Today's topic is about “Autism Spectrum Disorder: Evaluation & Diagnosis" written with Clinical Neuropsychologist, Dr. Matt Landstrom. To learn more about Dr. Landstrom and his clinical intersts, click here.

Introduction: What is Autism?  

Autism, or autism spectrum disorder (ASD), refers to a brain-based disorder with a range of conditions characterized by:

• Challenges with social skills and/or communication
• Sensory sensitivity  
• Sensitivity of lights and/or sounds
• Restricted repetitive behaviors, activities, and/or interests
• Behavioral concerns
• Nonverbal communication
• High levels of anxiety
• Easily frustrated
• Comorbidities

Because autism is a spectrum disorder, there is no 'one type' of autism but many sub-types and variations in presentation. Severity and symptoms of autism vary; that's why a professional diagnosis is crucial.

Specialized Team

As a neuropsychologists, our team has extensive training and expertise in evaluating and working with individuals on the autism spectrum across the life-span. Our clinicians have a strong understanding of normal developmental stages in language and learning.This is especially important in assessing autism because symptoms evolve and change over time.

Our team utilizes their expertise in brain-behavior relationships to evaluate cognitive and emotional difficulties, educate patients and their families about what to expect and what treatment options are available that best fit the needs and their desired outcomes.

Evaluation & Diagnosis  

A neuropsychological evaluation is a comprehensive and extensive understanding of cognitive processes and brain functioning by using the unique integration of genetic and developmental history and testing data. A neuropsychological evaluation identifies and clarifies disorders, helps in understanding the etiology of disorders, aids in tracking the evolution and changes over time of  disorders, and provides diagnostic clarity for patients and providers.

When patients are referred for symptoms of autism spectrum disorder (ASD) we use a comprehensive neuropsychological approach. To understand cognitive strengths and weaknesses, neuropsychological testing further evaluates:

• Attention & Concentration
• Verbal & Visual Memory
• Auditory & Visual Processing
• Visual Spatial Functioning
• Language & Reading Skills
• Sensory Development & Sensory Integration
• Gross & Fine Motor Development
• Social Skill Development
• Executive Functioning
• Emotional & Personality Development
• Behavioral Functioning

Clinical professionals, treatment programs, and educational institutions rely on neuropsychological evaluations to aid in treatment planning because recommendations create a specific, individualized, and effective path towards the best possible outcome.

Evaluation Process

Step 1: Intake

The intake focuses on discussing what brought you in, current concerns, and gathering relevant background information, such as mental health, medical events and history, and academic/occupational functioning. Prior to the appointment, any relevant additional records should be faxed over including any previous evaluation reports, school records or reports, accommodations or modifications, and other medical records. Prior to the appointment, we may also ask to consult with the referring provider. Such individuals may include therapist, school psychologist or counselor, case manager, psychiatrist, primary care physician, etc. Note: A consent to release form will need to be completed for each individual. Continually, an additional informant, such as a parent, spouse or significant other will also be asked to complete an additional set of questionnaires. Even for patients over the age of 18, having an additional informant is often crucial to the evaluation and is always beneficial.

Step 2: Testing

Testing appointments are scheduled to begin at 9:00am which decreases influence of factors like fatigue while allowing the opportunity to complete as much of the testing as possible. Testing typically takes 4-5 hours and occasionally two days of testing is needed. Many factors can influence the time required to complete testing. We recommend bringing snacks and/or lunch to the testing appointments for breaks.

• Testing is interactive, you will be engaged with different computer based exercises, block work, etc.

Step 3: Feedback

The feedback appointment allows your doctor to review the tests administered, provide an initial interpretation of testing results, and provide initial recommendations. If additional treatment or services are recommended, when possible/needed, you doctor will provide referrals that best fit your needs.

Step 4: Report

You will receive a written, comprehensive report which includes the background information, testing results, diagnosis, and detailed recommendations. Upon request, the evaluation report can be forwarded to additional parties such as the patient’s therapist, primary care physician or school. Reports vary in time and length to complete due to the individualization and special attention every report is given. If the report is needed on a certain date, please notify the office staff.

Step 5: Follow up

Landstrom Center wants to ensure successful treatment after the evaluation. We typically schedule your follow-up appointment about 4 weeks after you have received your report. During this appointment, your doctor will review progress and current treatments. If needed, recommendations may be adjusted, removed, added, or updated.

Additional Appointments

Still have questions? Or just want to talk with your doctor? No problem! You are welcome to schedule additional appointments as needed! Patients can follow up on regular intervals or on an as needed basis.

Gold Standard Assessment Tools

At Landstrom Center we have a large catalog of tests including the following Gold Standard Assessment tools:

• Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)
• Autism Diagnostic Interview-Revised (ADI-R)

Unique Environment

In our space, we aim to provide an office environment that is not only welcoming but is functional and adaptable to meet the unique needs or demands of each patient. We want to make our patients and their families as comfortable as possible throughout the process.

Our treatment spaces include dimmable, non-florescent lighting and a variety of seating and work surface options. Each room was also designed to provide lots of floor space for kids that prefer to work on the floor. Our team understands that it can be a challenge to sit for long periods of time and are able to utilize the hallways to take a movement breaks in-between tasks.

Conclusion: Clarity is crucial

There is no 'one type' of autism. Many factors influence the development and presentation of autism. As a spectrum disorder, autism has many different sub-types and varies greatly in each individual. Because of this, a professional diagnostic is crucial. Diagnostic clarity and comprehensive findings can help to greatly improve treatment outcomes and improve the quality of life for patients and their families. At Landstrom Center, we focus on the person, not just the diagnosis.