autism identification TRICARE providers


Explore this section for information and tools to aid the identification and diagnosis of Autism Spectrum Disorder (ASD ).

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Autism Spectrum Disorder (ASD)

ASD is a pervasive neurodevelopmental condition characterized by deficits in two major domains: 1) communicating and interacting with others and 2) restricted and repetitive patterns of behavior and interests.

Impairment is often detected in early childhood sometimes as early as ages 3 to 24 months. However, the degree of impairment varies greatly. If symptoms are mild or being masked by learned compensatory strategies, ASD may go undetected until later in life when social demands exceed the individual’s capacity.

Risk factors

While the exact cause of ASD is unknown, the current scientific consensus suggests that it is caused by a combination of genetic, biological, and environmental variables as outlined below.


Biological variables:

The known biological variables involved in causing ASD include complications during pregnancy or birth, maternal exposure to valproate and thalidomide, and/or low maternal folic acid levels.


Genetic variables:

Advanced maternal age is a known genetic variable in causing ASD. Other known statistics show that boys are roughly four times more likely to develop ASD than girls and siblings diagnosed with ASD increases the chance of developing it by 2-8%. Ten percent of children with ASD are also identified as having other genetic disorders.


Environmental variables:

Research supported by the National Institute of Environmental Health Sciences (NIEHS) indicates that early-life exposure to air pollution is a risk factor for ASD.


Common displays of ASD include:

  • Avoids eye contact
  • Desires to be alone
  • Repeats actions over and over again
  • Fails to observe objects pointed out by others
  • Struggles adapting when routines change
  • Struggles with “pretend” play
  • Repeats or echoes words and phrases
  • Fails to point at objects of interest
  • Shows unusual reaction to sensory stimuli
  • Regresses from previously attained milestones
  • Struggles relating to and/or lacks of interest in other people
  • Appears unresponsive to others but responds to certain sounds
  • Difficulties expressing their needs using typical words or motions
  • Prefers not to be held or cuddled, or might cuddle only when they want to
  • Displays interest in people but has trouble talking, playing, or relating to others
  • Struggles understanding people’s feelings and/or discussing their own feelings

Surveillance and screening

Research shows that early detection and intervention can prevent more serious problems in young adulthood and beyond. Routine developmental surveillance and screening is the best ways to help ensure ASD is detected and diagnosed early. Plus, it helps identify who can be appropriately referred for further evaluation and assessment.

Best practice: Providers should conduct routine developmental surveillance and perform age-appropriate screenings whenever parents or caregivers raise concerns about the child’s developmental progression. Routine developmental screenings are recommended at 9-, 18-, 24-, and 36-months and providers should screen specifically for ASD at 18- and 24-months.

View ASD specific screening tools

Screening tools and early intervention for providers

Tips to educate parents to support early detection and intervention: