Autism Assessments

What is Autism?

Autism is a type of neurodevelopmental disorder. It is a label given when individuals present with 1) social communication difficulties and 2) restricted, repetitive patterns of behaviours, interests or activities that significantly impact their day-to-day living. Although symptoms show up early on in the developmental period (i.e.,as early as 2 years old), some individuals only experience challenges as they enter school and socialization demands increase.

Common Signs and Symptoms:

Some signs may include:

  • little eye contact
  • very intense interests (e.g., watching the same youtube clip over and over again) or interested in things that are not typical for the child’s age (e.g., interest in toilets, lights)
  • repeating words or phrases (echolalia)
  • repetitive behaviours, such as spinning
  • intense reactions to minor changes in routine or surroundings
  • appearing uninterested in other children
  • difficulties communicating own needs either using words or gestures

For additional signs and symptoms: Canadian Paediatric Society & Autism Canada

What happens if my child has some/all of the above symptoms?

For many parents, seeing many of their child’s behaviours fit on these lists can be a very stressful experience. If this is the case for you, it would be helpful to first check in with your family doctor regarding your concerns as many of these symptoms share overlaps with other conditions. Your doctor will be the best person to talk to regarding whether an autism (or other) assessment is worth pursuing. Remember that a diagnosis is a label for certain patterns of behaviour and that a label does not change who your child is.

How to obtain an autism assessment in British Columbia:

In British Columbia, families have two options to access an autism assessment. I currently provide services through the public system as a Qualified Specialist in the BCAAN program at BC Children’s and through the private system.

Option 1: Through the public system (for free)

How to access:

  • Get a referral from your doctor
  • BC Autism Assessment Network (BCAAN) will coordinate an assessment as close to where you live as possible
  • After the assessment, BCAAN will send you a Clinical Outcomes Form with test results

Wait-times are often quite lengthy (average of 1.5 years): Current wait times

Option 2: Through the private system (out of pocket/extended health coverage)

How to access:

Wait-times vary depending on provider.

Diagnostic Process:

In British Columbia, the diagnostic process requires that the diagnosis of autism be completed by a registered psychologist, paediatrician or psychiatrist. Different types of assessments are required if your child is under the age of 6 or if they are above the age of 6.

For children under 6, multiple specialists are required based on the B.C diagnostic standards to make an autism diagnosis and Dr. Ho is happy to complete the Clinical Diagnostic Assessment (CDA- described below) and collaborate with your team.

An autism assessment for children above the age of 6 (also called a clinical diagnostic assessment (CDA)) involves the following components as outlined by the B.C diagnostic standards:

  • File review of medical and school documents (e.g., school report cards, assessments from other health providers if applicable)
  • Clinical intake with parents/caregivers: A semi-structured interview will be conducted with the child’s main caregivers in order to collect information about the child’s birth and developmental history (e.g., age when they took their first steps, age when they spoke their first words) as well as relevant educational and medical information.
  • Autism Diagnostic Interview-Revised (ADI-R): A semi-structured interview will be conducted with the child’s main caregivers. The purpose of this interview is to assess for features of autism that occurred early on in the child’s development (i.e., ages 4-5) and current day.
  • Autism Diagnostic Observation Schedule – Second Ed. (ADOS-2): This is a play-based semi-structured assessment with your child. The purpose of this assessment is to examine their social communication and interaction and to assess for the presence of restricted/repetitive behaviours.

Sometimes, the CDA alone is enough to address the question of autism. However, for some children, the challenges they have with social interaction may be due to other difficulties such as intellectual developmental disorder or a specific learning disability. As a result, Dr. Ho offers comprehensive autism assessments that also assesses your child’s cognitive and adaptive abilities. This will help us to understand your child’s thinking and adaptive functioning profile, which in turn, can help with tailoring interventions to specific areas of need.

What to expect in an autism assessment with Dr. Ho:

  • Two assessment dates: For most of my autism assessments, I complete the parent interview portions (i.e., clinical interview and ADI-R) virtually on a separate day as I understand that it can be hard to find childcare and many prefer to complete this in the comfort of their own home. However, I am also available to complete this portion in-person at the clinic if families prefer. In-person testing is usually completed in the clinic in one day.
  • Timely diagnoses and feedback: Research shows that children who obtain an early diagnosis and early intervention obtain optimal outcomes. With majority of my assessments, I am able to provide families with the diagnostic outcome on the same day as in-person testing. In exceptional cases (i.e., requirement for additional testing or information from other sources), feedback is completed as soon as possible in order to not delay access to intervention.
  • Comprehensive and easy-to-read reports: I strive to write meaningful and useful reports for parents so that it can be used to access appropriate school services and other interventions.