Scientists and doctors are getting better and better at diagnosing autism. One reason for the improvement in diagnosis is that autism is far more common today than in the past. Back in the 1940s, when autism was first recognized as a psychiatric disorder, autism was thought to be a very rare condition, affecting less than 1 in 10,000 children. Over the years, especially during the early 1990s, the number of reported cases of autism soared. Initially, most clinicians believed that this increase was due to increased awareness of the condition and that doctors were finally diagnosing autism correctly in children. In the past, most of these children might have been labeled as mentally retarded. However, most experts today believe that the actual number of children with autism is on the rise, and better diagnosis does not fully explain the recent rising tide of autism around the world.

Autism can most often be diagnosed by the time the child is three years of age, but some highly trained experts can start identifying autistic traits in children at six months of age. The diagnosis of autism is usually confirmed by a child psychiatrist or other specially trained mental health experts that have experience taking care of autistic children. However, the first sign of autism is most often noticed by the parents. More often than not, parents bring their children to the doctor, claiming that something is just not quite right about their child. What tips the parents off could be the way that their child plays with his toys or that he does not seem to be interested in other children. Delayed speech is a major warning sign.

At first, some doctors may brush off these parental concerns and reassure the parents that the child will just grow out of this phase and eventually catch up to his peers. While this wait-and-see approach may work for some children, it only delays crucial intensive therapy autistic children need to modify and improve their behavior. If you suspect that your child may be autistic, do not hesitate to bring this to your doctor's attention. A simple screening test could either give you peace of mind or provide your child the advantage of an early head start on treatment.

There are many standardized screening tests doctors use to diagnose autism. A popular one is called M-CHAT, which stands for the Modified Checklist for Autism in Toddlers. This checklist asks the parents a string of simple questions about their child's behavior. This screening tool is designed for toddler ages sixteen to thirty months. The checklist is provided here:

• Does your child enjoy being swung, bounced on your knee, etc.?

• Does your child take an interest in other children?

• Does your child like climbing on things, such as up stairs?

• Does your child enjoy playing peek-a-boo/hide-and-seek?

• Does your child ever pretend, for example, to talk on the phone or take care of a doll or pretend other things?

• Does your child ever use his/her index finger to point, to ask for something?

• Does your child ever use his/her index finger to point, to indicate interest in something?

• Can your child play properly with small toys (e.g. cars or blocks) without just mouthing, fiddling, or dropping them?

• Does your child ever bring objects over to you (parent) to show you something?

• Does your child look you in the eye for more than a second or two?

• Does your child ever seem oversensitive to noise? (e.g. plugging ears)

• Does your child smile in response to your face or your smile?

• Does your child imitate you? (e.g. you make a face — will your child imitate it?)

• Does your child respond to his/her name when you call?

• If you point at a toy across the room, does your child look at it?

• Does your child walk?

• Does your child look at things you are looking at?

• Does your child make unusual finger movements near his/her face?

• Does your child try to attract your attention to his/her own activity?

• Have you ever wondered if your child is deaf?

• Does your child understand what people say?

• Does your child sometimes stare at nothing or wander with no purpose?

• Does your child look at your face to check your reaction when faced with something unfamiliar?

© 1999 Diana Robins, Deborah Fein, & Marianne Barton

An answer is considered critical if you responded “Yes” to questions 11, 18, 20, and 22 and “No” to all the other questions. If you have more than three critical answers to any of the questions or more than two critical answers to questions 2, 7, 9, 13, 14, and 15, the risk is higher that your child may be diagnosed with ASD.

If the results from the M-CHAT indicate your child is at high risk for being diagnosed with ASD, talk to your doctor immediately. Remember that the M-CHAT is only a screening tool, so having a high-risk score does not necessarily mean that your child has autism. Nevertheless, consultation with an expert is appropriate if the scoring puts your child in a high-risk area.