Autism Integrative Care
Keystone offers autism integrative care as a part of its Department of Mental Health.
What Health Care Professionals Are Qualified to Diagnose Autism?
Primary care physicians and pediatricians refer a child and family to a specialist for further assessment and diagnosis. Specialists who can do this type of evaluation include:
Developmental Pediatricians (board certified doctors that have subspecialty training in developmental-behavioral pediatrics)
Child Neurologists (doctors who work on the brain, spine and nerves)
Child Psychologists or Psychiatrists (doctors who focus on the domains of development, emotion, cognition, education and family)
Our providers have extensive expertise with autism and other medical and behavioral conditions. We aim to carefully distinguish autism from other disorders and to support each family in getting the needed services and treatment.
During a team evaluation your child will be assessed by health care professionals from different specialties in Keystone Behavioral Pediatrics. The team includes a speech-language pathologist, occupational therapist and psychologist.
Team evaluations are especially helpful for families with young children and for families who may not be able to access these other services separately. They are also beneficial for clinically complex cases.
Team evaluations are scheduled in the morning and last four to five hours.
The specific components of the team evaluation will depend on your child’s individual areas of concerns, as well as whether your child has had recent evaluations in these areas.
Each child’s team evaluation will include:
- Medical, educational, and social history
- Direct observation by our team and interaction with parent and child
- General behavioral assessment tool
- Autism-specific assessment tool
- Assessment of child’s speech and language skills
- Assessment of child’s sensory-related difficulties, fine motor skills and self-help skills
Autism-Specific Assessment Tools
During the autism evaluation, we will use at least one of the following autism-specific assessments tools:
- Modified Checklist for Autism in Toddlers (M-CHAT)
- Childhood Autism Rating Scale, Second Edition (CARS2)
- Social Communication Questionnaire (SCQ)
- Autism Diagnostic Interview – Revised (ADI-R)
- Autism Spectrum Rating Scale (ASRS)
- Social Responsiveness Scale, Second Edition (SRS-2)
- Autism Diagnostic Observation Schedule – Second Edition (ADOS 2)
General Behavioral Assessment Tools
We will also use one of the following behavioral assessment tools:
- Child Behavior Checklist (CBCL)
- Behavioral Assessment System for Children, Second Edition (BASC-2)
- Conners Comprehensive Behavior Rating Scales (CBRS)
- Conners Early Childhood Global Index (CECGI)
Speech and Language Assessment Tools
A standardized speech and language assessment will be completed to assess your child’s level of functioning in the areas of receptive, expressive and pragmatic language skills. If warranted, your child will also receive a test of articulation and an oral motor assessment to determine the structure and function of speech mechanism as well as an assessment of feeding skills.
At least one of the following tools will be used during evaluation:
- The Clinical Evaluation of Language Fundamentals-4 (CELF-4)
- Preschool Language Scales-5 (PLS-5)
- Goldman-Fristoe Test of Articulation-2 (GFTA-2)
- Beckman Oral Motor Assessment
Occupational Therapy Assessment Tools
During the occupational therapy evaluation, your child will be assessed by an occupational therapist who specializes in pediatrics and early intervention. Standardized assessments will be used to assess:
- Self-care abilities
- Fine motor skills
- Motor coordination skills
- Visual perception skills
- Body mechanics and postural control
- Functional grasp development skills
Two or more of the following standardized assessment tools will be used depending on your child’s level of function:
- Peabody Developmental Motor Scale 2nd edition (PDMS-2)
- The Beery-Buktenica Developmental Test of Visual-Motor Integration (6th edition, Beery VMI)
- Pediatric Evaluation of Disability Index (PEDI)
- Bruininks-Oseretsky Test of Motor Proficiency 2nd edition (BOT-2)
- A comprehensive 235 itemized physical behavior questionnaire to assess sensory integration/processing difficulties
Autism Evaluation Results
After we have reviewed your child’s developmental history and test results, you, as the parent/caregiver, will meet with the interdisciplinary team to review the results and ask any questions. This is a separate visit and is typically scheduled three weeks after a child’s team evaluation.
For a child diagnosed with autism, we provide education and resources to help parents learn about autism and ensure that the family is on the right path to helping the child reach full potential. Parents then meet with one of our knowledgeable client care coordinators to schedule recommended treatment at Keystone or provide referrals to alternative community agencies.