Exclusion of toddlers from DSM-5
- Neurodiversity
- Thank you for your attention!
Topics Covered
- Main instruments in common use for AD screening
- Pros and cons of diagnosis in early childhood
- Controversial issues in diagnosis
- Criteria for general vs. subtypes of ASD
- Clinical issues in conveying diagnosis to parents
- Need for standardized ASD screening by pediatricians
- Barriers to screening
- Best age for universal screening
- Best sources of information
- Lessening cultural disparities in age of diagnosis by standardized screening
- Changes from DSM-4 to DSM-5 and their effect on diagnosis
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Fein, D. (2019, January 31). Diagnostic and screening instruments for autism [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved August 31, 2024, from https://doi.org/10.69645/BSIH3016.Export Citation (RIS)
Publication History
Financial Disclosures
- Professor Deborah Fein recieves royalties from the autism screening questionnaire which is incorporated into commercial profit due to ownership of MCHAT-LLC.
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
I'm Dr. Deborah Fein,
Professor of Psychology and Pediatrics at the University of Connecticut,
and I'm going to be talking about "Diagnostic and Screening Instruments for Autism".
0:11
The first topic is diagnosis.
0:14
What is the difference between diagnosis and assessment?
Diagnosis is just a decision you make about which classification,
which syndrome best applies to an individual.
Assessment is a much broader process.
It's the overall evaluation of the individual for the purpose of formulating
treatment plans and also for tracking changes over time.
So for the young child with possible ASD,
this assessment might include making a diagnosis,
and also looking and characterizing at the degree and
profile of his or her developmental delays,
examining the presence of interfering behaviors,
looking for the presence of ancillary symptoms like
difficulties with sleep and difficulties with eating,
looking at family functioning and resources so that you
can best advise the family of how to allocate those resources.
Then very importantly, looking at response to prior treatments,
in case treatment regiments need to be changed.
1:15
There are some pros and cons to making a diagnosis.
For me in most clinical situations,
the arguments in favor of making a diagnosis outweigh those against making a diagnosis.
These include, a better good proper diagnosis will give the child access to
services and that those will be appropriate services for the child's needs.
To some extent, you want to guide the family to have
realistic expectations of what the child is
expected to achieve in the next period of time.
You can also refer parents to
appropriate parent support groups and appropriate literature,
and then of course if the child is participating in research,
you want to have the correct diagnosis.
Of course there are some arguments against the use of diagnosis for very young children.
And these include that for some,
giving a diagnosis of autism will create
unnecessarily low expectations in parents or teachers,
will socially stigmatize the child or the family,
or create unnecessary parent distress.