Make a diagnosis? That doesn’t just happen! Not only must the presence of the criteria for autism spectrum disorders be examined and it must be determined which autism spectrum disorder exactly exists, a differential diagnosis must also be made. Now what is a differential diagnosis? And which disorders can you think of when making the differential diagnosis of autism and how does a disorder in the autism spectrum distinguish itself from them?
What is a differential diagnosis and why is it made?
When it is assumed that a person has autism, a specialized care provider, usually a psychiatrist, must determine which specific form of autism or which pervasive developmental disorder it is. To ensure that the correct diagnosis has been made, a differential diagnosis must also be made. There are several disorders that resemble forms of autism in terms of characteristics. However, the treatment methods for these other disorders are essentially different. In order to provide adequate treatment or guidance, it is therefore very important to make the correct diagnosis. Excluding disorders whose characteristics resemble the characteristics of autism is called differential diagnosis. In the chapter below you will find some disorders that should be ruled out if a form of autism is suspected.
Differential diagnosis in autism
Attachment disorders
The behavior of people with an attachment disorder or autism may resemble each other in certain respects. Both will often behave differently towards the people around them than ‘normal’ people. They will show little affection and attention. In contrast to autism, attachment disorders are often preceded by a history of affective pedagogical neglect and/or many changes in caregiver(s). Children are normally empathetic by nature. However, this development of empathy only comes about in a warm and safe interaction with other people. Children with a form of autism are not inherently empathetic. A warm and safe interaction with other people does not change this. Furthermore, in addition to the educational history, we can also use need for structure and language problems as distinguishing features of autism compared to attachment disorders.
Language disorders
Children or people with a form of autism often have problems with communication and language. We can separate autism from language disorders. People with a language disorder do use non-verbal communication. Children or people with a form of autism do not or hardly do this. If they do seek verbal contact, they often do so for practical reasons.
Deafness
Children with a form of autism often do not respond to sounds or when someone calls them. As a result, parents often think of deafness. A doctor can confirm or rule out this suspicion with a hearing test. In addition, here too, deaf children use non-verbal communication and children with a form of autism make little or no use of it. Here too, when they do use non-verbal communication in exceptional cases, they will often do so for practical reasons.
Mental disorder
Intellectual disability can and often does occur together with a form of autism. It is very difficult to distinguish between a person with an intellectual disability and autism and a person with an intellectual disability without autism. There are a number of characteristics with which a distinction can be made. In a child with an intellectual disability, language development will lag behind. However, if there is only an intellectual disability and not autism, the child will use non-verbal communication. If autism is also present, the child will make little or no use of non-verbal communication. In addition, there is also a difference in the need for structure and predictability. A child with an intellectual disability will often enjoy a birthday or holiday, because he/she is sensitive to socializing. A child with an intellectual disability and a form of autism can become confused or anxious due to these types of changes in his or her predictable structure. After all, he loses the overview by breaking the predictable structure.
Schizophrenia and personality disorders
Officially, classical autism is seen as a more serious disorder than autism-related disorders. However, children with autism-related disorders show many similarities with children who develop schizophrenia or personality disorders later in life. This distinction cannot be made at a young age, because the characteristics are too similar. A definitive diagnosis can then only be made at a later age.