If you are wondering whether your child might be autistic, you do not have to wait for certainty before you ask for help. Here is how the process usually goes.
1. Start with what you notice
Write down what you see: how your child plays, talks, responds to their name, handles changes, and reacts to sounds or textures. Short notes with dates are more useful to a doctor than a general worry. Short video clips of the behaviors you are asking about can help too.
2. Ask about screening at a well-child visit
Screening is a short questionnaire or checklist, not a diagnosis. The American Academy of Pediatrics recommends developmental screening at 9, 18 and 30 months, and autism-specific screening at 18 and 24 months. If your child's doctor has not offered a screening, you can ask for one. You can also ask at any other age if you have a concern.1
3. Get a formal evaluation
If screening raises a concern, the next step is a longer evaluation by one or more specialists, such as a developmental pediatrician, a child psychologist, a speech-language pathologist or an occupational therapist. They watch your child, ask you questions and may use structured tests. The result describes your child's strengths and challenges, and shows whether they meet criteria for an autism diagnosis.1 There is no blood test or scan for autism.
4. Do not wait on the waitlist alone
Evaluation waitlists can be long. Get on more than one list, ask each clinic how long the wait is, and ask your child's doctor whether an earlier appointment exists elsewhere. You can also start a separate, free track at the same time (next step).
5. Ask about early intervention or the school system
Every state and territory has a public early intervention program for babies and young children. Eligibility is based on an evaluation of your child's skills, and a doctor's referral is not necessary. CDC suggests calling your state's program and saying that you have concerns about your child's development and would like them evaluated. For a child age 3 or older, CDC suggests calling any local public elementary school and asking for an evaluation for preschool special education services.2 These can start before a medical diagnosis.
6. If your child has Medicaid
Medicaid's EPSDT benefit covers screening, diagnosis and treatment for enrolled children under 21, including developmental screening and services that are medically necessary to correct or improve a condition.3 Rules for how to get ABA and other services differ by state. For example, Washington's Health Care Authority says Apple Health ABA starts with an evaluation by an approved Center of Excellence provider.4 Ask your state Medicaid office or health plan what your state requires.
Questions to ask the clinic
- How long is the wait for an evaluation, and can we be on a cancellation list?
- Who will do the evaluation, and how many visits does it take?
- Will we get a written report we can share with schools and therapy providers?
- Does our insurance cover it, and do you need a referral?
1. CDC, Screening for Autism Spectrum Disorder.
2. CDC, Early Intervention.
3. Medicaid.gov, EPSDT.
4. Washington State Health Care Authority, Applied Behavior Analysis.
This guide is general information, not medical or legal advice. Talk with your child's doctor and your health plan about your situation.
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