Before an individual is suspected of having any medical condition or even a disorder, they usually exhibit some signs and symptoms. Red flags are the signs and symptoms seen. The term ‘red flag’ was originally associated with back pain in early 1980. Since then, numerous red flags for different conditions have been created. The presence of red flags indicates the need for investigation and or referral.
Autism Spectrum Disorder (ASD) has several red flags that can be identified by the parents, caregivers, teachers, occupational therapists, speech and language therapists. Within the school setting, teachers, occupational therapists, speech therapists, and the support staff are able to identify undiagnosed students who experience challenges within this learning environment. Historically, checklists have been instrumental in identifying the red flags of ASD but they are limited in indicating the likelihood of Autism.
One tool that is used to identify the likelihood of Autism is the Gilliam Autism Rating (3rd Edition) GARs-3. It is a norm-referenced screening instrument that has been in use for the past 25 years to identify individuals from 3 through 22 years of age who have severe behavioral problems that might be indicative of Autism. It has 58 clearly stated items that are subdivided into six subscales. These subscales are related to the definition of ASD by the Autism Society and are also based on the diagnostic criteria for Autistic Disorder (DSM-5). The subscales are;
- Restricted, repetitive patterns of behavior, interests, or activities.
- Persistent deficits in social interaction and social communication across multiple contexts.
- Deficits in socio-emotional reciprocity.
- Cognitive style.
- Maladaptive speech.
Interestingly the subscales contain all the red flags for ASD.
In addition to identifying individuals with ASD, the tool can be used for:
- Assessing serious behavioral problems.
- Documenting behavioral progress.
- Targeting goals for Individual Education Plans (IEPs).
- Collecting data for research.
In 2021, a study was conducted in Nairobi, Kenya by two occupational therapists (Perpetua Omondi and Mary Musyoki) within a school set up with an aim of enabling the teachers and parents to know the likelihood of autism in undiagnosed students who exhibited red flags of ASD and create individual intervention plans. The therapists used the GARs-3 to identify the likelihood of autism, target goals for Individual Education Plan (IEPs), and collect data for research.
From their findings, all participants’ scores indicated the probability/likelihood of ASD. The students who score indicated that they required substantial support formed 72% of the total group.
Red flags of ASD are a probable indicator of ASD. It is important that parents, caregivers, teachers, medical personnel, and support staff are aware of the red flags. Knowing these red flags will enable the children/teens/adolescents to access assessments that will aid in the identification of persons with Autism. With further background checks and observations, the level of severity shall be identified hence guiding the level of support required.