Frequently Asked Questions
Should I have my child evaluated for autism?
Deciding to get your child evaluated for autism may seem overwhleming.
There are many reasons families choose to get their child evaluated for autism.
- Common reasons to get an autism evaluation are:
- You want a diagnosis so that your child has access to services (see below)
- You want an answer for why your child is struggling with behavior and social cues
- Common misperceptions about getting an autism diagnosis:
- Getting a medical diagnosis will help your child qualify for services at school. Not quite! (see below)
What does an evaluation for autism look like?
A comprehensive autism evaluation oftens involves multiple steps to ensure an accurate diagnosis.
Screening
Your child may be screened for autism using a questionnaire like the M-CHAT to identifiy potential signs of autism. This typically happens at your child's well visits around 18-24 months. If the screening suggests the possibility of autism, a more in depth evaluation is conducted.
Evaluation
This includes structured observations of the child's behavior, communication, and social interactions, often using standardized tools like the Autism Diagnostic Observation Schedule (ADOS). Additionally, thorough interviews with parents, teachers, and other adults who know the child well are essential to gather information about the child's developmental history and behavior across different settings. Cognitive testing is also a crucial component, providing insights into the child's thinking patterns and helping to determine appropriate educational support. It's important that these evaluations are conducted by professionals trained specifically in diagnosing autism, as they can distinguish between autism and other conditions with overlapping symptoms, such as developmental delay, ADHD, or anxiety.
Specific tests or assessments that might be used during the evaluation
There are multiple assessments that may be used to diagnose autism. These specific assessments are used at the ND Autism Clinic.
The Autism Diagnositic Observation Schedule (ADOS) is a standardized set of activities and materials (toys, books, games or questions) that are used to evaulate a child's behaviors, social interactions, and communication skills. It is conducted by someone trained on the ADOS and usually takes about 30-60 minutes.
Cognitive or developmental testing like the Mullen, Bayley, DAS, WISC, WASI, or WAIS is used to understand the child's language level, perceptual skills, and nonverbal reasoning.
Questionnaires like the SRS-2, SCQ, and ABAS are used at the ND Autism Assessment Clinic to understand the child's behaviors in other settings.
What is the difference between a “medical diagnosis” and an “educational diagnosis/label” of autism?
There is a difference between medical diagnosis and education diagnosis (also know as "educational classification" or "educational eligibility") of autism spectrum disorder (ASD).
A medical diagnosis is made by healthcare professionals (e.g., psychologist, developmental behavioral pediatrician, primary care provider). They use criteria from the DSM-5, which defines ASD as a collection of behaviors that significantly impair daily functioning. Medical diagnoses are made at a doctor’s office, hospital, or clinic. This information goes in your child’s medical record. The medical diagnosis is communicated to your insurance company. A medical diagnosis is needed for insurance to pay for autism-related services offered in a clinical setting and (ABA, speech therapy, etc.) A child can be evaluated for a medical diagnosis starting around 16-18 months old.
In contrast, educational eligibility (which you might hear called “educational diagnosis” “educational classification”) is determined by your child’s public school system. A team within the school system, including parents, evaluates the child. The evaluation takes place at school. The evaluation is sometimes called an “IEP evaluation.” The team evaluates whether the student’s condition negatively impacts their educational performance. If the child receives an educational classification of autism, that means that the child requires an IEP (Individualized Education Plan), which is special education services under the Individuals with Disabilities Education Act (IDEA). The school-based services a child might receive are speech therapy, occupational therapy, physical therapy, and more. A child usually does not receive ABA through school. A child can be evaluated for eligibility for educational services starting from 3 years, 0 months.
While a medical diagnosis can inform the educational evaluation process, it does not automatically qualify a child for school-based services or an IEP. Additionally, state definitions and criteria can vary, and students who do not qualify under IDEA may still be eligible for accommodations under Section 504 of the Rehabilitation Act. If your child has a diagnosis of ASD made by a doctor, you may still need to request an evaluation through your child's school. Medical services focus on treatment and therapy, while educational services aim to support learning and functional development through an Individualized Education Program (IEP). Please see this article for more information.
Why does my child's diagnostic report recommend that they apply for Medicaid?
A child with a diagnosis of autism, intellectual disability, or other medical conditions is medically eligible for Medicaid insurance, regardless of the family's income. If you ahve private insurance, the child's Medicaid will supplement your private insurance and can be used to pay for things until you hit your deductible, coinsurance, etc. More information is available at https://www.in.gov/health/
What is the BDDS Wavier?
A child with a diagnosis of autism is eligible for a waiver from the Bureau of Disabilities Services (BDS). More information is available at https://www.in.gov/fssa/ddrs/developmental-disability-services/