Autism and ADHD: How to know if your child should be tested

"If you feel something isn’t right, please talk to someone who can take a closer look"

Three elementary school students hold pencils and work together at a table. Autism and ADHD screening can happen in the classroom.

Two behavioral problems most often associated with children are autism and ADHD, or attention-deficit/hyperactivity disorder. As a licensed child psychologist in the pediatrics department at Sanford Health in Bemidji, Minnesota, I currently have more than 50 patients with these conditions.

This is how I explain to parents what autism and ADHD are, what parents should look for and how to know if their child should be tested.

Autism screening

Autism spectrum disorder (ASD), or autism, refers to a broad range of conditions characterized by challenges with social skills, repetitive behaviors, speech and non-verbal communication. Autism affects an estimated 1 in 59 children. Many people with autism also have sensory issues, such as aversion to certain sights, sounds and other sensations. Signs of autism usually appear by age 2 to 3 but can start as early as 6 months of age.

One of the best sources of information on autism is Autism Speaks, a reputable organization dedicated to causes and treatments for autism spectrum disorders and related conditions. On its website is a helpful page called Learn the Signs, which highlights “red flags” that parents can identify that may indicate their child is at risk for ASD. Early signs include lack of social engagement, responsiveness and using communication in meaningful ways within relationships. For example, at 6 months of age you don’t see big smiles or other warm and engaging expressions, or there’s limited eye contact.

There is also a screener tool that Sanford Health pediatricians use called the M-CHAT (Modified Checklist for Autism in Toddlers). It is recommended by the American Academy of Pediatrics for ages 16 to 30 months. It’s a simple, quick, screening tool, even available online, to help parents determine whether their child should be seen by a professional.

Keep in mind that as a screening tool it’s designed to detect as many cases as possible, so there will be false positives. That’s why a follow-up with a professional is recommended.

If you notice your child is having any developmental difficulty, talk to your child’s physician or a psychologist with experience in early childhood development. We can conduct a relatively brief consultation to determine whether a full evaluation is needed for a condition such as autism spectrum disorder or some other developmental delay that could benefit from early intervention.

ADHD screening

Attention-deficit/hyperactivity disorder (ADHD) is a treatable, neuro-behavioral disorder found in kids, teens and adults.  It is estimated that nearly 17 million Americans are affected by ADHD. There are three main types of ADHD: predominantly inattentive, predominantly hyperactive/impulsive and a combined type.

Anyone can have moments of being inattentive, impulsive or hyperactive, but only a doctor or other professional provider can accurately diagnose ADHD. It’s important to rule out other conditions that can mask as ADHD, such as anxiety, depression, behavioral problems, trauma, developmental delays or learning disabilities. It could be a lot of things other than ADHD.

I recommend two good rating scales for determining a need to assess for ADHD:

Vanderbilt ADHD

This is a psychological assessment tool for use with children ages 6 to 12. Although it is not intended for diagnosis, it is widely used to provide information about symptoms and measure the severity of ADHD. The tool takes approximately 10 minutes to complete, and there are two forms. The parent form has 55 items and the teacher form has 32 items:

SNAP-IV R

This tool is available at adhd.net and is used with children and adolescents ages 6 to 18. It contains 90 items and takes about 10 minutes:

Remember, these screeners are not definitive tests, so you should always talk to your child’s physician or consult a child psychologist about a professional assessment if a screener indicates possible concerns.

Go with your gut

My overall advice for parents who are concerned about possible signs of autism and ADHD is to trust their instincts.

Go with your feelings about your child. You know them better than anyone else. If you feel that something isn’t right, please talk to someone who can take a careful, closer look and make helpful recommendations.

More stories

Posted In Behavioral Health, Children's, Health Information, Inclusion at Sanford