Spotlight On Progress in Evaluation and Diagnosis of Autism Spectrum Disorder

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Monitoring, screening, evaluating, and diagnosing children with autism spectrum disorder (ASD) as early as possible are important steps for making sure that children receive the services and supports they need to reach their full potential. There are several steps in this process.

More evaluated by 36 months

4-year-old children with ASD who received evaluation 2016 vs. 2014

More evaluated by 36 months 4-year-old children with ASD who received evaluation -  84% in 2016 versus 74% in 2014

Tracking ASD among preschool-aged children

Tracking ASD among preschool-aged children increases our understanding of the characteristics and early identification of younger children with ASD. Early identification helps families get earlier access to services in their communities. The Early Autism and Developmental Disabilities Monitoring (Early ADDM) Network collects information about ASD prevalence and early identification among 4-year-old children in a subset of six communities from the broader ADDM Network of 11 communities. The latest report from the Early ADDM Network provides critical information on progress made toward early identification of children with ASD and informs providers—particularly public schools—of future service needs.

Key findings from the Early ADDM Network

More children are being evaluated for ASD at an earlier age than previously reported
In 2016, a higher percentage (84% compared to 74%) of children identified with ASD by 4 years of age received their first developmental evaluation by 36 months compared to those in 2014. In addition, it indicates progress has been made toward the Healthy People 2020 goal of increasing the percentage of children with ASD who receive their first developmental evaluation by 36 months.

Comparing children aged 4 and 8 years in 2016 shown by age at ASD diagnosis

Comparing children aged 4 and 8 years in 2016 shown by age at ASD diagnosis

More children are being diagnosed with ASD at an earlier age
More children who were born in 2012 (1.02%) received an ASD diagnosis by 4 years of age compared to children born in 2008 (0.83%). This means more children are being diagnosed with ASD by age 4 now than previously.

Implications
These are positive findings because the younger a child is when he or she receives a developmental evaluation or ASD diagnosis, the sooner the child can begin to receive needed services.

Steps in the process to diagnose ASD
  • Developmental monitoring (also known as tracking or surveillance) is important for all children. Caregivers, such as parents, healthcare providers, and early educators, can learn how to look for developmental milestones—how children grow, move, communicate, interact, learn, and play. This information helps caregivers know what to expect at different ages, get ideas on how to promote positive development, and recognize potential concerns about development as early as possible. Developmental monitoring is an ongoing process, and CDC’s Learn the Signs. Act Early. program has tools and information to help at www.cdc.gov/ActEarly.
  • A developmental screen is a short test using a validated screening tool to identify whether a child is learning basic skills, and it can help determine if there might be a delay. The American Academy of Pediatricsexternal icon recommends screening children for ASD at 18 and 24 months of age.
  • A comprehensive developmental evaluation is a thorough review of how a child plays, learns, communicates, acts, and moves, and whether those characteristics have changed over time. Various professionals can conduct developmental evaluations, including teachers, social workers, nurses, psychologists, doctors, and speech-language pathologists. This evaluation can include clinical observation, parental reports of developmental and health histories, psychological testing, and speech and language assessments. A comprehensive developmental evaluation is often a key step in getting services, including those through the school system.
  • Diagnosis occurs when a developmental pediatrician, child neurologist, child psychiatrist, or child psychologist uses the results of the comprehensive evaluation to determine whether a child has ASD. Neurological and genetic testing can often exclude other disorders and can check for genetic and neurological problems that sometimes occur along with ASD. A medical diagnosis can be a key step in getting medical services provided through health insurance.