🧠 The Autism Spectrum Disorder (ASD)

is defined as a neurodevelopmental disorder, of neurobiological origin that usually causes impairment in the person's social, communicative, and behavioral areas. There may or may not be the presence of stereotyped, repetitive, or inflexible behaviors. Some authors in the scientific field, such as Bargiela et al. (2016), prefer to use the term Autism Spectrum Conditions (ASC in English), as it is a term that provides greater respect for neurodiversity, emphasizing that within this population group there are differences that make each individual unique, including having strengths as well as weaknesses that need to be worked on to promote their adaptation in the various scenarios and contexts in which they participate.

🧩 Severity of Symptoms

It is important to clarify that the severity of symptoms will vary from person to person, ranging from mild, moderate, or severe levels, which is why one of the first steps recommended to parents is to request an evaluation that allows for the exclusion or confirmation of possible symptoms related to the diagnostic criteria for autism.

🧠 Role of the Psychology Professional

This article will discuss the importance of the role of the psychology and educational neuropsychology professional regarding the evaluation and treatment of autism. It is appropriate to say that autism, being a neurodevelopmental condition with multiple challenges and needs, may also require the joint evaluation, support, and treatment of other professionals. Interprofessional collaboration through a multidisciplinary approach is the model that aligns with best practices for the care and treatment of patients with this diagnosis, given the educational, medical, functional skills, and biopsychosocial needs faced by this population group (Strunk et al., 2017).

🔎 Diagnosis of Autism

When referring to the diagnosis of autism, instruments such as the ADOS-2 (Autism Diagnostic Observation Schedule) and ADI-R (Autism Diagnostic Interview - Revised) stand out, both tests considered ideal for confirming or ruling out the diagnosis of autism, especially due to their high levels of diagnostic effectiveness, validity, and sensitivity (Lebersfeld et al., 2020; Thabtah and Peebles, 2019). It is important to clarify that apart from the mentioned tests, it is vital to use other techniques such as clinical interviews, observation, evaluating cognitive factors, functional skills, having experience in the diagnosis-treatment of autism, and relying on the impressions of other specialists, so that accurate, objective, and appropriate diagnostic conclusions can be made about each clinical case.

🧐 Summary of Recommended Tests

Below, I will provide a summary of the purpose, importance, and benefits of tests recommended in an autism evaluation plan.

  • ADOS-2 (Autism Diagnostic Observation Schedule): it is a standardized and semi-structured assessment that, through the use of "pressures" exerted by the evaluator, creates standardized contexts in which it is possible to observe social behaviors, communication, linguistic skills, or the presence of unusual or inappropriate behaviors that may or may not be related to autism-related symptoms. The ADOS-2 test can be applied from 12 months of age to adults (Lord et al., 2015).
  • ADI-R (Autism Diagnostic Interview - Revised): It consists of a 93-question interview that focuses on three domains of functioning that are diagnostically important concerning autism: on one hand, areas related to language/communication. Secondly, areas of reciprocal social interactions, and thirdly, questions related to restricted, repetitive, and stereotyped behaviors and interests. The ADI-R test can be applied to patients whose mental age is over 2 years (Rutter et al., 2011).
  • ABAS-II (Adaptive Behavior Assessment System): a useful test for measuring aspects related to adaptive behavior and functional skills. Adaptive skills are the set of competencies that a person uses to adapt to the demands of daily life. What does this mean? That the ABAS-II allows us to understand whether communicative, academic, community resource use, home, and school skills are within what is expected for the person's age, or if some type of intervention or specific follow-up plan is required to help children, adolescents, and adults improve their adaptation in the various environments in which they operate (Oakland and Harrison, 2013). If you wish to deepen your knowledge about adaptive behavior, I recommend reading the following article: Adaptive Behavior from a Neuropsychological Approach.
  • Intelligence Tests: intelligence scales allow us to understand the cognitive functioning level of the evaluated person, considering verbal, non-verbal, perceptual areas, working memory, and processing speed. The evaluation of intelligence can help us predict future academic performance, taking into account the unique strengths and weaknesses of the evaluated person. If you want more information on the topic of intelligence, I recommend reading the following article: Intelligence from the Neuropsychology and Education Perspective.
  • Neuropsychological Maturity (CUMANES and CUMANIN): neuropsychological maturity refers to the level of development, maturation, and organization of the nervous system, so that the person can perform adaptively and functionally to the various demands of their surrounding environment (Morales and Rincón, 2016). If you wish to deepen your knowledge about neuropsychological maturity, I invite you to read the following article: Neuropsychological Maturity and its Importance in Panamanian Education.

✋🏻 Evaluation and Recommendations

The evaluation itself is part of the process, as subsequently, based on the results, recommendations may include speech therapy, behavioral therapy, sensory therapy, neuropsychological stimulation, and educational support services. In the behavioral area, Applied Behavior Analysis (ABA) applies the principles of learning to decrease, increase, maintain, or generalize behaviors that are targeted and prioritized (Mulas et al., 2010). Therefore, it is essential during the evaluation to analyze the patient's behavior from the perspective of what they can and cannot do, making it important to ask: can the person establish eye contact? Are they able to vocalize sounds? Do they initiate conversations? Is there the presence of disruptive or unusual behaviors that do not correspond to the context? The answers to these questions will help the professional contextualize behavioral modification programs that fit the needs of each case.

🧐 Foundations and Support Institutions

There are various foundations or government institutions that provide advice, support, and guidance to families who need to expand their knowledge about autism. Some of these places are:

  • Panamanian Institute of Special Rehabilitation (IPHE): offers educational services and multidisciplinary support to individuals diagnosed with autism and other disorders. In the case of autism, currently, IPHE offers the Autism Program, which has been in operation since April 1976, and was later legally endorsed on March 9, 1989, according to Resolution No. 108. If you would like more information about this program, I invite you to click here.
  • The Ann Sullivan Center Panama – CASPAN is a public and social entity, non-profit, with legal personality, directed by a board, that offers resources, services, and support for individuals with autism and other cognitive disabilities, their families, and the community. Remember that we will be serving from January 2023 in Panama City, PH Centro Empresarial Mar del Sur, just 200 meters from the Vía Argentina Metro Station. To contact us, you can call or write to +507 65356362, and we are happy to assist you with your needs.

📚 References

  • Bargiela, S., Steward, R., & Mandy, W. (2016). The experiences of late-diagnosed women with autism spectrum conditions: An investigation of the female autism phenotype. Journal of autism and developmental disorders, 46(10), 3281-3294.
  • Lebersfeld, J. B., Swanson, M., Clesi, C. D., & O’Kelley, S. E. (2021). Systematic review and meta-analysis of the clinical utility of the ADOS-2 and the ADI-R in diagnosing autism spectrum disorders in children. Journal of autism and developmental disorders, 51(11), 4101-4114.
  • Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K. and Bishop, S. L. (2015). ADOS-2. Autism Diagnostic Observation Schedule - 2. Manual (Part I): Modules 1-4 (T. Luque, adapter). Madrid: TEA Ediciones.
  • Morales, A., and Rincón, C. (2016). Relationship between neuropsychological maturity and the presence-absence of crawling behavior. Acta De Investigación Psicológica, 6, 2450-2458.
  • Mulas, F., Ros-Cervera, G., Millá, Etchepareborda, M., Abad, L., Montserrat Téllez de Meneses (2010). Intervention models in children with autism. Rev. Neurol. (3) 77-84.
  • Oakland, T., & Harrison, P. (Eds.). (2013). ABAS-II clinical use and interpretation. Madrid Spain: TEA Ediciones.
  • Rutter, M., Le Couteur, A., & Lord, C. (2011). Autism diagnostic interview - revised edition (Second edition ed.). Spain: TEA Ediciones.
  • Strunk, J., Leisen, M., & Schubert, C. (2017). Using a multidisciplinary approach with children diagnosed with autism spectrum disorder. Journal of Interprofessional Education & Practice, 8, 60-68.
  • Thabtah, F., & Peebles, D. (2019). Early autism screening: a comprehensive review. International journal of environmental research and public health, 16(18), 3502.