Pixabay Images
For children on the autism spectrum, very early social skills training, preferably before school age, can have a major impact on later development. But a lot of kids are missing that crucial intervention.
For many, it’s not because they’re not getting diagnosed—it’s because they’re getting a different diagnosis first. Often, it’s ADHD, diagnosed by a pediatrician at age 2 or 3. Or parents are told that their child has sensory processing issues. Then, the autism isn’t picked up until the demands of school and social situations increase. One mother we know got both—sensory processing at 2 years old and ADHD at 4—before her son was diagnosed with autism just shy of his fifth birthday.
Those initial assessments are not necessarily inaccurate, as far as they go. It is estimated that 30 to 40 percent of children with an autism spectrum disorder do also have ADHD, and sensory processing challenges are so common in kids with autism, they are considered a symptom of the disorder. But they can delay an autism diagnosis if practitioners and parents stop there. And while these children are getting treatment for ADHD or sensory processing issues, they’re missing out on therapy that can have a much more important impact on their lives.
Seeing beyond the quick diagnosis
“There is a tendency that once a patient has a diagnosis, because they have a number of symptoms that fit that diagnosis, clinicians can develop a bit of tunnel vision where some other findings might be overlooked,” says Dr. Amir Miodovnik, a developmental pediatrician at Boston Children’s Hospital.
Dr. Miodovnik is the lead researcher on a study of autistic children, published in Pediatrics, which linked an initial diagnosis of ADHD to a delay of three years, on average, in the autism diagnosis. Children who had first been diagnosed with ADHD were nearly 30 times more likely to receive their autism diagnosis after age 6 than those for whom autism was their first diagnosis.
The study confirmed Dr. Miodovnik’s clinical experience. “We see a fair number of children we evaluate for autism spectrum disorder at an older age,” he says, “who previously have had an ADHD diagnosis.”
Why is autism overlooked in these early screenings?
There are a number of reasons why these initial evaluations don’t result in an autism diagnosis. To avoid delays, parents should be aware of them.
– Caroline Miller
Read more: Why Autism Diagnoses Are Often Delayed
An excellent article and so very true. I have a grandson who experienced the same thing…diagnosed to have Auditory Processing Disorder, then ADHD, and although obvious to me early on that he was autistic, the so-called experts didn’t see it and when I suggested that his symptoms perfectly coincide with Autism (rocking, obsession with repeated dialogue in videos, movies, etc, social ineptness with withdrawal from social situations, I was told…well he is talkative and has eye contact, so he can’t be autistic.
It is very frustrating to be met with such old-fashion ideas on Autism, but they still do exist today. It’s like they expected him to be noncommunicative or in a trance-like state before they would consider the Autistic Spectrum. And this was a communication specialist at a prominent cutting-edge facility. So years went by…my daughter and her husband believed the doctor and declared that he wasn’t Autistic and that he might outgrow whatever it is. Finally, in his Senior Year, he actually was diagnosed with Autism (Aspergers type) on the Spectrum. He had been on Adderall/other drugs for years to help his focus and concentration (& they did help) and had just stopped taking them after high school. He’s attending college now and is majoring in Music, but also works at a grocery store checking. Lately, he has been experiencing more distractions and finding it harder to focus so his neurologist has put him back on low-dose Adderall to see if it will improve his function. Anyway, the problem of misdiagnosing definitely exists and due to this misdiagnosis, children are having a very hard time navigating the social norms in the early elementary grades….just at the time that they need intensive help and interventions. As a result, many negative behaviors start to develop…attention-seeking behaviors, meltdowns, separation anxiety that hangs on, oppositional behaviors, and aggression or more introversion. The older they get, the more difficult it is to counter these behaviors. It is my feeling that early diagnosis and intervention is the true key to helping those on the Autistic Spectrum.