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Autism Spectrum Disorder Assessment
What is an Autism Assessment?
An autism assessment involves detailed evaluation of a child/adolescent’s development to determine if the individual meets the diagnostic criteria for Autism Spectrum Disorder (ASD). ASD is a neurodevelopmental condition in which a person has difficulties with communication and social interaction skills as well as restricted and/or repetitive behaviours and interests. In British Columbia, these assessments must follow the Standards and Guidelines set by the Ministry of Health and must include the use of specific assessment tools in order for a diagnosed child/adolescent to receive intervention funding.
Southpoint Development Clinic has two psychologists (Dr. Caelian and Dr. Hseih) who provide autism assessments for children and adolescents. Both Dr. Caelian and Dr. Hsieh have extensive experience assessing young people for autism, including those with complex presentations and high-functioning ASD. We are able to offer autism assessments in English and Mandarin-Chinese.
Why might an Autism Assessment be recommended/needed?
Sometimes parents are the first to suspect that their child may have autism. Other times, a professional in the community (e.g., paediatrician, preschool teacher/school teacher, speech-language pathologist, family doctor) may recommend an autism assessment. In most cases, assessments for autism are warranted when a child displays the following types of challenges:
- Delayed language development and social use of language
- Unusual use of language (e.g., echoing others, using unusual words, repeating things they have heard on television)
- Advanced vocabulary use and overly precise use of language
- Deficits in nonverbal communication (i.e., poor eye contact, lack of range in facial expressions, lack of gesturing)
- Reduced interest in peers and/or difficulty relating to peers
- Intense or unusual areas of interest
- Rigid adherence to routines and difficulty tolerating change
- Strong sensory aversions or interests
- Repetitive types of play/use of objects (e.g., lining up or colour coding toys, repeatedly filling/dumping or stacking objects)
- Repetitive/unusual movements with fingers, hands, and/or body
How can an Autism Assessment help my child?
It is very important to determine if a child/adolescent has ASD in a timely fashion. In BC, youth who receive a diagnosis of ASD are entitled to funding for treatment services until they reach adulthood. Early access to appropriate intervention is important so that we can maximize gains and help children and teens reach their full potential. In addition, treatment services are informed by an individual’s diagnosis so if a child/adolescent with ASD goes undiagnosed, treatment may be targeting only a subset of that person’s difficulties.
How is a private assessment different from a publically funded assessment?
In BC, there are two ways in which to obtain an autism assessment.
One option is a publically funded assessment, which is paid for by the government and organized through Sunny Hill Health Centre for Children and the BC Autism Assessment Network (BCAAN). The advantage of this option is that the assessment is free. The disadvantages are that parents do not have a choice regarding which clinician performs the assessment and there is a much longer waiting time. Parents must first see a physician and be referred to BCAAN. Once the referral is processed, there is typically a 6-12 month wait to be seen.
The other option is to pursue a private autism assessment like those available at Southpoint Development Clinic. Both Dr. Caelian and Dr. Hsieh were trained through BCAAN and provide the same assessments as available through the public system. If diagnosed, your child/adolescent will be eligible for the same funding as if they were seen through Sunny Hill/BCAAN. The advantages of doing a private assessment including being seen sooner and having the option to choose the clinician that evaluates your child/teen. This means that your child, if diagnosed with ASD, gets access to funding and supports as soon as possible. The only downside is that families pay for the assessment themselves. Many families have extended medical plans, however, that can cover most/all of the cost.
What is involved in an Autism Assessment?
An autism assessment involves the following components:
- Review of available prior reports (e.g., pediatrician consultation letters, school report cards, assessments from speech-language pathologists, occupational therapists, child development teams, etc.)
- Completion of an interview with parents/guardians to collect historical, personal, educational, and medical background information relevant to the assessment process.
- Completion of the Autism Diagnostic Interview-Revised (ADI-R), a parent/caregiver interview focused on features of ASD.
- Completion of the Autism Diagnostic Observation Schedule – Second Ed. (ADOS-2) with your child. The ADOS-2 involves a semi-structured interaction that allows assessment of communication, social interaction, play, and restricted/repetitive behaviours. To your child/teen, it will feel less like an assessment and more like they are playing and getting to know the psychologist. Together, the ADI-R and the ADOS-2 are considered the “gold standard” instruments for assessing features of ASD among children/adolescents.
- Parent and Teacher questionnaires relevant to autism and associated conditions.
At present, children under 6 years of age who complete private assessments for autism must also complete a speech-language assessment as well as a cognitive assessment to provide insight into their general developmental level. The information obtained from these additional components of the assessment helps us to make accurate diagnostic decisions and to rule out other conditions. Children 6 years and over are not required to complete these additional assessments but there are times when they may be recommended.
The assessment is usually completed across two dates, one focused on the parent component and the other focused on the child’s portion. For older youth who can manage longer appointments, we can do the full evaluation in one day. Following the assessment, your psychologist will score the measures and integrate the results with all prior information to decide whether your child has autism. You will then be invited back to the office for a feedback session to discuss those results and recommendations. If your child receives a diagnosis of autism, the funding paperwork will also be explained and provided at that time. A written report is sent out after the feedback session, allowing for additional input from you as appropriate. Each assessment, report and recommendation is tailor-made for your child/adolescent.
Please see “How should we prepare for our child/teen’s assessment?” under our FAQ tab for more detail.