Vanessa Cardy, MD, and Heidi James, MD
Late Diagnosis of Autism Spectrum Disorder
Vanessa reviews the case of a female patient who was diagnosed with autism spectrum disorder (ASD) at the age of 12. The case highlights how ASD is often diagnosed later in patients, particularly female patients, who meet most early social and emotional development milestones but have more telling symptoms during early adolescence.
- Include ASD in your differential for children who present with difficulties with emotional regulation, behavioral disturbances, or mood disorder.
- ASD symptoms to look for include
- Plateau or regression of previously acquired social skills
- Neurocognitive delays (including speech/language skills)
- Resistance to changes in routine
- Behavioral disturbances
- Children with a later ASD diagnosis may actually have exhibited symptoms earlier (in this case, obsessive interests and sensory issues) but met earlier social and developmental milestones, although perhaps with difficulty. The transitions of early adolescence can unmask their symptoms.
- The symptoms of attention ASD, attention deficit-hyperactivity disorder (ADHD), and anxiety disorders can overlap.
- Management includes
- Psychologist or behavioral therapist consults
- Engaging the school regarding an individualized educational plan
PEARL: Consider ASD in young adolescents with new emotional and behavioral symptoms.
Crunch Time FM Kiddos: Autism Spectrum Disorders
EM:RAP 2013 January: Autism