Identification

=**Who identifies or diagnoses the area of need?**=

Diagnosing Autism can be a difficult and confusing process as the symptoms are very similar to many other medical symptoms or conditions. Symptoms that may cause parents to question whether something is wrong with their child are **delays in speech development, unusual physical behaviors such as rocking, flapping, or toe walking, irregular sleep patterns and gastrointestinal problems.** None of these symptoms alone are signs of autism, but when put together they may raise concern. **Observations and interviews are a common way of making a diagnosis**, however one observation in a single setting cannot be used as an accurate diagnosing tool. Observations need to be done in several different occurrences and settings including the child's home, in a public setting or if the child is old enough, in school. **It is important for parents and/or teachers to provide input and history of the child to make an accurate diagnosis.** The medical professional taking the history from the parents may ask questions about their pregnancy, developmental milestones, eating and sleeping habits, sensory challenges, family history, etc. Although t**here is no medical test to diagnose a child with autism**, medical testing may be done in order to rule out other diagnoses or to identify possible causes of the symptoms shown.

=**The Autism Diagnostic Observation Schedule**= One diagnosing strategy that can be used by professions is **The Autism Diagnostic Observation Schedule (ADOS)**. It includes scoring direct observations of the child's interactions which accounts for the developmental level and age of the child. ADOS includes a standardized administration of activities given by the professional, which show the child's social interactions, communication and repetitive behaviors. The measure takes 30 to 60 minutes to administer and includes four different modules to use with individuals with different developmental and language levels. The activities vary based on the language level and chronological age of the child. Modules 1 and 2 are designed for children with a language level of less than 48 months. The activities include playing with bubbles, the release of an inflated balloon, and a pretend birthday party. Modules 3 and 4 are designed for older children, adolescents and adults who are able to use complex sentences and talk about things that are not immediately present. The activities include questions about emotions and relationships as well as retelling a story from a book and demonstrating a routine activity. For each task, a level of social structures is provided. During the first administration of a task a child is able to take as much initiative as possible. If this does not occur, the professional gradually makes the tasks more specific and increasingly structures the situation to get a better observation of the child. The ADOS is standardized in terms of the materials used, the activities presented, the professional's introduction of activities, the hierarchical sequence of social presses provided by the professional, and the way behaviours are coded or scored. Following the administration of the ADOS, behaviors are coded using a 0- to 3-point coding system, where a 0 indicates that the behavior is not abnormal in the way specified in the coding description and a 3 indicates that a behavior is abnormal and interferes in some way with the child's functioning. ADOS observations are based on specific coded behaviors that are included in a scoring algorithm using the DSM-IV diagnostic criteria, resulting in a communication score, a reciprocal social interaction score, and a total score. Scores are compared with an algorithm cut-off score for Autism or the more broadly defined ASD in each of these areas. If the child’s score meets or exceeds cut-offs in all three areas, they are considered to meet criteria for that classification on the measure.

=**The teacher's role?**= If a teacher suspects a child may have autism it is important to communicate this with the child's parents right away. The school can provide the needed assistance to the parents and the child's family to help them through the process of getting their child diagnosed. A teacher should speak with their admin. in order to get the proper supports put in place. The school may provide support for the family such as working with the school psychiatrist, speech and language pathologist or occupational therapist.

=Traits= Persons with autism may exhibit some of the following traits:
 * Insistence on sameness; resistance to change
 * Difficulty in expressing needs; uses gestures or pointing instead of words
 * Repeating words or phrases in place of normal, responsive language
 * Laughing, crying, showing distress for reasons not apparent to others
 * Prefers to be alone; aloof manner
 * Tantrums
 * Difficulty in mixing with others
 * May not want to cuddle or be cuddled
 * Little or no eye contact
 * Unresponsive to normal teaching methods
 * Sustained odd play
 * Spins objects
 * Inappropriate attachments to objects
 * Apparent over-sensitivity or under-sensitivity to pain
 * No real fears of danger
 * Noticeable physical over-activity or extreme under-activity
 * Uneven gross/fine motor skills
 * Not responsive to verbal cues; acts as if deaf although hearing tests in normal range.

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