Any discussion of the long or short versions of the autism screening test is bound to have proponents on one side or the other.
In my opinion, the 97-question autism screening test is far better suited as a test for ADHD; if you get through it without going nuts, you don’t have ADHD.
So, let’s make a distinction, right now, between screening for autism, and diagnosing autism. My job is to identify children who would benefit from early intervention to improve their function in the future.
The “short-list” autism screening test questions that I ask, usually at 18 months of age, are:
“Yes” is good:
- Does the child point or look where you point?
- Does the child watch your face and react to your expressions?
- Does the child pretend-help around the house?
- Does the child play with toys “appropriately” (“drive” cars, “talk to” dolls?)
- Does the child play interactively with other children?”Yes” is bad:
Preoccupation with something that isn’t interactive with a person?
Fear of noise?
And here is the short list of important diagnostic factors from Dr Wall’s autism screening test (in Nature):
Frequency of vocalization directed to others
Unusual eye contact
Responsive social smile
Shared enjoyment in interaction
Spontaneous initiation of joint attention
Functional play with objects
The first thing we need to do is step away for a moment from autism as a diagnosis, and start thinking of it as having failed a class in the school of hard knocks. Of course, ability has a lot to do with it, but to equate ability and performance is ridiculous.
Clinical autism is lack of elementary competence in interpersonal tasks: figuring out what someone feels or thinks, and trying to influence what they feel or think.
Paying attention to other people is the first step; imitating their interpersonal strategies is another; and “rehearsing” these strategies with pretend play is another.
Two possible factors that could decrease learning of interpersonal skills are:
- lack of motivation (“the irrelevant parent”)
- strong competing motivations (mainly to techno-toys and games)
In order for skills to be learned, the parent must become the most important object in the child’s world: one whose wrath is to be avoided, one from which all beneficence flows; one who matters, who inspires respect and therefore interest. In short, a leader.
And if the parent’s buttons are harder to find and push than those of a gaming handset, and if the effects of pushing those buttons will be more dramatic than anything on screen, that will be the parent worthy of attention.
Dr. Anatoly Belilovsky
A recognized expert in pediatric asthma and an advocate for immediate, comprehensive illness diagnosis, Anatoly Belilovsky, M.D., has gained acclaim and a large patient following for his fresh approach to general pediatrics and urgent treatment.
Board-certified in pediatric medicine, the Princeton graduate is listed as one of America’s Top Pediatricians and is a recipient of the Americhoice Quality of Care Award for his groundbreaking work with pediatric asthma patients.
Dr. Belilovsky is a dedicated physician whose mission is to provide quality urgent care 365 days a year and comprehensive early detection of illness through cutting-edge diagnostic methods and state-of-the-art non-radiological equipment. www.BabyDr.us.