Getting your child tested for autism starts with your pediatrician, who can perform an initial screening and then refer you to a specialist for a full diagnostic evaluation. The process typically involves two stages: a brief screening questionnaire at your child’s regular checkup, followed by a more in-depth assessment with a developmental specialist if concerns arise. The entire process can take anywhere from a few weeks to over a year depending on where you live and which specialists are available.
Start With Your Pediatrician
Your child’s pediatrician is the first stop. The American Academy of Pediatrics recommends autism-specific screening at the 18-month and 24-month well-child visits, but you can request a screening at any point if you have concerns. The most commonly used tool for toddlers is the Modified Checklist for Autism in Toddlers (M-CHAT), a parent-completed questionnaire designed for children between 16 and 30 months. It asks about behaviors like whether your child points at things, responds to their name, or makes eye contact. A score of 3 or higher, or a score of 2 on certain critical items, triggers a follow-up interview to determine whether a specialist referral is warranted.
If your child is older than 30 months, your pediatrician will likely use different screening tools or simply discuss your concerns and observe your child’s behavior during the visit. Either way, the pediatrician’s role is to decide whether a full evaluation is needed, not to make the final diagnosis.
Who Does the Full Evaluation
A formal autism diagnosis comes from a specialist. The CDC lists several types of professionals qualified to evaluate and diagnose autism: developmental-behavioral pediatricians, neurodevelopmental pediatricians, child neurologists, and geneticists. Psychologists and neuropsychologists also conduct evaluations, and some early intervention programs offer assessment services.
The best fit depends on your child’s age and situation. Developmental-behavioral pediatricians are often considered the gold standard for young children because they specialize in exactly this type of evaluation. Neuropsychologists are particularly helpful for school-age children because their assessments also map out cognitive strengths and weaknesses, which is useful for educational planning. If your pediatrician suspects a genetic condition may be involved, they may refer you to a geneticist as well.
What Happens During the Evaluation
A comprehensive autism evaluation is not a single test. It’s a collection of observations, interviews, and assessments that together build a detailed picture of your child’s development. The evaluation typically includes a parent interview covering your child’s developmental history, direct observation of your child, cognitive and language testing, and sometimes additional medical tests.
One of the most widely used diagnostic tools is the Autism Diagnostic Observation Schedule (ADOS-2), a 40- to 60-minute session in which a trained clinician interacts with your child using specific activities and materials designed to create social situations. The examiner watches how your child communicates, relates to others, and responds to both structured and unstructured social moments. They rate both spontaneous and prompted behaviors across communication, social interaction, and repetitive or restricted behaviors.
Parents are usually interviewed separately, either through a structured interview tool or a detailed conversation about their child’s developmental milestones, daily routines, and behavior patterns. The clinician wants to understand not just what your child does in the office, but how they function across different settings.
Additional Tests That May Be Ordered
The evaluation often includes tests to rule out other conditions that can look like autism or occur alongside it. A hearing evaluation with an audiologist is common, since hearing loss can cause speech delays and social difficulties that mimic autism. If the family history, physical exam, or clinical picture suggests an underlying medical or genetic condition, a genetics evaluation may be recommended.
Conditions like chronic headaches, gastrointestinal problems, and sinus issues can increase behavioral symptoms that overlap with autism. Ruling these out helps the team ensure the diagnosis is accurate and that treatable conditions aren’t being missed. The goal is a complete picture, not just a label.
What the Diagnosis Looks Like
To receive an autism diagnosis, a child must show difficulties in all three areas of social communication: back-and-forth social interaction, nonverbal communication like eye contact and gestures, and developing and maintaining relationships with peers. They must also show at least two of four types of restricted or repetitive behaviors. These include repetitive movements or speech patterns, rigid adherence to routines with distress at small changes, intensely focused interests, and unusual reactions to sensory input like strong dislike of certain sounds or textures, or a lack of reaction to pain.
These behaviors must be present from early childhood, even if they weren’t recognized at the time, and they must meaningfully affect daily functioning. The diagnosis also includes a severity level from 1 to 3, which reflects how much support your child needs. Level 1 means the child needs some support, Level 2 means substantial support, and Level 3 means very substantial support. This level can change over time as a child develops and receives services.
Wait Times Can Be Long
One of the biggest frustrations parents face is the wait. A survey of autism diagnostic centers conducted in late 2022 and early 2023 found that nearly two-thirds of centers had wait times longer than four months. About 31% reported waits of four to six months, 15% had waits of seven to eleven months, and over 15% reported waits exceeding one year or had stopped accepting new patients entirely. Only 13% of centers could see families within four weeks.
These delays vary significantly by region and by the type of specialist. Urban areas with major children’s hospitals sometimes have the longest waits because of high demand, while some rural areas have few specialists at all. Private-pay evaluations, where you pay out of pocket rather than through insurance, can sometimes shorten the wait, but they are expensive and not accessible to every family.
What You Can Do While Waiting
You don’t have to wait for a formal diagnosis to start getting your child help. If your child is under 3, contact your state’s early intervention program. These programs are federally mandated and provide services like speech therapy and developmental support based on developmental delay alone, without requiring an autism diagnosis. Your pediatrician can make the referral, or you can contact the program directly.
For children 3 and older, your local school district is required to evaluate your child for special education services if you request it in writing. The school’s evaluation is separate from a medical diagnosis and focuses on how your child’s development affects their learning, but it can unlock speech therapy, occupational therapy, and classroom accommodations while you wait for the clinical evaluation.
Keep a log of specific behaviors that concern you, including when they happen and how often. Note your child’s responses to social situations, changes in routine, sensory experiences, and communication attempts. This kind of detailed, concrete information is extremely valuable to the specialist when you do get your appointment, and it helps ensure nothing important is overlooked during a single evaluation session.