Laboratory Testing, Medical Consensus Guidelines
According to the recent recommendation of the American Academy of Neurology, almost no tests at all are required for most children with mild ASD. Specific testing should be considered according to the specific finding on history or examination.
A hearing test is indicated for all children with any type of speech delay or evoked potential testing (brainstem auditory evoked responses, BAER) for hearing evaluation. Specific developmental testing should also be performed, including an IQ test if indicated.
Lead Level Test
Lead level should be checked mostly in children who have PICA, where “everything goes to the mouth.”
A high-resolution chromosomal analysis is suggested in these children where indicated, mostly to detect Fragile-x, the Prader Willi, or Angelman’s syndromes. This is mostly performed when the child looks dysmorphic (unusual), or the head size is small (microcephally).
Blood Metabolic Testing
Not routinely suggested and should be considered when a regressive pattern is suspected or other clinical evidence leads one to suspect such a disorder.
An EEG is a brain wave analysis. It is suggested in those who have a regressive pattern to rule out Laundau Kleffner syndrome or other forms of seizures.
Imaging (Head CT or MRI)
Not routinely suggested, imaging should be considered if Touberouse sclerosis is suspected or other structural brain abnormalities are considered.
Tests Specifically Not Suggested on a Routine Basis
The following tests are not suggested on a routine basis: hair analysis, celiac antibodies, allergy testing and fungal immunologic, neurochemical micronutrients, and vitamin testing. Also stool, urine analysis, thyroid, lactic acid, or other sophisticated specific metabolic testing maybe be avoided.