TRICARE beneficiaries

Pathway to care

The process of recognizing, reporting, and ultimately receiving care for Autism Spectrum Disorder (ASD) can be long and challenging. The steps below identify what you can expect throughout this process.

Autism Spectrum Disorder (ASD) affects many lives in this country and the world. Currently, in the United States, about 1 in 68 children have ASD. Research tells us that ASD is more common in boys than in girls and likely caused by some combination of biological and environmental factors. There is still a lot that we do not know about ASD.

Because there is no cure for ASD and personalized care is often needed, the social and financial burden can be great. The impact, unfortunately, becomes even greater if the condition goes undiagnosed or untreated.

Current research suggests that early identification and intervention are the best ways to lessen the impact of ASD. The quicker symptoms are recognized, the sooner treatment can begin. And managing symptoms can help improve the quality of life for individuals and their families.

Step 1:Identification

What is Autism Spectrum Disorder?

Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition that hinders or limits how people behave, communicate, and interact with others. ASD often appears in early childhood. And it affects people differently. No two experiences are the same. Symptoms range from very mild to severe, or somewhere in between. Someone mildly affected may need only a little help to perform daily activities. But those with severe symptoms may have extreme challenges and need significant help. Learn more about the symptoms of ASD

Signs of ASD

Autism Spectrum Disorder (ASD) is diagnosed in children, young people, and adults. The core ASD symptoms are typically present in early childhood, but sometimes symptoms are not visible and can be hard to identify. This is particularly the case for people who are only mildly affected and if problems are masked by supports or other medical conditions. Knowing what to look for can help. The core symptoms of ASD are:

  1. Problems communicating and relating to others
  2. Limited and/or repetitive behaviors, interests or activities

Learn more about the signs of ASD by choosing from the age groups below.

Screening and assessment

The exact cause of ASD is unknown and there is no medical test to detect the condition. Currently, doctors rely on screenings and comprehensive evaluations to diagnose ASD. These assessments also help to identify if other medical conditions are present.

Screenings are most often used by Primary Care Managers (PCMs) or pediatricians to identify people who have signs or symptoms of ASD so that it can be diagnosed and treated. Screenings involve a list of questions about the beneficiary’s communication and social skills abilities that can be answered by the beneficiary, a caregiver, or the doctor. If the results of a screening indicate ASD may be a possibility, PCMs generally refer beneficiaries to specialists for follow-up tests to diagnose the condition. (Note: Screenings should not be used to diagnose ASD or any other medical conditions and should only be used to support the process.)

Primary Care Managers (PCMs) know the importance of early identification and intervention and may also refer patients for immediate treatment, even before the diagnosis is confirmed. If the screening is negative, PCMs may suggest follow-up visits or more frequent screenings to monitor symptoms.

Comprehensive evaluations are used to identify a beneficiary’s strengths and needs, find the cause of symptoms, and determine a diagnosis (ASD as well as other medical conditions). The comprehensive evaluation involves multiple assessments usually completed by a team of professionals who have experience and training in diagnosing and treating developmental delays and disability. The assessments often included in the comprehensive evaluation are:

  • A physical exam
  • Hearing and vision testing
  • Genetic and neurological testing
  • Review of family's medical history
  • Interviews with parents, family members, caregivers, teachers, etc.
  • Measurements to assess abilities and overall functioning

Once all assessments are complete, the specialist(s) reviews the results of the evaluation and, together with the beneficiary and their family, treatment plans and goals are decided. It is natural to experience a variety of emotions (including shock or relief) and concerns about the future after receiving the diagnosis. A diagnosis provides patients and families with answers, but it often leads to more questions on what to expect and what treatments are best. If you feel overwhelmed or unsure of where to begin, continue to the next step on the pathway to care.

For additional information about the process of diagnosing ASD, screenings, and comprehensive evaluations refer to the resources below:

Signs of possible ASD in young children

(birth to age 3 years)

According to the Center for Disease Control (CDC), signs of ASD can sometimes be seen in children ages 3-24 months. Parents and caregivers can help identify the condition early by learning about the standard developmental milestones and monitoring their child’s developmental progress overtime.

A developmental delay means that growth and development are happening slower than what is considered typical, or average. As a parent or caregiver, you know the child best. If age-appropriate milestones are not reached or if the child appears to be going backwards in their learning, talk to your child’s doctor right away. Catching ASD early and getting started on a treatment plan can help children achieve their full potential.

View our developmental grid to learn what to look for at each age

Learn more about identifying the signs of ASD by exploring the resources below.

Signs of possible ASD in school-aged children and adolescents

(age 5 - 17 years)

The signs of ASD are sometimes hard to notice in young children. As people get older and their circumstances change, new experiences can push people outside their comfort zone. ASD symptoms may be more obvious when people are challenged beyond their current abilities and skills.

Parents and caregivers can help identify the condition by learning the signs of ASD and monitoring how the child reacts to change or transitions (like starting school or moving from primary school to secondary school).

View our developmental chart to learn what to look for at this age

Learn more about identifying the signs of ASD by exploring the resources below.


Attached chart is adapted from the Centers for Disease Control and Prevention (CDC) ‘ASD: Signs and symptoms” found at https://www.cdc.gov/ncbddd/autism/signs.html

Signs of possible ASD in adults

The signs of ASD are sometimes hard to notice in childhood. As people get older and their circumstances change, new experiences can push people outside their comfort zone. ASD symptoms may be more obvious when people are challenged beyond their current abilities and skills.

You can help identify the condition by learning the signs of ASD, watching for certain behaviors, and monitoring reactions to change or transitions (like going to college, moving, or starting a new job).

Use this chart to learn what to look for in this age group

Learn more about identifying the signs of ASD by exploring the resources below.


The attached chart was adapted from the Centers for Disease Control and Prevention (CDC) ‘ASD: Signs and symptoms” found at https://www.cdc.gov/ncbddd/autism/signs.html

Step 2: Treatment

After receiving an ASD diagnosis, it is important to begin following treatment plans right away. Treatment can help stop symptoms from getting worse and also improve the well-being of beneficiaries and their families.

Currently, there is no known cure for ASD. The best approach is to treat the symptoms. Because there are many forms of treatment, it is important to discuss treatment options with doctors who specialize in caring for people with ASD. Choosing treatments supported by current research and suited for the beneficiary’s unique strengths and abilities are the best ways to ensure the effectiveness of care.

Because each diagnosis is different, we do not endorse any one treatment or program. Most people with ASD respond best to a coordinated and multidisciplinary approach. We encourage beneficiaries and their families to learn about all options and work with qualified professionals to choose the appropriate form of care.

Complementary and Alternative Medicine (CAM)*

To relieve symptoms of ASD, parents and providers may sometimes consider treatments methods that are outside of what is recommended by healthcare professionals or evidence based medicine, known as complementary and alternative treatments (CAM). CAM approaches may include special diets, chelation (a treatment to remove heavy metals like lead from the body), biologicals (e.g., secretin), or body-based systems (like deep pressure), vitamins or supplements, yoga, or massage. Although many families try CAM treatments, there are no guaranteed benefits. It is important to consult qualified professionals and maybe even seek a second opinion before starting such treatments. Together, you can identify the appropriate choice of treatment based on your child’s unique needs and also minimize the risk of harm to the child and family members.


Learn more

Behavior and communication approaches

The National Research Council defines behavior and communication approaches as treatments that offer structure, direction, and organization and encourage family participation. Some of the behavior and communication approaches provided for ASD include:

  • Applied Behavior Analysis (ABA)

    ABA focuses on behavior modification and uses principles such as positive reinforcement to increase good or useful behaviors (e.g., functional, communication, and social skills) and reduce negative behaviors (e.g., self-injury). ABA may be used to develop basic skills (e.g., looking, listening) in addition to more-complex skills (e.g., reading, communicating). ABA is conducted by a qualified professional who also tracks and measures the child’s progress. Learn more

  • Occupational therapy

    Occupational therapy teaches people skills to support independent living such as dressing, eating, bathing, and relating to people. Learn more

  • Speech therapy

    Speech therapy focuses on improving how individuals communicate. Some people are able to learn verbal communication skills, while others may learn how to use gestures or picture boards. Learn more

Therapies for children with autism spectrum disorder: A review of the research for parents and caregivers

Dietary approaches*

Although some therapists may develop dietary treatment plans to help individuals with ASD, not all dietary treatments are supported by scientific research or the medical community. It is important to discuss any dietary changes that you are considering with a qualified professional before making these changes. A doctor or nutritionist can help develop the plan to ensure the child is getting the essential vitamins and minerals.


Learn more

Early intervention and special education

Early intervention services are available to infants and toddlers less than three years of age. These services are designed to help children learn essential skills that are typically gained in the first two years of life, such as physical skills, thinking skills, communication skills, social skills and emotional skills.

Special education and school based services are provided for school-aged children and youth (three through 21). Educating individuals with autism often includes a combination of one-on-one, small group, and regular classroom instruction and must be designed to meet the child's specific needs and skills and minimize restrictions on the child's access to typical learning experiences and interactions.

NOTE:The Individuals with Disabilities Education Act (IDEA) is a federal law that governs how states and public agencies provide early intervention, special education and related services to infants, toddlers, children and youth with disabilities. Each state may administer these services differently. Services provided through IDEA may be in addition to what it is already provided through TRICARE. It is important to sign up through your states program(s) as soon as you are aware of the ASD diagnosis. To enroll in services, visit the Office of Special Needs: Education directory for children with special needs at Military Community and Family Policy or Center for Parent Information and Resources.


Medication

There are currently no medications to cure ASD or treat all of the main symptoms. Qualified healthcare providers can prescribe medication to help treat some symptoms and behaviors so individuals with ASD can focus on other things, such as learning and communication. Medication may be used to manage irritability, inattention, inability to focus, depression, seizures, aggression, and to reduce self-injury.

NOTE: Medication is most effective when used in combination with behavioral therapies.


Learn more

Step 3: Education

Starting treatment is only the beginning of the journey. ASD is a lifelong condition and to ensure people with ASD and their families get the best care, continued learning is essential. Learn more about ASD by exploring the following sections:

Step 4: Support

Caring for a loved one with ASD can be tough. ASD is a lifelong condition and we want to ensure people with ASD and their families get the best support. Explore Caregiver support for help to be at your best so you can provide the best care.