Getting Diagnosed: Interview & Observation

Soon, as work pressure increased, Chandni was unable to take Ria for group therapy, but Ria was doing well, and Dr. Kadam assured Chandni that Ria didn’t need therapy any more.

Ria’s paediatrician was amazed at her progress and would often ask parents who had children diagnosed with autism to speak with Chandni. Chandni always spoke in detail to these parents, remembering the days when she had been similarly distraught and at a loss as to what to do next.

Another book Dr. Kadam recommended, Out of Sync, also had good activities for older children with autism. Ria’s lack of empathy would disturb Chandni,  but she became better after Chandni tried the strategies mentioned in the book.

Chandni would ask Ria, “Would you like it if someone touched your cheek?”

“No!” Ria would say.

“Then don’t touch your twin’s cheeks,” Chandni would say, and Ria would stop doing that, at least for a while.

Ria had trouble waiting, but Chandni persisted, telling Ria she was in line and needed to wait for her turn, whenever such a situation came up – whether it was at the doctor, the mall, etc. Gradually Ria would sit through events, even if she was less interested in them.

Other books which helped, that Dr. Kadam recommended, included Thinking About You, Thinking About Me and Look Me In The Eye. For building conversational and social skills. Chandni tried the tips mentioned in the former – like showing Ria photos of events at school, and asking questions about them. Similarly, she showed photos to Ria of her marriage, friends, etc, to nudge Ria into asking questions about them.

The latter book was a memoir written by a man with autism – and it gave Chandni insight in the way autistics think. He worked with Pink Floyd, one of Chandni’s favourite bands. He also later had a job, got married, and managed his autism well.

Chandni found his story so gripping she read it within a day. She felt hopeful now, that Ria would be able to live a normal life – get a job, get married, etc.

Dr.Kadam formally tested Ria for autism when she was five. The diagnostic assessment was

carried out using two instruments considered to be the ‘gold-standard’ for ASD: the Autism Diagnostic Interview (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS-2).

The ADI-R is a parent interview covering developmental history and behavioural presentation in relation to autism. It captures information about qualitative impairments in communication, reciprocal social interaction and repetitive/stereotyped behaviours and sensory integration.

After talking with us about Ria’s behaviour over the years, her interaction with her peers, Dr. Kadam diagnosed her as having ASD.

The ADOS-2 is a semi-structured standardised assessment instrument, that includes a number of play-based activities designed to obtain information in the areas of communication, reciprocal social interaction and restrictive and repetitive behaviours associated with a diagnosis of ASD.

Dr. Kadam played with Ria using some toys. I was also present, so Ria was comfortable playing with the doctor. Dr.Kadam then determined that her eye contact could be better, but she did not have many signs of ASD.

To be continued...

This post is a part of Blogchatter A2Z.