Refer for intervention pending diagnosis – Primary care providers who suspect that a child has ASD should refer the child for developmental-behavioral services pending the comprehensive evaluation.(See "Autism spectrum disorder in children and adolescents: Screening tools".) It is important to check local educational system and insurance requirements for the given diagnosis to qualify the youth for treatment. The primary care provider can make a diagnosis of ASD using first- and second-tier screening instruments, which are discussed separately, if they have adequate clinical experience and confidence in the veracity of the evaluation they can perform. Having a clinical diagnosis may facilitate initiation of services. Make the initial diagnosis – Although most children will need to see a specialist (eg, developmental-behavioral pediatrician, child psychiatrist, child neurologist, psychologist), for a diagnostic evaluation, general pediatricians and child psychologists comfortable with application of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Text Revision criteria for ASD can make an initial clinical diagnosis.Accurate and appropriate diagnosis usually requires a clinician who is experienced in the diagnosis and treatment of ASD, ideally with input from multiple disciplines to assess core symptoms, functional impairment, severity, and comorbid conditions. ![]() Refer for comprehensive evaluation – Children who are identified as being at risk for ASD should be referred to a specialist (eg, developmental-behavioral pediatrician, child psychiatrist, child neurologist, (neuro)psychologist with expertise in ASD) for a comprehensive evaluation to establish the diagnosis.(See 'Diagnostic criteria' below and "Autism spectrum disorder in children and adolescents: Clinical features", section on 'Terminology'.) The abnormal social interactions are due to limited social communication skills (eg, difficulty with social attention and dyadic conversation with a limited ability to understand another's perspective) as well as restricted, repetitive patterns of behavior, interests, and activities. (See "Autism spectrum disorder in children and adolescents: Surveillance and screening in primary care" and "Developmental-behavioral surveillance and screening in primary care".)ĪSD should be suspected in children with abnormalities in social interaction that are not better explained by impaired cognitive skills. ![]()
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