Should I get my child assessed for Autism?
Autism (Autism Spectrum Disorder, or ASD) is a neurodevelopmental difference in one's way of being and experiencing the world. It typically results in difficulties in socially normed interactions and relationships as well as repetitive behaviors, fixated interests, or challenges with flexibility along with differences in sensory processing. To receive a diagnosis, these difficulties need to be significant enough to cause "clinically significant impairment" in function (**though "many autistic advocates embrace the social model of disability and view a range of neurological differences as being part of a natural human variation (neurodiversity)"(1), meaning that the "disorder"/ impairment is related more to how our society is arranged around how only a subset of people function and not something "disordered" in an individual). You can see the DSM5 diagnostic criteria for ASD here or find some online screening tools for ASD at different ages here.
What are some less obvious signs of Autism?
Autism is complex and multidimensional spectrum. No child with Autism is the same as another, and strengths, differences and challenges present differently between children, and within the same child in different environments (1). Because of this, it at times can be difficult to recognize. If your child is struggling socially and in other ways, some less obvious signs of Autism they might exhibit are:
Obsessive interests in specific activities or topics.
Difficulties connecting with or conversing with others outside of their own interests.
Significant difficulties with transitions and/or change.
Difficulties understanding social cues and interactions, such as knowing how to join in play with others or understanding when other children want to play or not.
A preference for isolation or social anxiety.
Difficulties making or keeping friends.
Difficulties understanding or acknowledging the thoughts and feelings of others, such as not realizing that others might not be interested in what they want to talk about, difficulties acknowledging or responding appropriately when they hurt others, or impulsively saying or doing things without understanding the social implications of their actions.
A need for control and avoidance of activities that are not their own idea (PDA is a profile of Autism, you can read about it here).
Difficulties with knowing where their body is in space or understanding personal boundaries.
Sensitivities to sensory input, such as the feel of certain clothing, picky eating, or sensitivity towards sounds.
Explosive emotions and behaviors.
Excessive seeking of movement.
Missing verbal or physical cues.
My child shows signs of having Autism, but I'm worried about having them "labelled"
There are children who quite obviously need a lot of support to learn developmental and motor skills, social communication skills, and/ or have behaviors that are too difficult for families to manage on their own. I don’t think many of those parents would question whether they should get diagnosis for their child to provide some answers and provide them with much needed financial and professional support for their child to thrive. But there are a lot of other children who may have less obvious challenges and their parents may struggle with whether or not to seek a diagnosis for their child, fearing what that "label" might mean.
Here are some things to consider when debating whether or not to get your child assessed for Autism:
Being Autistic or neurodivergent is much more recognized and accepted, if not praised, today through social media, in the school systems and among kids and in peer groups. There is much more acknowledgement that there are different learning styles and that people experience the world differently. There is much less stigma attached to a diagnosis and many people even wear one with pride (as they should!).
It is likely your child will get labelled by their peers and teachers, regardless of diagnosis, especially if their way of being is outside of what is seen as typical. It might be better for your child to be labelled as "Autistic" than to be labelled as "bad", "weird", "difficult", or "lazy".
Being diagnosed will allow your child to be provided with extra support to learn skills they might be lagging in and to buy equipment to boost their learning and help with self regulation, if you can't afford those things yourself. Children under 6 years old in BC receive $22,000 per year in Autism funding, and children over 6 years old receive $6000 and an additional $18000-$22000 (I couldn't find the exact numbers and it may vary by district) will be given their school to provide them with extra in class support or equipment. Up to 20% of a child's home funding can be used for equipment for things such as ipads, learning tools, sensory equipment, or social-emotional books and support, and the rest can be used for Occupational Therapy, Speech Language Pathology, Behavior Consultation and Intervention, or Physiotherapy. The earlier the intervention, the better, as your child can learn new skills best when they are young.
A diagnosis can help make sense of your child, though really, the support you give them or they receive should be based on their presenting needs and unique strengths and challenges, regardless of what their diagnosis is. Every Autistic child is different (as is every child), and so care should be taken to figure out who they are exactly, how they see and experience the world, and how they might learn best. That said though, there are traits common throughout the Autism spectrum, and there are also co-occurring conditions that are shown to be significantly more prevalent in those on the spectrum than in the general population. These include autoimmune conditions, seizure disorders, allergies and food sensitivities, gastro-intestinal problems, sleep disorders, and ADHD.
It's up to you whether you tell anyone about your child's diagnosis, should they receive one. You don't have to tell their school (though it might be helpful, in order to allow them to receive extra support), and if you do tell their school, you can have their diagnosis removed from their file in the future if they no longer require support. You also don't need to tell your child about their diagnosis until you feel they are ready.
What does an Autism assessment involve?
In BC, you can get a referral from your Pediatrician for the British Columbia Autism Assessment Network (BCAAN (Sunny Hill)) in order to have a publicly funded assessment, or you can self refer for a private assessment. In order to qualify for a diagnosis, an assessment must involve an IQ/developmental test completed by a psychologist, an assessment from a Speech Language Pathologist, a medical evaluation from a Pediatrician, and a clinical diagnostic assessment (CDA) completed by a Pediatrician, Psychiatrist or Psychologist trained in administrating it. Families may opt for a private assessment as public assessment wait times are currently around a year and a half. Private assessments cost between $2500-$3500 though may be covered by some extended health plans or you can apply for a grant through Variety Children's Charity if there is availability.
Here are some companies in the Vancouver area that are qualified to provide private Autism assessments. There are probably more which can be found through a google search:
Able Developmental Clinic - West Vancouver, Richmond, and Surrey
Dr. Marjolaine Limbos - Vancouver, Coquitlam, Whistler (Psychological assessment only)
Monarch House - Multiple locations in BC (Psychological and Pediatrician assessment only)
Fraser Developmental Clinic -New Westminster.
Compass Clinic- Vancouver.
Dr. Staci Illsey-Vancouver (Psychology only)
The Asante Centre- Surrey and Maple Ridge (Psychology only)
Southpoint Developmental Clinic -Surrey (Psychology only).
Dr. Kelly Price and Associates -Victoria (Psychology only).
Dr. Alex Kwee -Fort Langley (Psychology only).
Dr. Ryan Chan- Vancouver (Psychology only).
Cognostic- Vancouver (Psychology only)
Akira Child Development Group- Vancouver
Dr. Rae-Seebach- Vancouver (Psychology only)
Dr Rashmeen Nirmal- Vancouver (Psychology only)
Please note with that the companies providing only the Psychological portion of the assessment, you will also need to seek out an assessment from a Speech Language Pathologist and Pediatrician.
You can check out this lengthy document put out by the BC Ministry of Health Planning if you want further details regarding assessment and diagnosis. Or you can check out the Government of BC's website for a quick rundown of the assessment process and next steps.