The diagnosis of children with PDD-NOS or ASD has become an urgent need for child development services, in view of the rising incidence of the condition in the western world, with emphasis on early diagnosis. The Merkaz Shalom CDC has developed a rapid pathway for early diagnosis using the multidisciplinary team for children under three years with suspected ASD. Some of these children will have a "working diagnosis" of ASD .
The "Autism Law" enacted in Israel has resulted in some ethical dilemmas for the CDC team. Firstly, many parents pressure the team to label the child with ASD in order to receive the financial benefits of the law. Secondly, a number of children under age three years with an uncertain diagnosis in the CDC, have received the diagnosis of ASD from a single outside consultation by a developmental pediatrician or child psychiatrist, due to the desire of the parents to receive the diagnosis of ASD.
Charman and Baird (2002) have suggested caution in diagnosing ASD in the young, and not relying only on formal evaluation instruments, stressing the importance of observing children interacting with their peers and the importance of the clinical evaluation by trained professionals. Premature labeling with ASD will influence the perception of the child by both the family and those working with the child. The presentation of a "working diagnosis" is usually understood and acceptable to parents and should replace the trend to rapid diagnosing of ASD. CDC professionals must preserve ethical standards of care and resist pressures to label children with ASD.