Assessment Methods for Autism, ADHD, and Learning Disabilities in Children

Assessing developmental disorders like Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD), and Specific Learning Disabilities (SLD) requires both early screening (pre-assessment) and comprehensive diagnostic evaluations. Below is a structured overview of the standardized tests, screening tools, and alternative assessment methods for each condition, along with a comparison of tools used internationally versus those available in India. We also highlight where these assessments can be accessed in India and note differences in accessibility, cost, and availability compared to global standards.

Autism Spectrum Disorder (ASD) Assessments

Autism assessments typically involve an initial screening to identify children at risk, followed by detailed diagnostic evaluations for confirmation. Internationally, clinicians use a combination of parent questionnaires, observational schedules, and interviews. In India, many global tools are used at specialist centers, alongside indigenous tools developed for broader accessibility.

Screening Tools for Autism (Pre-Assessment)

Early screening is crucial for ASD. Common autism screening tools include:

• M-CHAT (Modified Checklist for Autism in Toddlers) – A parent-report checklist used worldwide for toddlers (~16–30 months) to screen for autism risk. It is widely used globally and in India, helping flag children who need a full evaluation.
• SCQ (Social Communication Questionnaire) – A 40-item parent questionnaire for children 4 years and above, often used as a screening tool for ASD.
• TABC (Trivandrum Autism Behavior Checklist) – An Indian-developed checklist for screening children ages 2–6 for autism traits.
• Ages and Stages Questionnaire (ASQ) – A general developmental screening tool (for 6–60 months) that is used globally to monitor developmental milestones.

Other screening tools include the Autism Behavior Checklist (ABC) and the Indian Autism Screening Questionnaire (IASQ), designed for broader community screening in India.

Diagnostic Assessment Tools for Autism

If a screening indicates risk, a comprehensive assessment is conducted by specialists to diagnose ASD. Key diagnostic methods include:

• DSM-5 / ICD Criteria-based Evaluation – The DSM-5 or ICD-10/ICD-11 criteria form the basis of diagnosis.
• ADOS-2 (Autism Diagnostic Observation Schedule) – A gold-standard observational assessment used globally, available at specialized centers in India.
• ADI-R (Autism Diagnostic Interview – Revised) – A structured parent/caregiver interview covering developmental history and autism symptoms.
• CARS (Childhood Autism Rating Scale) – A behavior rating scale used worldwide and widely implemented in India.
• ISAA (Indian Scale for Assessment of Autism) – A 40-item diagnostic scale developed in India, mandated for autism certification.
• SRS (Social Responsiveness Scale) – A caregiver/teacher questionnaire measuring the severity of social impairment.
• GARS (Gilliam Autism Rating Scale) – Another questionnaire-based tool for parents/teachers, sometimes used in Indian settings.

Alternative assessments include clinical observation, play-based evaluations, and input from therapists when standardized tools are unavailable.

ADHD Assessments

Assessing ADHD in children involves gathering information across settings (home and school) and comparing behaviors to developmental norms. Pre-assessment typically uses rating scales or checklists completed by parents and teachers, while diagnostic evaluation may include clinical interviews and, occasionally, objective tests. In India, the approach is similar to global practice, though the availability of certain proprietary tools is limited.

Screening & Rating Scales for ADHD (Pre-assessment)

Initial identification of ADHD often uses standardized behavior questionnaires:

• Vanderbilt ADHD Rating Scales – A widely used free questionnaire for parents and teachers.
• Conners Rating Scales (Conners-3 or Conners-4) – A comprehensive set of standardized rating scales for ADHD.
• CBCL (Child Behavior Checklist) – A broad behavior checklist including an “Attention Problems” scale.
• SNAP-IV – A free 18-item ADHD checklist often used in research and schools.

Diagnostic Evaluation for ADHD

Diagnosing ADHD is primarily a clinical process integrating information from rating scales, interviews, and ruling out other causes. Key components and tools:

• Clinical Interview & DSM-5 Criteria – The cornerstone of ADHD diagnosis worldwide.
• Continuous Performance Tests (CPTs) – Computerized attention tests like T.O.V.A. or Conners CPT.
• INCLEN Diagnostic Tool for ADHD (INDT-ADHD) – A DSM-based structured assessment tool developed in India.
• Neuropsychological Assessments – Cognitive assessments, including IQ tests and executive function evaluations, when needed.

Learning Disabilities (Specific Learning Disorders) Assessments

Assessing learning disabilities in children involves determining whether a child’s academic skills in reading, writing, or math are significantly below expectations given their age and intellect.

Screening and Early Identification of Learning Disabilities

Early signs of learning difficulties can be spotted by teachers or through targeted screening tools:

• Teacher Observations & School Screening – Teachers identify students struggling with reading, writing, or math.
• Dyslexia Screening Tests – The Dyslexia Screening Test (DST-J India) and the Dyslexia Assessment for Languages of India (DALI) are used.
• SLD Screening Questionnaires – The NIMHANS SLD Screening Questionnaire (SLD-SQ) is used for preliminary identification.

Formal Assessment (Psycho-educational Evaluation) for Learning Disabilities

A comprehensive evaluation for SLD typically includes standardized testing of intellectual ability and academic achievement:

• Intelligence Tests (IQ Assessment) – The Wechsler Intelligence Scale for Children (WISC-V) is commonly used. In India, the Malin’s Intelligence Scale for Indian Children (MISIC) is widely used.
• Academic Achievement Tests – WIAT-III, Woodcock-Johnson, and Indian-developed tests like the Diagnostic Test of Learning Disabilities (DTLD) and DALI provide standardized measures.
• Cognitive Processing Tests – Tools like CTOPP for phonological processing, Beery VMI for visual-motor integration, and memory/attention tests may be included.
• Alternative Assessments – Informal reading inventories, writing samples, and curriculum-based assessments are used in cases where formal tests are unavailable.

Summary of Global vs. Indian Assessment Tools

Assessment Type	Global Tools	India-Specific Tools
Autism Screening	M-CHAT, SCQ	TABC, IASQ
Autism Diagnosis	ADOS-2, ADI-R, CARS	ISAA
ADHD Screening	Vanderbilt, Conners	INDT-ADHD
Learning Disability Screening	DST, CBCL	DALI, NIMHANS SLD-SQ
Learning Disability Diagnosis	WIAT, Woodcock-Johnson	MISIC, DTLD

Accessibility, Cost, and Availability (India vs Global)

While India has access to most global tools, their use is often limited to specialized centers due to cost and training requirements. Indigenous tools like ISAA and DALI are making assessments more accessible in regional languages. Most assessments remain out-of-pocket expenses for families in India, though government initiatives and NGOs are working to increase accessibility.

Where to Get Assessments in India

• Hospitals & Diagnostic Centers – AIIMS, NIMHANS, private pediatric clinics.
• NGOs & Special Education Centers – Action For Autism, Maharashtra Dyslexia Association.
• Government Initiatives – District disability assessment boards, rehabilitation centers.
• Online Resources – M-CHAT, Vanderbilt forms, DALI tools through UNESCO-NBRC.

This guide aims to provide parents, educators, and professionals with a clear understanding of available assessment methods and how to access them in India.