At present, there is no biological marker on the basis of which a diagnosis can be made. The basis of clinical diagnosis of ASD is, above all, high-quality and complex observation, which must be based on a very good knowledge of the usual manifestations of these disorders at various stages of development.
Various objective tools have been developed to diagnose and evaluate the symptoms of ASD. The combination of Autism Diagnostic Observation – Second Edition (ADOS-2) a Autism Diagnostic Interview – Revised (ADI-R) is considered the “gold standard” in the diagnosis of ASD, both scales providing a comprehensive and complex picture of o ASD.
Autism Diagnostic Observation – Second Edition (ADOS-2)
a diagnostic method that focuses on evaluating the manifestations of ASD during a partially structured interaction with the administrator.
ADOS-2 consists of z five modules, which are selected depending on the chronological age and verbal communication level of the individual:
Toddler module for children from 12 to 30 months of age.
Modul 1 for individuals 31 months of age and older who do not use speech consistently (in phrases),
Modul 2 for individuals of any age who use speech in phrases, but the speech is not fluent
Modul 3 for fluent verbal children and young adolescents.
Modul 4 designed for fluently verbal older adolescents and adults.
The activities provide an interesting and standardized context for social behaviour in the form of play or conversation. During the 40-60 minutes of ADOS-2 examination, the administrator will get a picture of four areas – language and communication skills, mutual social interaction, play, stereotypes and and narrowly defined interests. Based on the ADOS-2 examination, it is also possible to determine the quantitative rate of ASD symptoms (Lord 2000; Lord 2012).
Autism Diagnostic Interview – Revised (ADI-R)
is a partially structured interview with a parent / caretaker that covers the three main areas of ASD problems, which are the quality of reciprocal social interaction, the quality of communication, and limited, repetitive and stereotypical patterns of behaviour. It lasts 90-150 minutes and is suitable for individuals with developmental level corresponding to the level of at least two years of age (Lord 1994; Kim 2012).
In addition to evaluation through specific evaluation scales, the diagnosis itself consists of a thorough evaluation of the developmental history (anamnesis), relevant information for differential diagnosis and possible comorbidities, while the result of the specific scales does not replace the clinical judgment of the expert.
Diagnosis of ASD is not easy due to the high variability of manifestations. It often requires a comprehensive and interdisciplinary cooperation of several medical specialists – paediatrician, child psychiatrist, neurologist, specialist in metabolic diseases, geneticist, psychologist, medical pedagogist (Šuba, 2016).
LORD, C., RISI, S., LAMBRECHT, L., et al.: The Autism Diagnostic Observation Schedule – Generic: a standard measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord, 30, 2000, č. 3, s. 205-23.
LORD, C., RUTTER, M., DILAVORE, P. C., et. al.: Autism diagnostic observation schedule, Second Edition (ADOS-2). Torrance, CA: Western Psychological Services, 2012.
LORD, C., RUTTER, M., LE COUTEUR, A.: Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. J Autism Dev Disord, 24, 1994, č. 5, s. 659-85.
KIM, S. H.; LORD, C.: New autism diagnostic interview-revised algorithms for toddlers and young preschoolers from 12 to 47 months of age. Journal of autism and developmental disorders, 42, 2012, č. 1, s. 82-93.
ŠUBA, J.: Autizmus a poruchy autistického spektra z pohľadu pedopsychiatrie. Pediatr. prax, 17, 2016, č. 4, s. 144–146