Diagnosing and treating autism

April is National Autism Awareness Month. The Child Development Clinic at Children's Hospital of Richmond at VCU (CHoR) provides comprehensive assessment for pediatric patients with developmental delays or disabilities, including those with autism spectrum disorders.

The medical, psychological, social work and educational testing offered by the clinic leads to a diagnosis and recommendations to help patients and their health care providers with care planning, referrals, follow-up care coordination and treatments.

We sat down with Pasquale Accardo, M.D., professor and chief of the Division of Developmental Pediatrics at CHoR, to learn more about autism, including symptoms, diagnosis and treatment.

What is autism?

Autism is a neurodevelopmental disorder – this means that it is a chronic brain problem – a difficulty that the brain has with processing certain kinds of information. In the case of autism, typically the greatest difficulty is dealing with social interaction.

What are the common signs and symptoms of autism?

Common signs of autism vary with age:

• Young children often first present with language issues.
• Preschool and school-age children often exhibit attention deficit hyperactivity disorder (ADHD) symptoms and other challenging behaviors.
• Older children have significant socialization problems, repetitive and obsessive compulsive behaviors.

Symptoms of autism do change with time; certain delays are more common in younger children whereas socialization and processing problems are more common in older children and adults.

How is autism diagnosed?

Autism is diagnosed using a variety of approaches:

• A clinical history and examination may be sufficient.
• Formal testing can include a variety of questionnaires, including the Gilliam Autism Rating Scale and the Childhood Autism Rating Scale, administered to the parents and teachers.
• Autism Diagnostic Observation Schedule (ADOS) testing is considered the gold standard.

How is autism treated?

Autism is best treated with a variety of Early Intensive Behavioral Interventions (EIBI); speech language therapy and occupational therapy can also be used. Applied Behavior Analysis (ABA) is considered the standard for behavioral intervention, but most other effective behavioral programs are variants on ABA.