Autism spectrum disorder can be challenging to diagnose accurately, as its symptoms often overlap with those of other conditions. This overlap can result in misdiagnosed autism, delaying crucial interventions.
Early and accurate diagnosis is essential to ensure individuals receive the appropriate therapies and support tailored to their unique needs. Unfortunately, misdiagnosed autism can have significant impacts on individuals and their access to appropriate support and resources.
The importance of an accurate autism diagnosis
Noticing that your child is not following the same developmental milestones as their peers can be challenging. You may feel eager to find ways to support them, address their needs, and ensure they have the accommodations necessary to thrive in school and daily life.
Before creating an effective plan, obtaining a diagnosis is a crucial first step. While autism presents differently in every individual, a formal diagnosis serves as the foundation for accessing resources, support, and accommodations.
In many cases, schools require a diagnosis to provide services through an Individualized Education Plan (IEP), and it is often necessary to qualify for government assistance and programs.
Every autistic child’s experience is unique. However, understanding the common symptoms and patterns can guide families in exploring therapies and strategies that may benefit their child.
Autism often co-occurs with other developmental or genetic conditions. This makes an accurate and comprehensive diagnosis essential for creating a care plan tailored to your child’s specific needs.
How often is autism misdiagnosed?
Autism misdiagnosis is a significant concern, but there’s no clear answer on how often it occurs. Research indicates misdiagnosis or delayed diagnosis is common.
For instance, one study found that over 75% of participants received an autism spectrum disorder (ASD) diagnosis approximately eight years after their first mental health evaluation.
The diagnostic process relies heavily on behavioral observation rather than definitive tests, such as brain scans or lab work, which contributes to diagnostic challenges.
The diagnostic process relies purely on symptoms rather than definitive tests, which makes the diagnosis more challenging. The symptoms often overlap with other conditions, such as obsessive-compulsive disorder (OCD), where repetitive behaviors can be mistaken for compulsions.
Additionally, some autistic individuals mask their symptoms to fit in, further complicating diagnosis.
Co-occurring conditions add another layer of complexity and lead to a misdiagnosis of autism. Estimates suggest that 70% to 80% of autistic individuals also receive a diagnosis of another psychiatric condition.
This highlights the need for accurate and thorough evaluations to provide the right support and interventions.
Recognizing early signs of autism
Parents and caregivers may notice signs of autism in their child at different stages, with some recognizing symptoms before their child’s first birthday. While a reliable diagnosis can sometimes be made by age two, many children are not diagnosed until after age four.
Between six and 18 months, early signs of autism may include:
- a lack of response to names,
- limited eye contact,
- difficulty engaging in joint attention (e.g., sharing focus on objects),
- repetitive movements (e.g., rocking or arm flapping)
- engaging with toys in unconventional ways (e.g., lining them up or focusing on toy parts rather than using them as a whole).
Autism screenings are typically conducted during 18- and 24-month check-ups, but if early signs are noticed before these milestones, parents should not hesitate to contact their child’s pediatrician.
Developmental screenings are also available at 9, 18, 24, and 30 months. Additional screenings can be requested based on the child’s specific needs or concerns.
Pediatricians are often the first to assess developmental concerns, but some children with higher-functioning autism may not show signs until school age.
In these cases, teachers trained to identify developmental delays can be valuable allies in noticing behaviors that may warrant further evaluation by a pediatrician.
Once concerns are raised, a pediatrician may refer the child to specialists for an accurate diagnosis and treatment plan.
These specialists may include:
- developmental pediatricians,
- educational psychologists,
- speech therapists,
- occupational therapists,
- physical therapists,
- geneticists,
- neurologists, and
- social workers.
What can autism be misdiagnosed as?
Autism symptoms can often overlap with other conditions, making it difficult to distinguish between them.
To accurately diagnose autism, healthcare professionals typically refer to the Diagnostic and Statistical Manual, Fifth Edition (DSM-5).
They may also assess your child for other conditions, such as:
- fragile X syndrome,
- sensory processing disorder,
- anxiety,
- hearing or vision impairments, and
- various genetic disorders.
A comprehensive approach involving multiple specialists provides a more thorough understanding of your child’s symptoms. This process, known as differential diagnosis, helps to distinguish autism from other conditions that may present similarly.
Several conditions share symptoms with autism and should be carefully considered during the diagnostic process.
Conditions similar to autism include:
- congenital rubella syndrome,
- Cornelia de Lange syndrome,
- Down syndrome,
- fragile X syndrome,
- Klüver-Bucy syndrome,
- Landau-Kleffner syndrome,
- Lesch-Nyhan syndrome,
- untreated phenylketonuria (PKU),
- Prader-Willi syndrome,
- Rett syndrome,
- Tourette syndrome,
- tuberous sclerosis, and
- Williams syndrome.
Additionally, many children with autism may receive multiple diagnoses, as autism often co-occurs with:
- anxiety,
- depression,
- sensory processing disorder,
- allergies and immune system issues,
- high or low pain thresholds,
- PICA,
- sleep problems,
- hearing or visual impairments, or
- savant syndrome.
The importance of accurate diagnosis in preventing autism misdiagnoses
Early intervention is crucial, but so is ensuring the right intervention. An accurate autism diagnosis helps tailor therapies to your child’s unique needs.
Whether your child requires psychotherapy, occupational therapy, or creative therapies like art or hippotherapy, a comprehensive diagnosis ensures they receive the support necessary for success in school, family life, and communication.
Avoiding autism misdiagnoses is the first step toward giving your child the best chance to thrive.
FAQs
Q: What is commonly misdiagnosed as autism?
A: Conditions such as ADHD, sensory processing disorder, social anxiety, and certain language disorders are often misdiagnosed as autism due to overlapping symptoms like social challenges and communication difficulties. However, these conditions have distinct characteristics and require different approaches to treatment.
Q: Can a child be misdiagnosed with autism?
A: Yes, a child can be misdiagnosed with autism if other conditions with overlapping symptoms, such as ADHD, anxiety, or language disorders, are not properly evaluated. Misdiagnoses can occur due to limited assessment tools or insufficient observation of the child in different environments.
Q: What does masking in autism look like?
A: Masking in autism refers to the act of hiding or suppressing autistic traits, such as mimicking social behaviors, suppressing stimming, or forcing eye contact, in order to fit in or avoid judgment.
Q: Can developmental delay look like autism?
A: Yes, developmental delay can sometimes resemble autism, as both may involve delays in speech, motor skills, and social interaction. However, developmental delay is typically a global delay across multiple areas, while autism is a neurodevelopmental disorder characterized by specific social communication and behavioral challenges.
Q: Can a child have signs of autism but not be autistic?
A: Yes, a child can exhibit signs commonly associated with autism, such as social difficulties or repetitive behaviors, but not meet the criteria for an autism diagnosis. These signs can be part of other developmental or behavioral conditions, and a thorough evaluation is necessary to determine the underlying cause.
References
Autism Spectrum Disorder (ASD). (2018, April 26). Retrieved from https://www.cdc.gov/ncbddd/autism/data.html
Gesi, C., Migliarese, G., Torriero, S., Capellazzi, M., Omboni, A. C., Cerveri, G., & Mencacci, C. (2021). Gender differences in misdiagnosis and delayed diagnosis among adults with autism spectrum disorder with no language or intellectual disability. Brain Sciences, 11(7), 912. https://www.mdpi.com/2076-3425/11/7/912
Wiggins, L. D., Durkin, M., Esler, A., Lee, L. C., Zahorodny, W., Rice, C., … & Baio, J. (2020). Disparities in documented diagnoses of autism spectrum disorder based on demographic, individual, and service factors. Autism Research, 13(3), 464-473. https://onlinelibrary.wiley.com/doi/abs/10.1002/aur.2255
Fusar-Poli, L., Brondino, N., Politi, P., & Aguglia, E. (2022). Missed diagnoses and misdiagnoses of adults with autism spectrum disorder. European archives of psychiatry and clinical neuroscience, 272(2), 187-198. https://link.springer.com/article/10.1007/S00406-020-01189-W
Other articles you may be interested in:
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- 8 Things to Do After an Autism Diagnosis
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