Written by: Dr. Campos, PhD, Licensed Clinical Psychologist.
Psychological research continues to support the importance of an early Autism Spectrum Disorder (ASD) diagnosis and treatment (Reichow & Wolery, 2009). Autism Spectrum Disorder is one of the fastest growing disabilities, and it is defined as a neurodevelopmental or neurobiological disorder characterized by social-communication deficits and restricted, repetitive behaviors, interests, or speech. ASD may also present with cognitive or intellectual disabilities, which are often associated with greater impairments in overall functioning. Especially when untreated, ASD can co-occur with others disorders, such as Anxiety Disorders and Depressive Disorders. ASD presents in early childhood although symptoms with impairments in functioning may not be notable until after a period of regression, or loss of skills. The importance of and methods for achieving an early diagnosis will be discussed.
Autism Diagnostic Process
Although ASD is a life-long condition, early diagnosis has been found to be associated with more favorable outcomes. An early diagnosis is considered before preschool age. With an early and reliable diagnosis, a toddler or child can subsequently receive intensive, evidence-based treatment (e.g, Applied Behavioral Analysis, Verbal Behavior Therapy) during a period of malleability unparalleled to other developmental periods. Furthermore, home, academic, and social environments can be adapted to meet the needs of children or toddlers with ASD.
There are various methods to achieve an early ASD diagnosis; however, research-based methods often include a thorough developmental/psychological evaluation incorporating standardized measures developed and revised specifically for detecting ASD symptoms. As an example of an increasingly recommended and utilized measure, the Autism Diagnostic Schedule-Second Edition (ADOS-2) is a standardized, observational measure that can be used with toddlers, children, adolescents, and adults. Given the flexibility of use with a range of ages and verbal abilities, an early diagnosis can thus occur with confidence. In addition to such measures, a thorough Autism-specific clinical interview incorporating an overview of a toddler or child’s history, symptoms, functional impairments, family history, developmental milestones and delays, and medical conditions is imperative.
Autism Treatment and Accommodations
As noted, during early developmental periods, toddlers and children are more likely to exhibit behavioral changes through the use of behavioral modification methods. Treatment is usually intensive and targeted to address specific ASD symptoms (e.g., social-communication deficits). A gold-standard treatment approach is Applied Behavior Analysis. ABA therapy is considered a gold standard due to its significant association with favorable outcomes, such as increased daily living skills and reduction of symptom intensity and frequency (Dawson et al., 2010). One example of a sub-category of ABA therapy used for toddlers and young children is Early Intensive Behavioral Interventions, or EIBI. This structured treatment approach facilitates the development of targeted behaviors and reduces the likelihood of problematic behaviors. Parental training is a component of this treatment, which assists in increasing the likelihood that desirable behaviors will occur in home environments (not just therapeutic environments).
In addition to treatment, an early diagnosis affords teachers, caretakers, and others the opportunity to modify the environment to help children or toddlers diagnosed with ASD. For example, early diagnosis can identify specific adaptive functioning (or daily living functioning) skill deficits and strengths that can be addressed in the environment.
In sum, an early, reliable Autism Spectrum Disorder diagnosis from a trained professional can yield numerous benefits. For more information on this topic, please see:
Dawson, G., et al., Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 2010. 125(1): p. e17-23.
Hyman SL, Levey SE, Myers SM, Council on Children with Disabilities, Section on Developmental and Behavioral Pediatrics. Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Peditarics. 2020 Jan;145(1).
Reichow, B., & Wolery, M. (2009). Comprehensive synthesis of early intensive behavioral interventions for young children with autism based on the UCLA young autism project model. Journal of Autism and Developmental Disorders, 39(1), 23–41.