There is no medical test for diagnosing ASD. An accurate diagnosis is based on behavioral assessments. This involves an observation of the individual’s developmental levels. ASD may only be diagnosed by physicians, psychologists, and/or psychological associates who are following the guidelines set forth by the Diagnostic and Statistical Manual (DSM-V).

The information gathered during the behavioral assessment involves observations covering:

• Social Skills
• Communication Skills
• Verbal and Nonverbal cognition skills
• Fine and Gross motor skills
• Self-care skills
• Early academic skills

Each individual is different. Some may show delays in social, learning or language skills, but they will have motor skills like those of other children their age. Puzzles and computer brainteasers might be simple but forming friendships and having lengthy conversations might be hard. Some individuals with ASD may be proficient completing a complex task (i.e., math equations) but still require assistance with simple ones (i.e., using a spoon). 

The cause of ASD is still unknown. However, researchers believe that there is genetic and environmental component that may be playing a role in causing ASD. Researchers have found differences in the development of several regions in the brain of individuals with ASD suggesting that the structure of the brain can be disrupting normal brain development and therefore causing some of the characteristics of ASD. In addition, the theory that parental practices and childhood vaccinations are responsible for ASD has been disproved by several peer-reviewed research studies.

There is no cure for ASD. The goal of treatment such as ABA Therapy is to individualize the treatment to help reduce ASD symptoms and support them in developing and learning in their own unique way.

Applied Behavior Analysis (ABA) therapy is evidence-based approach that has been proven to be the most effective way for teaching skills deficits and changing maladaptive/inappropriate behaviors to functionally appropriate behaviors for individuals with ASD. Our therapeutic approach is based on Skinner’s Verbal Behavior, and we offer one-on-one sessions during which we focus on improving individual specific behaviors, such as social skills, communication, academic as well as daily living skills such as fine motor dexterity, hygiene, grooming, domestic capabilities, punctuality, and job competence.

There are several benefits of ABA Therapy. It usually targets behavior modification. One of the objectives is to show improvement in someone’s functional skills and a decrease in undesired behaviors. This therapy reaches children of all ages, and all unique backgrounds.

ABA Therapy is beneficial to:

• Increase communication skills.
• Increase social skills.
• Improve attention, focus, memory and academics skills.
• Decrease inappropriate behaviors (i.e., screaming, biting).

Teach adaptive daily living skills (i.e., tooth brushing, washing hands) to increase independence.

Each individual with ASD is unique and therefore some services needed for one child may not be required for another. However, some individuals require a multi-disciplinary approach to their child’s treatment. Other services that may be beneficial for your child could include Occupational Therapy, Speech Language Therapy and/or Physical Therapy.

It is advised to get an evaluation at the earliest if you are concerned about your child’s development. Research shows that the sooner a child gets therapy the better it is for their learning trajectory. However, no matter how old your child is, if you have some doubts about their development you should speak to your pediatrician and/or family doctor. Your pediatrician would be an expert in neuro-typical developmental and can guide you to the next step.

The Verbal Behavior Milestones Assessment and Placement Program (VB-MAPP) (Sundberg, 2008).  This assessment program is based on Applied Behavior Analysis with a focus on Skinner’s (1957) and analysis of verbal behavior.  The VB-MAPP can help identify a student’s strengths and weaknesses across a variety of critical skills.  The assessment also makes it easy to compare and contrast the child’s skills with those of typically developing children. 

The VB-MAPP breaks languages and related skills down into 16 different skill areas (or domains), including: 

• Manding (asking to receive reinforcers, or to remove undesirable items or events).
• Tacting (naming things and actions in the physical environment).
• Listener skills (receptive language).
• Visual perceptual skills and matching to sample.
• Motor imitation (copying the actions of others).
• Echoic (repeating the phonemes, words, and phrases of others).
• Play skills.
• Social skills.
• Vocal output.
• Group learning skills.
• Reading skills.
• Learning barriers (e.g., behavior problems, compliance, prompt dependency).

As always, remember that every child is different. That is why it is impossible to make a blanket statement about what specific goals you should have for your child. Here is a better question: “What goal should I have for myself?” Why? Because if you start with this question, you are in total control of the outcome. And if you create great goals for yourself, you can do whatever it takes to help your child be the best they can be. When it comes to goals for your child, an expert in the field can help guide you what goals they should work on first before moving on to the next goal. Goal setting should be done with the clinicians and the parents to ensure everyone agrees and are on the same page.

• The Doris Duan-Young Autism Center offers a one-stop solution for comprehensive autism care, bringing together clinical, therapeutic, and social disciplines. Our protocols and programs are innovative, and evidence based, backed by industry credentials, accreditations, and certifications.
• We offer one-on-one customized behavior program so your child can overcome some of the most difficult maladaptive behaviors.
• Our staff are highly qualified and come from diverse backgrounds so you can be assured your child is getting the best therapy possible.
• You receive constant feedback and monitoring of your child’s progress towards specific behavior goals so you can be sure your child is always moving in the right direction,
• We offer support training for you so that you can continue to help your child make progress -everyday, even when you are away from the center.

Evidence shows the earlier the intervention the more effective it will be. Every child with ASD is different and the sooner we help the child gain skills the easier it will be to decrease and/or avoid maladaptive skills. For example, if a child has been using tantrums for several years to get what he/she wants, it may be harder to break this kind of behavior pattern.

The Doris Duan-Young Autism Center helps children replace maladaptive behaviors with appropriate ones. The reason early intervention is so important is because the longer a child exhibits a maladaptive behavior, the more conditioned that behavior becomes. It will typically take longer for the child to unlearn that behavior before he begins learning the new behavior.

Each child experiences different challenges, however common one relate to:

• Communication.
• Difficulty with language skills or speech.
• Difficulty with comprehension of language (receptive language).
• Difficulty with verbal (words) and nonverbal (gestures, body language) communication.
• Difficulty with social use of language (e.g., greeting, informing, and requesting).
• Uneven language development.
• For example, many children with ASD have excellent memory (visually/auditory). Some may be able to read words before age five, but not be able to comprehend what they have read or respond to the language of others.
• Social skills.
• Difficulty interacting with other people and prefers to be alone.
• Restricted, limited, or unusual use of eye contact.
• Difficulty paying attention.
• Turn-taking skills are challenging.
• Difficulty with pretend play.
• Lack of awareness of nonverbal social cues.
• Socially inappropriate behavior (e.g., may lack awareness of personal space and come too close to others).
• Difficulty with empathy.
• Repetitive and restrictive behaviors.
• Some children may have more repetitive sensory or motor focus while others may have restricted interest in special topics.
• Behavioral characteristics do change over time (with some behaviors disappearing and reappear or get replaced by other behaviors).
• Children may be excessively active and have difficulty with attention.
• A lack of danger awareness.
• Specific fears that affect their quality of life (e.g., fear of bathing, fear of haircuts.)

A Board Certified Behavior Analyst (BCBA) is a professional who holds a graduate-level certification in behavior analysis. An individual certified at the BCBA level is an independent practitioner who provides behavior-analytical services. This practitioner holds the authority to supervise the work of Board Certified Assistant Behavior Analysts (BCaBAs), Registered Behavior Technicians (RBTs), and others who implement behavioral-analytical services. In order to qualify for the BCBA credential, one must hold a minimum of a Master’s Degree and pass the board certification exam and abide by the Professional and Ethical Compliance Code for Behavioral Analysts.

A Board Certified Assistant Behavior Analyst is an undergraduate-level certification in behavioral analysis. A professional holding this certificate at the BCaBA level may not practice independently and must be supervised by an individual certified at the BCBA/ BCBA-D level. Additionally, a BCaBA can independently supervise the work of a Registered Behavioral Technician and others who implement behavior-analytical services. To qualify for the BCaBA credential one must hold a minimum of a Bachelor’s degree from an accredited (BACB) University, completed verified coursework, a defined period of supervised practical experience (to apply for exam), have a coursework in ethics and professional conduct to apply for the credential,and pass the BCaBA exam to become certified.

A Registered Behavioral Technician is a professional who practices under the close supervision of a BCBA or a BCaBA. The RBT is responsible for directly implementing behavior-analytical services. To qualify for the RBT credential, one must hold a Bachelor’s Degree in Psychology/ Special Education or any related field, completed 40-hours of RBT Training and pass the RBT competency assessment and exam.

In 2020, the Centers for Disease Control and Prevention (CDC) reported approximately 1 in 54 children in the U.S. is diagnosed with an ASD, according to 2016 data.

• 1 in 34 boys identified with ASD
• 1 in 144 girls identified with ASD

If you are working with a behavior analyst, the best way to help is to be fully involved and participate in the therapy.  Research shows the more involved parents, caregivers and other members of the child’s life are the more likely the child will generalize their skills across different settings and with different people.

Stop feeling guilty. Guilt is one of the most destructive human emotions imaginable. First, let’s step into a ‘common sense’ corner. We have no idea what causes ASD. Institutions with virtually unlimited time and budgets have been researching the causes of ASD for years and still nobody has come up with an answer to a single cause. So to even consider whether or not you caused your child’s ASD is pointless! What is helpful is to figure out what to do next.