Diagnostic Process

If you are concerned that your child might be on the Autism Spectrum, ask your GP to carry out a screening assessment and if he/she is concerned, to write a referral letter.

In some cases, a referral letter can also be written by one of the following:

  • Occupational therapist
  • Speech and language therapist
  • Teacher

Once you have a referral letter, make an appointment with one of the following professionals:

  • Developmental paediatritican (government or private)
  • Clinical Psychologist
  • Educational Psychologist
  • Psychiatrist


(Click here for a list of service providers or please contact us for further information.)

There may be a waiting period to see a specialist for a diagnosis. Please just be patient. The ideal situation is for the diagnosis to be conducted by a team of specialists.

Once the doctor / psychologist / psychiatrist has diagnosed your child with ASD, they should write a referral report, which they will then send to the Western Cape Department of Education (WCED).

The WCED then processes your child’s referral and their name will be placed onto the central waiting list for an appropriate school, based on the level of support needed.

Some tests, which may be conducted by the professional diagnosis include the following:

  • ADOS (Autism Diagnostic Observation Schedule)
  • ADI-R (Autism Diagnostic Interview – Revised)
  • Griffiths Mental Development Scale
  • MChat (Modifies Checklist for Autism in Toddlers) – A parent questionnaire – screening tool

DSM-V Diagnostic Criteria

The following criteria must be met for a diagnosis of Autism Spectrum Disorder to be given (according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5):

A. Persistant deficits in social communication and social interaction across multiple contexts, manifested by the following:

  1. Deficits in social-emotional reciprocity
    • E.g. Abnormal social approach
    • Inability to have back and forth converstaion
    • Reduced sharing of interests and emotions/affect
    • Failure to initiate or respond to social interactions
  1. Deficits in nonverbal communicative behaviours used for social interaction
    • E.g. Poorly integrated verbal and non-verbal communication
    • Abnormalities in eye contact and body language
    • Deficits in understanding and use of gestures
    • Lack of facial expression and non-verbal communication
  1. Deficits in developing, maintaining and understanding relationships
    • E.g. Difficulties in adjusting behaviour to suit various social contexts
    • Difficulties in sharing imaginative play or in making friends
    • Absence of interest in peers

B. Restricted, repetitive patterns of behaviour, interests, or activities, as manifested by at least TWO of the following:

  1. Stereotyped or repetitive motor movements, use of objects, or speech
    • E.g. Simple motor stereotypes
    • Lining up of toys
    • Flipping objects
    • Echolalia
    • Idiosyncratic phrases
  1. Insistence on sameness, inflexible adherence to routines, or ritualised patterns of verbal or nonverbal behaviour
    • E.g. Extreme distress at small changes
    • Difficulties with transitions
    • Rigid thinking patterns
    • Greeting rituals
    • Need to take same route or eat same food everyday
  1. Highly restricted, fixated interests that are abnormal in intensity or focus
    • E.g. Strong attachment to or pre-occupation with unusual objects
    • Extremely restricted or persistent interests
  1. Hyper-or hypoactivity to sensory input, or unusual interests in sensory aspects of the environment
    • E.g. Apparent indifference to pain/temperature
    • Adverse response to specific sounds or textures
    • Excessive smelling or touching of objects
    • Visual fascination with lights or movement



 Level 1:            “Requiring some support”


  • Able to speak in sentences ad engages in communication
  • But reciprocal communication fails
  • Attempts to make friends are odd, and usually unsuccessful


Level 2:            “Requiring substantial support”


  • Speaks simple sentences
  • Interaction limited to narrow special interests
  • Markedly odd nonverbal communication


Level 3:            “Requiring very substantial support”


  • Few words of intelligible speech
  • Rarely initiates interaction
  • Unusual approaches to meet needs only
  • Responds only to very direct social approaches