Autism Spectrum Disorder: Warning Signs, Detection, Diagnosis and Assessment in Children and Adolescents
Haute Autorité de la Santé. (2018).
Saint-Denis (France): Haute Autorité de la Santé, (RWS Language Solutions, Trans.), 1-46.
This guideline provides recommendations to optimize the process for detecting and diagnosing autism spectrum disorder (ASD) in children or adolescents under 18 years of age.
Haute Autorité de la Santé (France)
If the child exhibits characteristics of autism, the child, regardless of age, should receive a referral for "a communication and language assessment by a speech and language therapist, possibly specifying with rehabilitation if necessary" (p. 21).
Universal and routine screening for autism spectrum disorder in the general population is not recommended.
"A regression of language or interpersonal skills should also lead to screening for [autism spectrum disorder] ASD, regardless of the child’s age, when there are no abnormalities in the neurological examination that would immediately point toward another diagnosis" (p. 10).
The initial assessment should include a communication evaluation using standardized tests that examines both nonverbal and pragmatic skills.
Screening for autism spectrum disorder (ASD) is recommended for children with characteristics of autism or for those who have a higher likelihood of being on the spectrum (e.g., siblings of children on the autism spectrum). Screenings for children with a higher likelihood of being on the autism spectrum should start at age one and continue throughout the child's ongoing developmental monitoring.
"Pending ... results of the complete diagnostic process, the first assessments should be prescribed and local interventions should be implemented, especially in the area of communication.... The expected time between the detection of [developmental differences] ... and the start of interventions ... should be less than 3 months due to the developmental urgency in the young child" (p. 12).
"An individualised clinical assessment should be performed, focusing on the different aspects of the child’s development and functioning and on his/her environment (multidimensional evaluation); it should be specific, detailed and performed in varied contexts.... The assessment is based on direct and indirect observations collected from those close to the child, especially his/her parents, but also from professionals at childcare centres and schools. It also uses batteries of standardised tests appropriate for the child’s age, developmental profile (e.g. language, motor skills, etc.), behaviour and testing context, giving preference to the validated tests and scales available" (p. 16).
Children with characteristics of autism should undergo a hearing test.
