Services and support

Diagnosing autism spectrum disorder

The diagnostics of autism spectrum disorder (ASD) has evolved over time. Today, autism is seen as a spectrum with varying degrees of severity. It is estimated that 1–1.2% of the population has ASD, which is much more than was previously thought. Some autism spectrum disorders are typically not diagnosed until the child starts school and faces more demands regarding social interaction skills. Symptoms may not become obvious until later, for example in life transitions, such as when you are under more pressure due to further studies or independent living.

“The diagnosis was a big relief for us, because we no longer had to suffer from uncertainty. After the diagnosis, we’ve been able to deal with the symptoms much better.”

It is necessary to diagnose ASD in young people and adults as well in order to make realistic plans for an independent life, vocational education and other rehabilitation while preventing social exclusion. Support should be given as soon as ASD is first suspected. Following more thorough assessments and a diagnosis, rehabilitation and guidance in the local environment can be targeted with a more specific goal in mind and taking account of the individual needs.

How to seek an assessment?

If you suspect that a young person may be on the autism spectrum, you should first contact the school health service, student health service or public health service. A general practitioner can refer you to specialized health care where an interdisciplinary team led by a specialist will conduct examinations and assess whether the criteria are met. Assessments are also conducted by private service providers. You should find out the costs of the assessments and possible insurance coverage in advance.

You can prepare for the doctor’s appointment by filling in the Autism Spectrum Screening Questionnaire (ASSQ) and by writing down observations based on which you have started to suspect autism spectrum disorder and how these features have presented in different phases of life.

Autism spectrum disorder is usually diagnosed in an interdisciplinary team using various lists of symptoms related to screening and assessment, structured interviews and observation tools. When making a diagnosis, the key elements are communication, social interaction and interests. The individual’s entire developmental history is considered when making a diagnosis. Assessments are necessary and an ASD diagnosis is required to obtain the appropriate support and services.

Diagnosis of ASD is changing

As part of the revision of the diagnostic criteria for autism, the ICD-11 revision of the International Classification of Diseases will replace ICD-10, and instead of separate diagnoses (autism, Asperger’s syndrome, atypical autism, disintegrative developmental disorder), the single diagnosis of “autism spectrum disorder” will be used.

What feelings does the diagnosis cause in parents?

The diagnosis of a young person can cause both positive and negative feelings in parents. Parents may worry about stigmatization and the future of the young person and their opportunities to study and live independently. On the other hand, learning the diagnosis may also be a relief. The diagnosis can also cause significant positive changes for the young person in terms of the expectations towards them, acceptance and understanding their need for support. The assessment also enables targeted rehabilitation and support.

The young person turns 16 – services and support change in many ways

Author: Erja Pietiläinen, Senior Advisor, child and family policy

The Finnish Association on Intellectual and Developmental Disabilities

Originally published in the Finnish edition of the Handbook on Disability Services by the Finnish Institute for Health and Welfare (Vammaispalvelujen käsikirja)

As a young person approaches adulthood, many things change. Age brings new rights to the young person, and they also come with responsibilities.

The table below describes the key changes in terms of services and young people who are becoming independent. Young clients should be transferred according to plan, through accompanied transfer, from the services for children to the services for young people and adults. The authorities should make sure that the young person continues to have access to the services and support they need.

The young person and their family should prepare for changes in the young person’s services and support. There may also be various age-related limits in hobbies and other recreational activities.

When the young person turns 16, the benefits for childhood and early adolescence will stop and they will have to e.g. reapply for Kela’s benefits. Benefits and financial aid are mainly related to subsistence, studying and supporting other daily life. Changes may also occur in healthcare and social welfare services.

Municipalities are responsible for organizing health and social services

The need for social services is initiated by contacting the social services in your home municipality. The contact can be made by the person with ASD themselves, their family member or a professional, for example. After the matter has been initiated, the social services conduct an assessment of the need for services in which the client’s life situation and needs for support are examined. When conducting an assessment of the need for services, the client should be informed of their rights and responsibilities based on general and special legislation and the various options for providing the services.

The municipality / wellbeing services county is responsible for preparing a client or service plan. The plan describes the need for services and a plan for organizing the services and support. The client or service plan indicates how the services are organized. The plan gives the social welfare client and their family member a chance to participate in the planning of support and to influence the services they are given. A decision on a particular service usually requires a written application, such as an application for housing services.

In healthcare services, the attending physician is responsible for making a rehabilitation plan. The rehabilitation plan is made in a public healthcare unit together with the rehabilitee and their family member. The rehabilitation plan is typically made together with an interdisciplinary team, which can include a psychologist and an occupational therapist or other worker.

The rehabilitation plan describes the measures that are deemed necessary based on the assessments, feedback and discussions with the rehabilitee. The plan is based on the need for rehabilitation, assessed together by the rehabilitee and the attending party. The rehabilitation plan is always made individually while considering the overall situation. The provided rehabilitation is compensated by public healthcare, Kela or insurance companies.

Adapted service system

Below is a description of the service system that has been created from the perspective of the potential needs for services of a young person who is pursuing further studies and becoming independent.  The description of the service system is not exhaustive, but its purpose is to help you make sense of the services that are available. Read more about the services (in Finnish)

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