Tests and diagnosis

By Mayo Clinic Staff

Your child's health care provider will look for signs of developmental delays at regular checkups. If your child shows any symptoms of autism spectrum disorder, you'll likely be referred to a specialist who treats children with ASD, such as a child psychologist, pediatric neurologist or developmental pediatrician, for a thorough clinical evaluation.

Because ASD varies widely in severity, making a diagnosis may be difficult. There isn't a specific medical test to determine the disorder. Instead, a specialist in ASD may:

  • Observe your child and ask how your child's social interactions, communication skills and behavior have developed and changed over time
  • Give your child tests covering speech, language, developmental level, and social and behavioral issues
  • Present structured social and communication interactions to your child and score the performance
  • Include other specialists in determining a diagnosis
  • Recommend genetic testing to identify whether your child has a genetic disorder such as fragile X syndrome

Signs of ASD often appear early in development when there are obvious delays in language skills and social interactions. Early diagnosis and intervention is most helpful and can improve skill and language development.

Diagnostic criteria for ASD

For your child to be diagnosed with autism spectrum disorder, he or she must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

ASD includes problems with social interaction and communication skills and restricted, repetitive patterns of behavior, interests or activities that cause significant impairment in social, occupational or other areas of functioning.

Impaired social and communication skills

To meet ASD criteria, your child must have problems across multiple situations with:

  • Social and emotional give-and-take in social settings — for example, an inability to engage in normal back-and-forth conversation, a reduced ability to share experiences or emotions with others, or problems initiating or responding to social interactions
  • Nonverbal communication behaviors used for social interaction — for example, difficulty using or understanding nonverbal cues, problems making eye contact, problems using and understanding body language or gestures, or a total lack of facial expressions
  • Developing, maintaining and understanding relationships — for example, difficulty adjusting behavior to suit various social situations, problems sharing imaginative play or in making friends, or a lack of interest in others

Restricted, repetitive patterns of behavior

To meet ASD criteria, your child must experience at least two of these:

  • Odd or repetitive motor movements, use of objects or speech — for example, body rocking or spinning, lining up toys or flipping objects, mimicking sounds, or repeating phrases verbatim without understanding how to use them
  • Insistence on sameness, rigid routines, or ritualized patterns of verbal or nonverbal behavior — for example, extreme distress at small changes, expecting activities or verbal responses to always be done the same way, or needing to take the same route every day
  • Interests in objects or topics that are abnormal in intensity, detail or focus — for example, a strong attachment to unusual objects or parts of objects, excessively limited narrow areas of interest, or interests that are excessively repetitive
  • Extra sensitivity or a lack of sensitivity to sensory input or an unusual interest in sensory aspects of the environment — for example, apparent indifference to pain or temperature, negative response to certain sounds or textures, excessive smelling or touching of objects, or visual fascination to lights or movement
Jun. 03, 2014

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