Autism Myth #3: My Doctor or School Ruled Out Autism

by | Apr 9, 2020

Reading Time: 4 minutes

Autism Myth #3: My doctor or my school ruled out autism

Dear Community,  April is the month to honor people with autism and bring awareness to the challenges many families face.  This is our series on autism myths. Below is myth #3. Please read and share.  My doctor ruled out autism.  Yep, I said it! Most doctors do not diagnose nor can they rule out autism.  What’s that now?  Although there are certainly some pediatricians and general practice doctors that diagnose autism, this is not the norm. Further, any doctor that truly can rule autism in or out, would do testing. Some developmental and behavioral pediatricians, psychiatrists, and pediatricians diagnose autism. In that case, they run autism specific tests, that may include some social skills testing, rating scales, or collaboration with other professionals.  If your doctor is testing your child for autism, you would know.  Again, if your child is being evaluated for autism, your doctor would tell you that and you would likely have to come in for a separate visit. This testing usually takes several hours, and there are specific tests doctors would use, such as the STAT, ADOS, GARS, CARS, and Vineland*. Note: the Vineland is not a diagnostic test for autism but is a developmental assessment commonly used during an autism evaluation.  Alongside this myth is the idea that the speech therapist, occupational therapist, or school psychologist, ruled autism out. Again, these professionals do NOT diagnose autism independently. Specialists of this nature are often on diagnostic teams but do not independently diagnose OR rule out autism.  Alongside this myth is the idea that, “my school ruled out autism.” Schools DO NOT diagnose or rule out autism. Schools will assess autism for the purpose of special education identification. That is, if schools are concerned that a child may have a qualifying disability, such as autism, they conduct evaluations to determine whether or not that child qualifies for services under that educational category. Schools can not and do not diagnose autism or rule it out. Why do doctors not diagnose autism though? Many parents feel frustrated to hear this news. They feel that their pediatricians know their children best and are able to answer so many other questions, why not this? There are a lot of reasons for this but a couple are most common: 
  1. Autism is a complex diagnosis and most pediatricians and general practice doctors do not have specific training in autism or developmental disabilities. 
  2. Doctors are charged with running through a long list of questions and assessments during well-checks and there simply isn’t time to do autism tests which often take several hours.
There are a couple things that irk me about this myth.  1. We hear it all the time. Dr. Kroncke and I have heard comments like this almost daily. “My doctor told me we should just ‘wait and see’.” “My doctor said he doesn’t have autism because he has great motor skills” “My doctor said he doesn’t have autism because his language is so advanced” “My doctor said she doesn’t have autism because she has such a huge vocabulary.”  Kids with autism can have all of those skills! To be fair, it’s possible that there was some miscommunication. Maybe the doctors told these families, “I am not concerned about autism right now” or something of that nature. Sometimes people do hear what they want to hear. However, in the case that doctors are ruling out autism without any testing, I find that troubling. Why? See the next point below.  2. Wasted time. When parents are told that their kids do not have autism, precious time slips away. Young children who are identified early can make substantial gains due to the brain plasticity and the ability to intervene in the developmental trajectory. The gist is, if we can help them early, we can help them so much more.  Okay, but if the doctor doesn’t do it, who does? The best place to assess for autism is a hospital or diagnostic clinic with a licensed psychologist or medical doctor who clearly tests for autism. Many private clinics focus on autism assessment. Those practices will have tests like the ADOS that they use to diagnose or rule out autism. To get a valid test for autism, you need a licensed diagnostic clinician with expertise in that area.  But what now in the age of Coronavirus? Unfortunately, a lot of hospitals are postponing autism evaluations. Many local clinics are starting to make the shift to telemedicine and are still conducting evaluations. If you need a list of options (including us and many others), we are happy to provide that. Some worry that by asking the question, they will essentially ‘make it true.’ That is, they think that if the psychologist is looking for autism, it will be found, whether it’s there or not. I cannot speak for every clinic and hospital, but I can tell you from my own experience, nothing could be further from the truth. I have personally seen many families come in with autism concerns and go home with a totally different diagnosis, or a clean bill of health. And although diagnosis can be stressful for parents, they virtually always say they feel relieved. They feel that they understand their children better, know what services they could benefit from, and can see the path forward. So, families, please do not be afraid. If there are concerns, pursue a diagnostic evaluation, and do not delay.   Thank you for reading.  Onwards and upwards! Dr. Willard

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