School Age-Screening & Diagnosis
Despite increased awareness and improved developmental screenings, some children with autism are not diagnosed until they reach school age. These Children often have a history of social immaturity as well as speech and language delays. They can also have learning difficulties and behaviors that are somewhat odd or different from their peers. Parents and teachers may begin expressing concerns that something just “isn’t quite right”. Children may go through several different types of autism evaluations in order to get into treatment. These may involve different types of professionals and different testing tools. Caregivers must ensure their child has the appropriate assessment in order to get their “ticket” to services.
Requesting an assessment with the multidisciplinary team at school will be essential. This evaluation is done through the public school district or intermediate school district (ISD) to determine eligibility for special education services, appropriate classroom placement, and support services within the school district. The school psychologist, social worker, speech therapist, occupational therapist and teacher generally work together as a team to complete the evaluation, which usually includes testing of speech and language skills, intellectual ability, and social, emotional, and behavioral functioning. This assessment is referred to as an Educational Certification rather than a medical diagnosis.
This evaluation is completed by a physician or medical doctor such as a developmental pediatrician, pediatric neurologist, or psychiatrist who usually obtains a patient history and physical examination and makes general behavioral observations during the clinic visit. This assessment does not usually include any standardized testing.
Approved Autism Evaluation Center (AAEC):
In Michigan, many private insurance providers require Autism Evaluations to be completed through an AAEC in order for autism therapies, primarily Applied Behavioral Analysis, to be reimbursed. In general, these centers meet criteria developed in partnership with the Michigan behavioral health care community and use a comprehensive, team approach to diagnosing autism. A list of approved AAECs can be found here http://www.bcbsm.com/content/dam/public/Common/Documents/approved-autism-evaluation-centers.pdf
This evaluation is completed by a psychologist who uses standardized testing materials specifically for diagnosing Autism, such as the Autism Diagnostic Observation Schedule (ADOS) or the Autism Diagnostic Interview-Revised (ADI-R). A psychological evaluation for Autism is generally more comprehensive than a medical evaluation and may also include assessment of IQ, developmental level, language, behavior, daily living skills, and social abilities. It will often take several hours to complete and includes a parent interview as well as direct observation of the individual being tested.