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POSITION:HOME Autism Knowledge Base

Screening and diagnosis

2020-08-10

1.What behaviors of the child mean that the parent should take the child to the diagnosis?

According to the United States National Child Health and Human Development Advice for parents:

1. After 12 months of life, he has not shown any desire to talk.

2. Do not point, shake or grasp with hands at 12 months after birth;

3. Not being able to speak a single word for 16 months after birth;

4, in the first 24 months after birth have not been able to speak two words independently;

Sudden loss of language or social skills at any stage.

Parents should pay attention to, any of the above characteristics does not mean that your child is already autistic, but because the disease is not fixed, so the above symptoms are just a reminder, remind parents to take the child to the hospital for further diagnosis.

2.How to early screening and diagnosis

Because the cause of autism has not yet been identified, there is no medical device that can be used directly to test and diagnose autism. So the primary basis for diagnosing autism is observation of the patient's behavior and the use of pedagogical and psychological tests.

Diagnosing autism requires two steps: a screening test and a comprehensive assessment. Screening test is the first step of comprehensive evaluation, which is mainly completed by filling out questionnaires. It takes a short time and does not require high medical knowledge of testers. Parents, teachers, family doctors can do it. A comprehensive assessment needs to be done by a professionally trained child psychiatrist or psychologist.

Screening scale:

Two screening scales, ABC and CABS, which have been introduced in China, are introduced in the Screening scale in the "Guidelines for the Treatment and Rehabilitation of Children with Autism" issued by the Ministry of Health in August 2010.

Autistic Children Behavior Scale (ABC) : there are 57 items in total, and each item is rated at 4 levels. The total score ≥31 indicates the presence of suspected autism-like symptoms, and the total score ≥67 indicates the presence of autism-like symptoms, which is applicable to people from 8 months to 28 years old.

The Kirschner Autism Behavior Scale (CABS) : There were 14 items, each of which was scored at a level 2 or 3. A total score of ≥7 at level 2 or ≥14 at level 3 indicates the presence of suspected autism. The scale is suitable for rapid screening of children in child care clinics, kindergartens and schools for people aged 2 ~ 15.

If the results of the above screening scale show suspicious symptoms, parents should take the child to a professional institution (e.g., Beijing Sixth Medical Hospital, Children's Hospital, Boai Hospital, United Family Hospital) for further diagnosis.

Diagnostic scale:

At present, a commonly used diagnostic scale has been introduced in China, namely the Children autism Rating Scale (CARS). There are 15 items in the scale, and each item has a 4-level score. The total score < 30 is non-autism, the total score 30-36 is mild to moderate autism, and the total score ≥36 is severe autism. This scale is applicable to people over 2 years old.

In addition, ADOS-G and ADI-R are widely used diagnostic scales in foreign countries. Although they have not been officially introduced and revised in China, they can be diagnosed in some private hospitals, such as United Family Hospital in Beijing.

3.Is it possible for professionals to be misdiagnosed?

This happens occasionally, but the odds are not high. If the person is very experienced and knowledgeable in the field of autism, they are able to give a more reliable diagnosis before the child is three years old. Of course, there are reasons why rare errors can occur.

For example, some children may have symptoms so mild that they are ignored by the diagnosable, which may be the most common mistake. In addition, some children may have only communication and social problems before they exhibit repetitive behaviors, which can also lead to not being diagnosed with autism at the beginning, but later being diagnosed. But whatever the reason, if a child is having problems growing up, we should seek professional help immediately.

Some children are diagnosed with autism, and as they get better, as they get older, people say that these children are being misdiagnosed, which is not the case, but that being treated at a very young age can eliminate certain symptoms earlier, so it looks more like a delay in communication. In other words, early treatment, because children are young, they can recover faster.

4. Could it be any other disease?

Other potential problems must be ruled out before a doctor can diagnose a child. For example, children with hearing impairment may exhibit autism-like symptoms (misfit, name calling, unresponsive, self-stimulating behavior), and an otolaryngologist can help us identify the possibility of a disorder in a room. It could also be language retardation. A child with a language delay may have difficulties with social interactions, but usually does not avoid them in the same way as someone with autism. The person around also can think of is the child 'noble language late'? Yes, it is true that some children learn to speak later than others, but very few children with significant language impairments, even if they are not autistic, can recover without treatment.

Proper treatment not only won't hurt, but can help improve the situation. Passive waiting is a waste of time and can harm a child's life. Other potential problems must be ruled out before a doctor can diagnose a child. For example, children with hearing impairment may exhibit autism-like symptoms (misfit, name calling, unresponsive, self-stimulating behavior), and an otolaryngologist can help us identify the possibility of a disorder in a room. It could also be language retardation. A child with a language delay may have difficulties with social interactions, but usually does not avoid them in the same way as someone with autism. The person around also can think of is the child 'noble language late'? Yes, it is true that some children learn to speak later than others, but very few children with significant language impairments, even if they are not autistic, can recover without treatment.

Proper treatment not only won't hurt, but can help improve the situation. Passive waiting is a waste of time and can harm a child's life.

5. What should parents do when their child is diagnosed with autism?

For most parents, it comes as a shock to learn that their child has autism. This is perfectly normal and understandable. However, at the same time, parents should actively help their child plan his life, because with the right treatment and planned arrangement, the child's quality of life will be improved and improved. When a child is diagnosed, parents should:

1. Learn more about autism by reading books and browsing websites;

2. Collect information about autism treatment centers in the cities where they live;

3. Communicate and help with other parents of autistic children;

4. Help the child to choose a suitable treatment center as soon as possible;

5. Maintain close contact with therapists and doctors;

6. Cooperate with the therapist to make a treatment plan and future life plan for the child.

6. Critical period for autism treatment

Research shows that the earlier the diagnosis and treatment (around age 3), the better the chance of reducing behavioral problems in autism.

Kirschner Autism Behavior Scale:

As one of the most widely used autism screening scales at home and abroad, the Kirschner Autism Behavior Scale is composed of 14 items. According to Kirschner, the total score is divided into points, which can effectively distinguish autistic children from control children. Taiwan's Xie Qingfen et al modified the "dichotomy" of Kirscher's autism Behavior Scale into "never", "occasionally" and "often" after it was used in clinic in 1983, so as to become a three-point method of 0, 1 and 2, with 14 points as the dividing points. It was found that the sensitivity of this table to screening autism and loneliness tendency was high, but the specificity was not high. If used as one of the screening tools for epidemiological investigation, a comprehensive analysis of detailed medical history and clinical signs is needed to determine the diagnosis.

Behavior shows reaction intensity

1. not easy to mix with others to play

2. deaf as a bell, as if he were deaf

3. Teach him what to learn, strong resistance, such as refusing to imitate, speak or act

4. Ignore the danger

5. You can't accept changes in your daily habits

6. Use gestures to express your needs

7. A funny smile

8. You don't like hugs

9. non-stop movement, unable to sit, too much activity

10. Don't look at other people's faces. Avoid eye contact

11. Transition favors certain things

12. like to spin things

13. Do weird movements or play over and over again

14. Indifference to your surroundings

Autism Screening Scale for young children (18 months or older)

Some questions for parents:

1. Has your child ever played pretend? For example, pretend to drink tea with a toy teacup.

2. Does your child ever use his index finger to point to something he needs, likes or is interested in?

3. Is your child interested in other children?

4. Does your child like peek-a-boo?

5. Has your child ever taken or shown you anything?

If the answers to two or more of these questions are "no," suspect autism.

Doctor's Observation:

1. Did the child make eye contact with you in the clinic?

2. Draw the child's attention, then point to an interesting toy across the room and say, "Hey, look, there's a car over there." Watch the child's face.

3, to attract the child's attention, then give the child a toy small cup and teapot, said to the child: "have a cup of tea." Observe the child to see if he is pretending to drink tea or pour tea, etc. (Other toys can also be used)

Ask the child: "Where is the light?" "Or" Show me the lamp. "Does the child point to the lamp with his index finger?

If two or more of the answers to these four questions are "no" or "no," suspect autism.