Asperger’s testing for children now falls under the realm of autism spectrum disorder testing, a multidisciplinary process including a variety of physical and cognitive assessments.
As a caregiver, it can be challenging to know what’s a part of typical childhood and what might indicate a child needs additional support.
Autism spectrum disorder (ASD) testing, which includes testing for symptoms that were once referred to as Asperger’s, can be a part of identifying neurodevelopmental conditions that affect areas of communication, socialization, and behavior in children.
Asperger’s syndrome is no longer a formal diagnosis, though it remains a popular term. It was the name given to a specific set of neurodevelopmental symptoms first described by Hans Asperger in 1944.
Currently, if you would have qualified for an Asperger’s diagnosis, you now meet the criteria for “ASD level 1 without language or intellectual impairment.”
At level 1, ASD symptoms are mild, but doctors can still evaluate them using a variety of tests.
Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R)
The M-CHAT-R is a screening questionnaire for children between the ages of 16 and 30 months. The questionnaire requires parents to answer 20 questions about their child’s behaviors. The results can determine whether further assessment is required for the child.
Social Communication Questionnaire (SCQ)
The SCQ is a 40-question questionnaire for parents to complete. The SCQ is designed for children 4 years and older. The questionnaire takes approximately 10 minutes to complete.
Screening Tool for Autism in Toddlers and Young Children (STAT)
STAT is a diagnostic tool that requires a trained clinician to observe and interact with children ages 24 to 35 months to evaluate the child for ASD symptoms. The observation consists of 12 activities. It generally takes around 20 minutes to complete.
Autism Diagnostic Observation Schedule (ADOS-2)
The ADOS-2
To conduct ADOS-2, a professional observes your child in preplanned scenarios designed to generate responses relevant to an ASD diagnosis, like exhibiting empathy or reciprocal play.
The Autism Spectrum Quotient (AQ)
The AQ is a self-administered questionnaire across five areas of assessment:
- social skills
- communication skills
- attention switching
- imagination
- attention to detail
Each section has 10 statements. Children are asked to rate how strongly they agree or disagree with each. Each question is then scored a “1” or a “0” based on the response. A score of 26 or greater indicates the possibility of ASD.
The Childhood Autism Rating Scale (CARS)
CARS is an observational evaluation tool that allows a clinician to score children 1 through 4 on 15 areas of assessment.
“The CARS consists of 15 items that measure the child’s behavior, communication, and social interaction,” explains Amira Martin, a licensed clinical social worker and adjunct professor at Colombia University. “The higher the score, the more severe the autism symptoms.”
She adds that CARS is typically administered by a trained clinician and takes about 30 to 60 minutes to complete.
The Social Responsiveness Scale (SRS)
A 65-item questionnaire, the SRS specifically measures social challenges related to ASD. It scores in areas of:
- social awareness
- social cognition
- social communication
- social motivation
- autistic mannerisms
“The SRS is widely used in research and clinical settings, and it has been found to be a reliable and valid measure of social impairments related to autism spectrum disorders,” says Martin.
A caregiver can administer it. SRS takes approximately 20 minutes.
Other ASD evaluations
There’s an abundance of ASD testing tools available for caregivers and professionals — each developed to improve accuracy for identifying symptoms occurring on a spectrum.
Other examples of tests include:
- The Infant/Toddler Checklist
- Parents’ Evaluation of Developmental Status (PEDS)
- Gilliam Autism Rating Scale (GARS)
There’s no singular test that can diagnose ASD.
Martin indicates the complexity of ASD means the diagnostic process often involves a team of medical professionals, not just a questionnaire.
“For example, a pediatrician can assess the individual’s overall health and development, while a psychologist can evaluate their cognitive and behavioral functioning,” she says. “A speech therapist can assess the individual’s communication skills and identify any language delays or deficits.”
Ruling out underlying medical conditions first may require a different set of tests, such as:
- blood work
- neuroimaging
- genetic testing
- electroencephalogram (EEG)
If no other conditions are present, and your team of specialists agrees on existing challenges related to development, communication, and social skills, a diagnosis of ASD can be made following criteria in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, text revision (DSM-5-TR).
What’s the DSM?
The DSM is a clinical manual that provides diagnostic criteria for mental health conditions.
It’s the product of input from more than 200 experts around the world who came together in review groups to achieve a research-based consensus on diagnostic criteria.
The symptoms of ASD have a wide variety of presentations, but autistic children tend to show differing abilities in areas related to:
- social communication/interaction
- restrictive or repetitive behavior
Based on these broad categories, autism symptoms can include:
- appearing distracted
- avoiding eye contact
- challenges holding a conversation
- hyperfocus on topics of interest
- trouble understanding others’ points of view
- difficulty sharing in imaginative play
- trouble making and keeping friends
- displaying expressions and mannerisms that don’t fit what’s being said
- repeating or restrictive behaviors
- becoming upset by change
- experiencing sensory sensitivities
- single word or phrase speech
- intellectual deficits
Asperger’s, or level 1 ASD, can include any of the symptoms associated with autism.
What set Asperger’s apart from ASD originally, in addition to milder symptoms overall, was that no language delays or cognitive deficits were present.
At what age do autism symptoms generally appear in children?
The symptoms of ASD are usually noticed
Asperger’s syndrome was removed as a separate diagnosis in 2013 with the publication of the DSM-5.
The main reason for this was that Asperger’s couldn’t be reliably differentiated from autism through a lack of language delay and cognitive deficits. These symptoms weren’t unique to Asperger’s and could be seen across the entire spectrum of autism.
There’s no telltale sign that your child should be evaluated for autism. Martin recommends considering evaluation if you notice:
- delayed speech and language skills
- sensory processing issues
- lack of interest in socializing
- unusual play
- repetitive behaviors or interests
- frustration with change
“If a parent sees any of these signs, they should definitely speak with their child’s pediatrician,” Martin says.
Asperger’s testing in children is now a part of the broader evaluation of ASD. In 2013, Asperger’s was officially renamed to “ASD level 1 without language or intellectual impairment.”
While many ASD evaluations exist that can aid in an overall diagnosis, there’s no singular one that definitively identifies ASD.