Diagnosing autism is done by observing how your child reacts and behaves in given situations. There's no blood test or MRI or tissue sample that can show your child has autism. Braden's diagnosis paperwork is about 10 pages of evaluations and testing results plus background information and current specifics obtained from us, his parents, through interviews and questionnaires. Two doctors were present for my son's appointment. One was a psychologist and the other a doctor of medicine, or MD. This appointment lasted about 4 hours. Here's the criteria for diagnosing autism used by mental health professionals in the United States.
Hearing that your perfect little child has autism is not easy. It hurts. There's no way around that pain. The internet is peppered with all kinds of treatments and therapies designed to help your child and maybe, if you're lucky, make all the symptoms go away. But, when looking for answers, how often does anyone just hand it all over to the Lord and pray?
"I have heard your prayer and seen your tears; I will heal you."
2 Kings 20:5
• Bayley Scales of Infant Development - Second Edition (Bayley - II)
• Vineland Adaptive Behavior Scales, based on interview with parents
• Autism Diagnostic Observation Schedule (ADOS)
• Childhood Autism Rating Scale (CARS)
• M-CHAT, brief questionnaire completed by parents
• Child Behavior Checklist for ages 1-1/2 - 5 (CBCL), completed by parents
¹Summation of Test Findings
The Bayley Scales of Infant Development - Second Edition is a measure of cognitive skills in young children. Skills are measured in the areas of expressive and receptive language, visual-motors skills, and problem solving. Braden's score indicates that he is showing very significant developmental delays with his overall functioning at the 14 month level with a chronological age of 25 months. In the area of expressive language, he was not heard to say any words but he did vocalize at least four different vowel-consonant combinations, which is at the 8-month level.
Braden's adaptive behavioral functioning was measured using the Vineland based on his parents' report. He showed significant delays in all areas, with his skills ranging from the 1 year to 1-1/2 year levels.
Braden's socialization skills are the most delayed, at the 1-year level. He reaches for familiar people, laughs and smiles appropriately in response to positive statements, and participates in simple games and activities with others. He shows an interest in the activities of others, but he shows no interest in other children.
[Braden] was given the ADOS, which is a structured play session in which he is given a variety of different play activities that are designed to elicit maximum interest to evaluate his social relatedness, communication, and pattern of play. Behaviors that are associated with a diagnosis of autism are evaluated in an objective manner with this measure. On this measure and on the others, Braden did show a significant number of behaviors that are associated with a diagnosis of autism. In the area of communication, he demonstrated a number of unusual or abnormal patterns. His delays in language, along with the repetitive vocalizations that he does make, are often associated with autism. He does not use very effective means of nonverbal communications such as pointing or gesturing. He also rarely directs his vocalizations to others as a means of communicating his wants, needs, or interests. He does not play with toys in a functional or creative manner, but often engages in repetitive, stereotyped behavior such as spinning wheels and other objects while he stares at it intensely and vocalizes. He also engages in some repetitive motor mannerisms such as turning around in circles and occasional hand flapping.
The CARS is another method of rating autistic behavior in a variety of different categories that are associated with the diagnosis. Braden's score on this measure indicates a mild to moderate degree of autism.
¹ Directly from Braden's Psychological Evaluation
Braden's Autism Diagnosis
My wife and I have one child named Braden (pronounced "Brad in" as opposed to "Brad out"). He received the medical diagnosis of autism shortly after his second birthday at the Oakland Children's Hospital. But his grandma had him diagnosed a few months earlier. The pediatrician kept telling us not to worry. Boys develop slow sometimes he would say. But my Mom, Braden's grandma, knew better. Braden's doctor would later tell us that he never had a patient with autism. I suppose that's why he didn't recognize the symptoms.
Grandma never really had to come out and tell us she suspected Braden had autism. I can't imagine how hard that would have been. She says it was hard enough to face us when we questioned her about it. We uncovered her thoughts of autism in a rather "happenstance" way. My wife was browsing the web on Grandma's computer when she noticed she had been to more than one autism website. My wife called me into the room and we looked at one of the sites, read the list of symptoms, and saw that our son was a spitting image. The list read like a description of him, even the spinning of objects that pointed to Sensory Integration Dysfunction, a term we weren't yet familiar with.
A couple painful months of waiting went by in between the time we made the appointment and the time Braden was seen for his evaluation. Our only day at the Children's Hospital and Research Center at Oakland, otherwise known as the Oakland Children's Hospital, was June 17, 2004. Each of the two doctors took their turns testing our son in the different areas. One doctor evaluated his speech. He had no words at age 2. None. He was a silent child except when he cried or made sounds while stimming.
Most of this diagnosis appointment was like play time to Braden. All his testing was structured like that. Halfway through the appointment he was tired and he took a little nap laying across my legs.
Sometime around the 3 1/2 hour mark they gave us the news. News that Grandma already knew, but news that crushed us all none-the-less. Our only child has autism. The remaining half hour was filled with us, his parents and grandma, asking questions. Many of the questions could not be answered. Nobody knew how Braden would respond to treatment. There were a lot of question marks on his future. As we look back, in retrospect, it would have been so nice to have parents of other kids with autism to talk to.
We know now that when you have a child with autism you become an expert on autism, especially as it pertains to your child. It's the same way with anything. If my son had Fragile X I'd become an expert on Fragile X Syndrome.
The only other thing I remember about June 17, 2004 is that we got back home around 11am and I immediately began searching for a bar. In Benicia, California no bars were open. I was out of luck.
The following days were difficult emotionally. To this day it can still be like a roller coaster. But my wife and I began doing everything we could to help our son. We educated ourselves and we're striving to educate others. My career path took a radical change. Indeed, we as people are radically changed.
God continues to heal us and Braden every day. Praise His holy name!