When we think of some kind of child developmental disorder, probably the first names that come to mind are ADHD and autism. The latter condition is particularly difficult for many people to understand and can lead to a high level of suffering for the child who suffers from it, as he or she does not feel understood, and for his or her close environment as he or she fears not being able to get close to their little one.

Having autism also implies a series of difficulties that will have to be faced and that must be dealt with throughout the developmental process and the life of the subject. But in order to help this sector of the population, it is first necessary to be able to determine whether or not one has this disorder. In this sense, we need a series of tests to detect autism . In this article we are going to mention some of the most applicable ones.

Autism: what is it?

Before we go into some of the major tests and trials that exist to detect autism, it would be useful to go into a little more detail about the notion that we have regarding this disorder.

We call autism, now autism spectrum disorder, a type of neurodevelopmental disorder (i.e., originating during the stage of neuronal growth and development) characterized by the presence of problems and severe difficulties in language, socialization, and behavior. This disorder can usually be detected before the age of three , appearing very early in life.

Each of the three aspects mentioned above presents particularities that make the adaptation of the child to the environment difficult .

At a socio-relational level we observe the presence of a lack of interaction and an apparent disinterest in linking with others, being closed in on themselves. People with this disorder have severe difficulties in possessing a theory of mind that allows them to see that others are entities with a mind that is independent and separate from their own. There is a difficulty in initiating and responding to social interactions, with little social-emotional reciprocity.

With regard to communication problems , there is a marked literalism (they do not usually understand figurative language), as well as a high degree of difficulty or impossibility in understanding and using non-verbal language. It is also not uncommon for there to be delays in language acquisition, and problems in the practical use of language appropriate to its context are notorious. In some cases, the subject may not develop language at all. They also often have problems with turn-taking and responding to interactions.

Finally, also in the behavior they present alterations. The presence of restricted interests and a high need for routines stands out , being the presence of changes something tremendously stressful for them since they need them to have a sense of security. It is not unusual for them to have repeated expressions, movements or use of objects, often as a way of calming down. It has also been observed that it is frequent to have a hyper or hyposensitivity to stimulation, reacting excessively or not reacting at all to noise and lights.

These are some of the main characteristics and criteria of people with autism. It must also be taken into account that, although it is generally diagnosed in children, it is a chronic disorder that will persist into adulthood and that requires appropriate therapeutic management in order to reduce the possible affectation in the different areas of life and increase the level of autonomy and well-being of these people.

The main screening tests for autism

A basic aspect to be able to intervene in this disorder is the fact of detecting it. In this sense, numerous tests have been developed over the years in order to detect the presence of an autism spectrum disorder and the aspects that in each case appear altered. These tests can be passed on to different agents, either to the child himself or more usually to parents and teachers.

Here are some of the most popular tests used to detect autism, recommended by such well-known publishers as TEA Editions or different organizations specializing in autism.

It is important to bear in mind that those we are going to mention are not all those that exist, but only some of the most representative ones. It should also be noted that, in this as in other disorders, the results of a test are neither determining nor a sufficient condition for diagnosis, and other information should also be assessed, such as those obtained in an interview, with the observation of the person or with the reports of other persons .

1. Autism Diagnostic Observation Scale (ADOS)

One of the reference and most well-known tests in the diagnosis of autism, this is a scale developed for the purpose of evaluating communication skills, social interaction and the play and use of materials and which provides cut-off points. It consists of four modules of which only the one that is appropriate for the subject in question by age range and communication level is applied . A minimum mental age of two years is required and allows the child to be assessed on the basis of his/her performance. At present, more advanced editions such as ADOS 2 can be found.

2. Interview for the Diagnosis of Autism (ADI)

The ADI and its review (ADI-R) are clinical interviews designed to conduct a comprehensive assessment of a possible case of autism. It consists of around 93 questions (in the ADI-R version) which explore language, reciprocal social interaction and restricted behaviours/interests. It focuses on the typical behaviors of the subject with autism that rarely appear in people without this condition. The score can be coded and then interpreted with algorithms, and does not have a comparative scale.

3. Adaptive Behavior Assessment System (ABAS)

Instrument that assesses adaptive behavior from birth to 89 years old. It assesses the areas of communication, use of community resources, functional academic skills, home life, school life, health and safety, leisure, self-care, self-direction, social, motor and employment.

The second version (ABAS-II) also includes the global conceptual, social and practical indexes. Although it is not only about autism, it allows the evaluation of the main areas affected by this disorder. It is the parents, teachers or relatives who usually give answers and complete the test, although the subject himself can also answer it.

4. Autism Spectrum Quotient (AQ)

This is a Baron-Cohen questionnaire of 50 questions that is designed to be answered by the subject himself, and which is based on evaluating the degree of agreement (between total agreement and total disagreement, there being a total of four possible answers) with each of the different questions. In this sense we can find specific versions for different profiles, such as the Autism Spectrum Quotient for Children (AQC), Autism Spectrum Quotient for Adolescents (AQA) and Abbreviated Autism Spectrum Quotient (AQS).

They can also be filled in by relatives or teachers. It offers cut-off points that allow to separate the old Kanner type autism from Asperger’s syndrome , and allows to distinguish different phenotypes .

5. Social Communication Questionnaire (SCQ)

This questionnaire of quick application must be answered by the subject’s caregivers, consisting of a total of 40 items among which interaction problems, communication problems and restricted and stereotyped behaviors are evaluated. It has a form A that evaluates the subject’s whole life and a form B to assess the situation of the last three months. Depending on the result, it may be advisable to take another more complete test such as the ADOS or the ADI.

6. Autism Spectrum Screening Questionnaire (ASSQ)

This questionnaire is designed for children between seven and sixteen years of age, consisting of a total of 27 questions to be answered with Yes/No/Sometimes. It is more of a screening, and tends to focus more on former Asperger’s (now part of Autism Spectrum Disorder). It must be completed by parents and teachers and allows for the identification of different predominant features in children with social interaction and behavioural problems. Currently there is a revised extended version (ASSQ-REV), which is more complete.

7. Modified Childhood Autism Questionnaire (M-CHAT)

Screening test to be answered by the child’s parents. If the child fails more than three items, a more detailed examination must be carried out to assess the presence of ASD. Designed to assess children around two years of age, based on questions to be answered with Yes or No.

8. Autism Spectrum Inventory (IDEA)

Inventory generated for the purpose of evaluating a dozen characteristics of people with autism and other neurodevelopmental disorders. More than screening, it focuses on assessing the severity of the patient’s condition. It allows the identification of the severity of the autistic features , as well as generating treatment guidelines and testing the changes that these treatments generate.

Also, depending on the score, the subject can be classified into four different types of autism (highlighting classic and Asperger’s, as well as regressive autism and high functioning autism. It must be completed by the professional based on the information coming from the observation and interview to the environment.

9. Infant and Toddler Questionnaire (CSBS DP)

It is a scale that values the presence of different predictors of language and social communication. Designed to be used between six months and two years. It should be completed by a parent, caregiver or person in frequent contact with the child.

10. Childhood Asperger’s Syndrome Test (CAST)

37-question questionnaire for early detection of characteristics of children with Asperger’s disease . It is passed by parents of children between four and eleven years of age.