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How To Get An Autism Diagnosis

Many parents are unsure of where to turn or what steps to follow to have their child assessed for autism. They simply don’t know where to start to get an autism diagnosis.

  • Do you have concerns about your child’s development? 
  • Have you brought them up to your child’s physician? 
  • Are you wondering what the process is to get an autism diagnosis in Ontario? 

At your child’s 18 and 24 month check-ups the doctor should be screening your child for autism. They’re likely using a tool called the M-CHAT-R (Modified Checklist for Autism in Toddlers – Revised). The M-CHAT-R is 20 questions about your child’s behaviour. No screening tools catch EVERY child so even if your child passes the M-CHAT-R, you can still request the doctor make a referral to a specialist for further testing.

To diagnose autism, the person will use formal assessment tools and their clinical judgement. There isn’t a blood test or a scan that you can do that will show autism. Diagnosticians need to have a lot of training and experience identifying autism.

Image of  testing materials used during autism diagnosis.

Paths to an autism diagnosis

There are three ways to get an autism diagnosis in Ontario.

Medical:

A family physician, a child’s paediatrician, a developmental paediatrician, a neurologist or a psychiatrist can all diagnose autism. OHIP pays for this assessment and it will not cost you anything. If your doctor is not able to reliably make the diagnosis, they would refer you to someone with more experience and training. Many physicians do not give a detailed report of the child’s level of functioning but will simply write a diagnosis letter. However, as with all OHIP services, there could be a wait to be assessed, especially if you need a referral.

A diagnostic hub:

There are 5 diagnostic hubs in the province. The hubs use a multi-disciplinary approach and perform standardized test. Specifically, there is usually a psychologist, an occupational therapist, a speech-language pathologist and a behaviour analyst on the diagnostic team. They will interview you and interact with your child for a few hours, usually over a few appointments. The provincial government pays for the assessment if it’s done at a hub. Nonetheless, the wait for an appointment can be OVER A YEAR. After the assessment you will receive a written report, describing your child’s behaviour and current level of functioning. Usually, the hub will have you come in for a summary meeting to discuss the findings and talk about next steps and referrals. The hub will give you a list of many resources in your community where you can turn for help.

A private assessment:

Some families choose to use a psychologist to provide the assessment and diagnosis. In fact, Autism testing can cost between $3000 and $5000. The psychologist will interview you and will do standardized tests with your child. Many psychologists use a test called the ADOS (Autism Diagnostic Observation Schedule). Often, psychologists recommend that parents not be in the room during testing. It can be very difficult for parents to watch. This is because your natural instinct is to help your child, but the point of the testing is to determine how your child behaves without assistance. Generally, the full assessment takes place over 3 or 4 visits. The first visit is a parent interview. The second and third are the testing with the child. The last appointment is usually the review of the findings and referrals.

Do you need an autism diagnosis to start treatment?

No! Every child who is not meeting their milestones would benefit from early intervention. Accessing Focused ABA , S-LP or OT services would benefit your child, especially while you’re waiting for a diagnostic assessment.

Early Start Denver Model (ESDM): Unleash Potential!

Read time: 4 minutes

The brain has a unique property called neuroplasticity. This means that our brains are constantly able to change and grow. Children under 5 years old have the easiest time with neuroplasticity. Even when the child has been diagnosed with autism, it is possible to make significant gains that are life changing. We can achieve this through early intervention. Specifically by using the Early Start Denver Model, we can begin even before a diagnosis is made. 

Child playing with is mom during an Early Start Denver Model session.

Within a therapeutic environment, the autistic child presents a higher chance of developing language, cognition, and social interaction abilities. We can teach skills to overcome the challenges associated with the autism diagnosis. But the essential thing is for the intervention to begin early on.

ESDM: The earlier, the better

Developmental specialists recommend the therapy to start as early as possible, as this leads to the best outcomes. Parents should not wait for the diagnosis but seek the help of a therapist as soon as they have suspicions about their child’s development. 

The sooner we start the intervention, the better the outcome is likely to be. Parents might struggle to accept the diagnosis, but they should waste no time in pursuing therapy.

A better chance of addressing behavioural issues 

Autistic children often have challenging behaviours which become more challenging over time. Addressing challenging behaviours is generally easier in younger children because they don’t have a long learning history. Having a long learning history means that the behaviour has been reinforced for a long time. Similar to a habit, behaviours with long learning histories are hard to break.

If there are challenging or non-adaptive behaviours present early intervention can replace them with alternative behaviours. The key is teaching replacement behaviours that meet the same needs but are more effective. For example, if a child is taught that they will get your attention if they cry, they will keep crying. They do this because that strategy works. But if you reward a child for using another strategy (e.g.: a word approximation, directed eye gaze or pointing) they will use the new behaviour instead. And then the challenging behaviour will fade away.    

ESDM: Individualized intervention from an early age

The therapist will develop an individualized intervention plan, based on the child’s needs, behavioural issues and the use of the Early Start Denver Model Curriculum Checklist. The Curriculum Checklist is a list of skills that are divided into levels that represent different ages.  The therapist uses the Curriculum Checklist to assess your child’s strengths and areas of need relative to same age peers. The purpose of the intervention plan is to help the child develop a wide range of skills including: attention, communication and interaction. 

As mentioned above, a structured environment will offer opportunities for learning. It facilitates the growth of skills, while it allows the therapist or parent to monitor the progress being made on a consistent basis. The therapist can adjust the plan as necessary, but the chief goal will remain the same: the child learns through play while having fun.

Early Intervention: Families receive support early on

As parents of special needs children, especially autistic children, it is normal to feel helpless and frustrated. Early intervention, though, can be highly beneficial for the entire family. It can provide support early on, reducing the amount of stress parents experience. Having an action plan and strategies to use will help parents to feel empowered and as though they are taking action. 

It is vital that the parents are also implementing the strategies and using therapeutic interventions with their children. The child has a limited number of hours with the therapist each week but many more hours with their parents. These hours should be maximized! 

What matters is that they capture the attention of the child and pursue communication. Being creative and silly will go a long way. 

ESDM: A combination of ABA and play

An experienced therapist will give the child time to become accustomed to the unfamiliar environment, chaining skills together to create a smooth session. It takes time to build the relationship, and only then will the therapist focus on addressing behavioural issues, cognitive and speech delays, etc.

Taking advantage of the brain’s neuroplasticity 

We see the best results up to the age of five years, as that is when the child’s brain is most malleable. We can unleash the learning potential in therapy and limit the effects of the autism diagnosis. As a result, the overall quality of life can improve, thanks to the newly learned skills. 

The benefits of early intervention using the Early Start Denver Model in autistic children are obvious. The earlier the child enters a structured, therapeutic environment, the better his/her progress will be. Parents should actively collaborate with the therapist, practicing taught strategies at home and helping their children unleash their full potential.

To learn more about how Side by Side Therapy can help your child with an Early Start Denver Model program, please connect with us!

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