HPSSC - 2015
Child Health Nursing (Pediatrics)
Easy
Autism is diagnosed at?
Appeared in: HPSSC - 2015
Explanation
- Autism Spectrum Disorder (ASD) is a neurodevelopmental condition with an onset in the early developmental period.
- While developmental red flags can be observed in infancy, a reliable and stable diagnosis is typically made by the age of 2 to 3 years.
- This timing aligns with when the core deficits in social communication and the presence of restricted, repetitive behaviors become more apparent and can be reliably assessed.
- A survey mentioned in psychiatric literature found the average age of diagnosis for children with autistic disorder to be 3.1 years.
- Routine developmental screening for all children is recommended at 18 and 24 months to identify those at risk who need further diagnostic evaluation.
Why Other Options Were Wrong
- Option B: Diagnosis at 5 years of age is considered late. The primary goal of healthcare providers is early identification and intervention to improve developmental outcomes.
- Option C: A diagnosis at school age represents a significant delay in identification. Most children with ASD are identified before they start formal schooling.
- Option D: A definitive diagnosis is rarely made in infancy. While early signs ('red flags') can be present, it is difficult to distinguish them from normal developmental variations at this age.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Typical age of diagnosis for Autism Spectrum Disorder (ASD) as background academic context rather than a clinical decision trigger.
- Nurses, especially in community and pediatric settings, are at the forefront of developmental surveillance. They use standardized screening tools like the M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) during well-child visits at 18 and 24 months.
- Early identification is paramount. A nurse's ability to recognize red flags and make a prompt referral for a comprehensive diagnostic evaluation can significantly lower the age of diagnosis, enabling access to early intervention services that improve long-term outcomes.
- What if? If a parent expresses concern that their 15-month-old is not yet talking but meets all other milestones, the nurse should reassure the parent about the wide range of normal development but also emphasize the importance of the upcoming 18-month screening for a more formal assessment of social and communication skills.
How to Approach the Question
- First, identify the core of the question. It asks for the typical age of diagnosis for autism, not the first appearance of symptoms or the age for screening.
- Consider the options in the context of child development. Autism is a disorder that begins early in life.
- Evaluate the extremes: 'Infancy' is generally too early for a definitive diagnosis due to normal developmental variability. '5th year' and 'School age' are considered late, as the focus is on early intervention.
- Recall the standard pediatric screening schedule. Universal screening for ASD is recommended at 18 and 24 months.
- Logically conclude that a formal diagnosis would typically follow a positive screening result. This places the most common age of diagnosis in the period immediately following these screenings, which is the 3rd year of life (ages 2-3).
Concept Tested & Keywords
- Concept Tested: Typical age of diagnosis for Autism Spectrum Disorder (ASD).
- Stem keywords: Autism, diagnosed
- Lead-in keywords: BEST, MOST RELEVANT CLUE
Question ID
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Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 391-393
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 12070-12072
Practise the full HPSSC - 2015
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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