Detection and diagnosis of autism spectrum disorder
Do you think your son or daughter, a family member, or you yourself might have ASD? Where can you go to get diagnosed? What are the steps you should follow?
In this article we explain what the public care circuit for autism spectrum disorders (ASD) is in Spain.
If the person is a minor:
The first thing you should do is make an appointment with your pediatrician at your health center or primary care clinic for an evaluation. If deemed necessary, the pediatrician will refer you to a specialized care service . This service may vary depending on the child's age and the autonomous community where you live. Typically, the referral is to an early intervention center, which generally serves children up to 5 or 6 years old. From age 6 to 18, referrals and care are provided at child and adolescent mental health centers.
There are also specialized units, usually located in leading hospital centers, which handle more complex cases.
If you are of legal age:
If you suspect you have autism spectrum disorder and you are an adult, you should see your family doctor at your primary care health center. After the assessment, and if deemed necessary, you will be referred to an adult mental health center or a hospital unit specializing in autism spectrum disorder.
I've been diagnosed with autism spectrum disorder in adulthood… Now what?
How is autism detected?
In young children, the first level of detection occurs in primary healthcare, during routine pediatric checkups. These are a key opportunity to obtain developmental information. In children aged 0-5 years, the Haizea-Llevant scale or other "well-child" protocols are used, allowing for the possible early detection of cases. This scale assesses children's cognitive, motor, and social development, exploring a total of 97 skills related to neurodevelopmental areas.
If there are warning signs, the M-CHAT-R (Modified Autism Early Detection Questionnaire) screening instrument is also used for children aged 1 to 3 years, with which the pediatrician can assess aspects of development and behavior susceptible to clinical characteristics of ASD through questions.
If, after these assessments, the suspicion of developmental disorder or ASD persists, the pediatrician makes a referral to specialized care, to the early intervention center for children under 6 years of age or to the child and adolescent mental health center for children aged 6 to 18 years, where a specific diagnostic assessment will be carried out.
In some cases, validated psychometric instruments are used, such as the ADI-R (Autism Diagnostic Interview-Revised), a clinical interview that allows for an in-depth evaluation of individuals exhibiting characteristic symptoms of ASD, or the ADOS-2 (Autism Diagnostic Observation Schedule), a standardized assessment of communication, social interaction, and play or imaginative use of materials. These diagnostic instruments may be used when referring the individual to a specialized mental health center or unit.
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