 How a Diagnosis is Made
 DSM-IV Criteria |
HOW A
RESEARCH DIAGNOSIS IS MADE
Leo Kanner,
professor of child psychiatry at Johns Hopkins University, first
described autism in 1943. Several decades of research determined that
autism was not caused by parenting practices, but by abnormalities in
the brain. By the 1970's, research began investigating the cognitive and
brain basis of autism and the result was the first neurobehavioral
(brain-behavior) models.
As each model was subjected to further testing, more was learned about
the cognitive deficits and the brain in autism. The growing evidence for
autism as a disorder of brain and cognitive development and as a family
genetic disorder demonstrated to the broader scientific community the
importance that autism had for understanding human function, brain
development, and genetic regulation of brain development. An
understanding of these processes is key to developing powerful
interventions in this and other disorders. All of these events have led
to substantial improvements in the recognition of autism and related
disorders and earlier diagnosis. The goal now is to begin
widespread screening at 18 months by primary care physicians and 0-3
programs.
Today, a research diagnosis of autism is primarily based on several
diagnostic assessment tools: the Autism Diagnostic Observation Schedule
(ADOS) and the Autism Diagnostic Interview-Revised (ADI-R). Both are
used in the research study process to determine traits and
characteristics that are common in autism. They have become critical
measures in providing an accurate research diagnosis of autism spectrum
disorders.
The Autism Diagnostic Observation Schedule (ADOS) helps evaluate
observable behaviors associated within the autism spectrum. It is a
semi-structured test in which the individual is given a number of
situations, tasks, and demands and the tester observes behaviors across
four domains: communication, qualitative impairments in reciprocal
social interaction, imagination/creativity and repetitive behaviors and
restricted interests. The collected information is then quantified and
calculated into an algorithm. The total scores from two domains,
communication and reciprocal social interaction are used to classify
individuals as meeting the ADOS criteria for autism spectrum disorders (ASD).
The Autism Diagnostic Interview-Revised (ADI-R) is a structured
interview designed to obtain detailed descriptions of those behaviors
that are necessary for the differential diagnosis of pervasive
developmental disorders (PDD). The interview primarily focuses on the
key characteristics listed in the
Diagnostic and Statistical Manual of Mental Disorders
(DSM-IV)These features are reciprocal social interactions,
language, communication and play, and restricted, repetitive behaviors
and interests.
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