What is Rule Out Autism Spectrum Disorder?

April 9, 2016 1:04 PM

My son was diagnosed with "rule out autism spectrum disorder, mild." Help me understand this.

My son, 16, has social, academic and emotional challenges. He has had a full Neuropsych evaluation, plus various school evaluations. The most recent of these, conducted by a psychologist, diagnosed him with "rule out autism spectrum disorder, mild." This sounds like a command, or a recommendation, but my googling has determined that it is an actual DSM-V diagnosis.

But what does it mean? Is my son on the spectrum or not? We certainly wouldn't be surprised if he was, but we'd just like to know for sure. My older son has ASD and his diagnosis was much more cut and dried.

I've tried searching online, but all I'm finding are documents aimed towards professionals and they just confuse me more. Any sources you could point me to that a layman would understand would be appreciated.

posted by Biblio to Health & Fitness (10 answers total)

What I think you're seeing when you search is the criteria for Social Communication Disorder. In order to receive that diagnosis, they have to determine that the symptoms/characteristics are not better explained by ASD.

IANYD, but my guess is that the psychologist is saying "yeah, I'm ruling out ASD"
posted by DebetEsse at 1:23 PM on April 9, 2016 [1 favorite]

Response by poster: That makes sense. The only thing that still confuses me is that if they ruled out ASD wouldn't he have gotten diagnosed with Social Communication Disorder instead? It seems so strange that NOT having ASD is its own diagnosis.
posted by Biblio at 1:33 PM on April 9, 2016

A rule-out diagnosis is one that the practitioner suspects might apply but does not have enough information to definitively say "Yes, this diagnosis fits" or to say "No, this diagnosis doesn't fit." It's basically a notation that the patient needs further evaluation (from that practitioner or another).

Sometimes rule-out diagnoses are listed simply for insurance purposes, however, to explain to the insurance company why the assessment is being billed.
posted by lazuli at 1:34 PM on April 9, 2016 [14 favorites]

(Are there other diagnoses listed, or just that one?)
posted by lazuli at 1:41 PM on April 9, 2016

Iazuli has it. A rule out diagnosis is usually one that is suggested at the time of the referral and the evaluation is conducted to determine whether it fits or not. Sometimes it's also used if the evaluator feels that there are some characteristics of that diagnosis, but they don't have quite enough information to say for sure if that diagnosis fits or not. In either case, the evaluator should be meeting with you to review the results of the evaluation and walk you through what their thinking is. You should absolutely feel free to contact them to ask questions and to ask for a feedback meeting if you have not had one yet.
posted by goggie at 1:46 PM on April 9, 2016 [1 favorite]

"Rule out Autism Spectrum Disorder" is not by itself a diagnosis of Social Communication Disorder. It is one of the DSM-V criteria for making a diagnosis of Social Communication Disorder. Honestly, it sounds to me like the psychologist may have a mistake in writing up the report - perhaps she was copying and pasting from a previous report template (which is standard), and didn't copy over the sentence she meant to. You should definitely call the psychologist and ask for more clarification. Did you meet with the psychologist to discuss their findings, or did they just send you the report? Typically there should be a face to face meetings where they go over their findings, and you get the chance to ask questions. (IAAPsychologist, IANYPsychologist).
posted by scalar_implicature at 1:46 PM on April 9, 2016 [2 favorites]

Response by poster: My son has other issues that have been diagnosed, but not by this psychologist. We got the results of the evaluation at his IEP meeting and the psychologist was not there. Another staff member orally reported the findings. At the time I thought she said the psychologist had ruled out ASD. It was only when I saw the diagnosis written in the IEP we got in the mail that I started to question what it meant. I will contact the psychologist and see if he can explain it better.
posted by Biblio at 2:39 PM on April 9, 2016

It was only when I saw the diagnosis written in the IEP we got in the mail that I started to question what it meant.

It quite likely only means "Let's keep an eye on this in case more symptoms become apparent" (or possibly that whoever typed up the IEP included it mistakenly). Getting clarification from the psychologist sounds like a good plan.
posted by lazuli at 2:52 PM on April 9, 2016

Response by poster: Thanks for pointing me in the direction of the term "rule out diagnosis." I was able to find more information. Basically, a rule out is a provisional diagnosis that allows students to access appropriate services. So my son's IEP now contains accommodations for ASD, which it did not before. Obviously he needs a more complete evaluation, but in the meantime he is being accommodated at school.
posted by Biblio at 3:05 PM on April 9, 2016 [7 favorites]

I've got two kids with special needs. They've both had "rule out _____" placed on the list before. It's just something the doctor/specialist writes to indicate that there are some signs, but that there isn't enough information. They usually write it when they are referring you to a specialist who can rule that out. If they thought it was likely, they usually write "diagnosis likely" or "likely". Some doctors/psychs will write it when they aren't referring the child or when they are still supporting the child's treatment, so that the accommodation can be made in the IEP while they continue to investigate.
posted by Chaussette and the Pussy Cats at 7:09 PM on April 9, 2016 [1 favorite]