The contribution of speech-language pathology in an interdisciplinary assessment protocol for diagnostic investigation in suspected ASD cases

Introduction: Autism Spectrum Disorder (ASD) is defined by a set of behavioral, interaction, and social communication impairments associated with rigid and repetitive patterns. For its diagnosis, a speech-language assessment is essential to describe language-related elements, particularly pragmatic skills. Objective: To present a speech-language assessment proposal within a protocol developed by an interdisciplinary team composed of a neuropsychologist, a child and adolescent psychiatrist, and two speech-language pathologists for ASD screening in children with complaints related to behavior, interaction, and social communication. Method: The structured protocol for speech-language assessment is divided into three stages. In the first stage, free play observation is conducted, along with the application of the Pragmatic Skills Assessment Protocol for children with Autism Spectrum Disorder (PAHPEA). In the second stage, standardized child development scales are used according to age group (Bayley III, Vineland - 3rd edition, and IDADI). In the third stage, the TiPiTi Language Examination is applied. Results: Seventeen children participated in the study (13 boys, M = 9 years). Among them, seven scored difficulties in social communication on the PAHPEA, showing restricted use of communicative functions and reduced diversification of communication means; nine presented difficulties in adaptive behavior and communication in the Bayley-III, Vineland, or IDADI report scales; and five showed expressive and receptive language difficulties in the TiPiTi. Five children were diagnosed with ASD; one was diagnosed with Attention Deficit Hyperactivity Disorder (ADHD); one was diagnosed with Intellectual Development Disorder; and one received a diagnosis of Selective Mutism. Conclusion: The structured speech-language assessment significantly contributes to clarifying the diagnosis of ASD by encompassing not only oral language evaluation but also the analysis of pragmatic aspects of communication, which are important diagnostic criteria for ASD. Additionally, it aids in ruling out or integrating other neurodevelopmental disorders based on the child`s performance on language tests. Keywords: ASD; assessment; speech-language pathology. Reference: American Psychiatric Association-APA. (2023). *Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR* (Artmed, Org.).