How Do I Get My Child Tested for Autism?

little girl focused on organizing and lining up crayons

Kinzie Riehm / Getty Images

Table of Contents
View All
Table of Contents

There is often nothing about how babies or toddlers with autism spectrum disorder (ASD) physically look that sets them apart from other kids their age. In fact, they may learn to sit, crawl, and walk on time. But as they continue to grow and develop, kids with ASD may communicate, interact, behave, and learn in ways that are different from most other children.

For instance, kids with ASD may have speech and language delays, display behavioral differences, and interact with others in ways that are not quite the same as other kids their age. It is usually at this time that parents start to wonder if something might be wrong.

If you find yourself in this situation—where you wonder if your child might have autism—beginning the assessment process in order to get an official diagnosis may seem like a daunting task. Below we help alleviate some of this stress by discussing how you can go about getting your child tested for ASD including where to start and what signs to look for.

What Is Autism Spectrum Disorder (ASD)?

Autism—or autism spectrum disorder (ASD) as it is now called—is a neurodevelopmental disorder characterized by challenges with social skills, repetitive behaviors, speech issues, and nonverbal communication challenges. ASD is relatively common and always appears during early childhood.

"Currently, one in 44 children in the U.S. are affected by autism, with males being three times more likely to be diagnosed than females," says Christine Eichelberger, PhD, a psychologist at the Center for Autism Spectrum Disorders at Nationwide Children’s Hospital. In part, this ration is likely due to females with ASD being missed because they are more likely to "mask," or hide, their symptoms.

In the past, there were different diagnoses for autism but in 2013, the American Psychiatric Association merged four distinct autism diagnoses into one diagnosis: ASD. Included in this merge is what was originally known as autistic disorder, childhood disintegrative disorder, pervasive development disorder, and Asperger syndrome.

The primary reason for changing the diagnosis to a spectrum disorder is because experts recognized that there is no one type of autism but many subtypes. In other words, each person with ASD has a set of strengths and a set of challenges that are unique to them. The ways in which they learn, speak, think, problem-solve, and communicate can range across a spectrum from highly skilled to severely challenged.

Christine Eichelberger, PhD

While autism is considered a lifelong condition, it is a spectrum and there is wide variation in the type and severity of symptoms people demonstrate.

— Christine Eichelberger, PhD

"While autism is considered a lifelong condition, it is a spectrum and there is wide variation in the type and severity of symptoms people demonstrate," Dr. Eichelberger explains. "According to current DSM-5 diagnostic criteria, there are three levels of autism based on the severity of symptoms and how much support an individual requires: Level 1 (mildest, requiring support), Level 2 (requiring substantial support), and Level 3 (most severe, requiring very substantial support)."

Typically, the signs of ASD appear by age 2 or 3 but some development delays can appear even earlier and kids can be diagnosed as early as 18 months, says Meagan Adley, PsyD, a pediatric psychologist at Cleveland Clinic Children's Center for Autism.

"One of the biggest hallmarks of autism spectrum disorder is difficulty with social engagement," says Dr. Adley. "So, a very young child might have difficulties with back and forth, not make eye contact, seem disinterested, not respond to their name, not have a social smile, not point or wave, and seem fixated on certain objects early on."

Signs of Autism Spectrum Disorder

It is important to note that children will not necessarily display all of these signs. Likewise, the severity with which they display these signs will be different as well. Here are some common signs of ASD:

  • Not displaying big smiles or joyfulness as a baby
  • Avoiding eye contact or having limited eye contact
  • Lacking facial expressions
  • Experiencing delayed language development
  • Refraining from pointing, waving, or reaching
  • Losing previously acquired speech, babbling, or social skills
  • Preferring solitude and alone time
  • Having difficulty understanding feelings or social cues
  • Displaying ongoing repetition of words or phrases
  • Resisting minor changes in routine or surroundings
  • Having restricted interests
  • Engaging in repetitive behaviors (flapping, rocking, spinning, etc.)
  • Having intense or unexpected reactions to sounds, smells, tastes, textures, lights, and/or colors

How ASD is Diagnosed

Diagnosing ASD is a complex process because there is no medical test or blood test to diagnose the disorder. Instead, healthcare providers look at a variety of factors to make a diagnosis including the child’s developmental history and behavior.

"In order to be given a diagnosis of autism, an individual must satisfy the diagnostic criteria outlined in the DSM-5," says Dr. Eichelberger. "This includes deficits in social interaction and communication as well as restricted repetitive and stereotyped patterns of behavior. The symptoms have to exist in early childhood, impair the individual’s functioning, and are not better explained by a different diagnosis."

In the end, diagnosis of ASD is made by using all the information collected by history, observation, and testing. Here are some of the tests and methods that are used to diagnose ASD.

Developmental Monitoring

According to the American Academy of Pediatrics (AAP), pediatricians often begin looking for signs of ASD during the very first well-child visit. In fact, they will watch how your baby laughs, looks to you, attempts to get your attention, uses hand gestures, and even cries. These cues combined with your family history, health exams, and input from you will help them determine if your baby is at risk for ASD.

Often referred to as developmental monitoring, this process involves watching how your child grows and changes over time. Healthcare providers are looking for whether or not your child meets the typical developmental milestones when it comes to speaking, behaving, learning, playing, and moving.

They also might ask you questions about your child’s development as well as talk and play with your little one to see if they are developing and meeting milestones. You also can participate in developmental monitoring. If you notice that your child is not meeting milestones, talk with your child's pediatrician or a healthcare provider about your concerns.

Well-Child Visits and Developmental Screenings

At your toddler's 18- and 24-month well-child visits, the AAP recommends screening all kids for ASD in addition to regular developmental observations. This type of screening can help determine if your child has any significant developmental and behavioral challenges early on. Additionally, screening is recommended for all kids, not just those with symptoms.

Overall, there are a multitude of tools your provider may use to screen your child. The AAP does not endorse one particular type of screening, so your healthcare provider may choose from any number of tools including ages and stages questionnaires, the pervasive developmental disorders screening test-II, communication and symbolic behavior scales, and a modified checklist for autism in toddlers.

Comprehensive Behavioral Evaluations

Although a brief test using a screening tool does not provide an ASD diagnosis, it can provide insight into whether or not your child is on the right development track or if a specialist should take a closer look. If the screening tool identifies an area of concern, a formal developmental evaluation may be needed.

"A team of professionals—a psychologist, speech-language therapist, occupational or physical therapist, and developmental-behavioral pediatrician/psychiatrist/neurologist—observes [your] child’s current behavior, reviews their developmental and medical history, and interviews [you], the parents, in order to determine a diagnosis," explains Dr. Eichelberger. "As part of this assessment, a direct interaction measure such as the Autism Diagnostic Observation Schedule (ADOS) is usually administered by a trained clinician."

Overall, this is a formal evaluation that provides a more in-depth look at your child’s development. These specialists may observe your child, give them a structured test, ask you questions, or ask you to fill out questionnaires.

Genetic Testing

The AAP recommends that families be offered genetic testing, such as Chromosomal Microarray (CMA) testing and Fragile X testing, especially if they are diagnosed with ASD.

Currently, as many as 20% of children with ASD have abnormalities of their chromosomes that can be identified using genetic testing. In fact, some studies indicate that up to 25% to 35% of patients are identified with certain types of genetic tests. 

If your child has unusual physical features or developmental delays or if there is a family history of Fragile X Syndrome, intellectual disability of unknown cause, or other genetic disorders, you may want to talk to your child's healthcare team about genetic testing.

"There are specific genetic conditions—such as Prader-Willi Syndrome, Angelman Syndrome, Rett Syndrome, Landau-Kleffner Syndrome, William’s Syndrome, and Fragile X—which are associated with autistic-like characteristics," Dr. Eichelberger says. "Therefore, the medical component of a formal autism evaluation often includes genetic testing in order to determine any genetic causes of the child’s delays."

Why You Should Get Your Child Tested for ASD

While the thought that your little one might have ASD can feel overwhelming, it is important that you do not ignore the things you are seeing or experiencing. Instead, make sure you bring your concerns to a healthcare provider or your child's pediatrician, Dr. Adley says.

Meagan Adley, PsyD

Research demonstrates that early intervention leads to positive outcomes later in life for people with autism.

— Meagan Adley, PsyD

"Research demonstrates that early intervention leads to positive outcomes later in life for people with autism," Dr. Adley says. "So, the sooner a child is diagnosed, the better the outcome. Starting early can help the child learn better coping strategies and give both the parents and the child access to education and support early."

Plus, once a child is tested and receives a diagnosis, they can begin evidenced-based therapies and have access to supports, services, and accommodations that can improve their outcome and quality of life, Dr. Eichelberger says. Since the spectrum is so wide, these therapies and supports can vary for different kids, so it's important to consult with your provider before determining a course of action.

Certain therapies, and funding for those therapies, rely on having a formal diagnosis of autism from a trained professional, she says. Early intervention can be crucial to your child's future success.

"[Plus] the brain is more malleable in the first few years of life, [and] it is easier to help young children reach important developmental milestones in the areas of social skills, communication, motor skills, and self-help skills," Dr. Eichelberger says. "Starting early intervention also results in reduced frustration for the child and fewer problem behaviors."

A Word From Verywell

If you suspect that your child might have ASD, do not hesitate to bring your concerns to your child's pediatrician or a healthcare provider. They can provide some initial screening and refer you to specialists if additional testing is needed.

Remember, the sooner you receive an official diagnosis, the better it is for your child in the long run. Aside from the fact that early diagnosis can benefit both you and your child, there also is a chance that your child could have something other than ASD, so it is important to be upfront with your providers about what you are witnessing at home.

8 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Pediatrics. What are the early signs of autism?

  2. Centers for Disease Control and Prevention. Autism spectrum disorder.

  3. Autism Speaks. What is autism?

  4. Autism Speaks. What are the signs of autism?

  5. American Academy of Pediatrics. How pediatricians screen for autism.

  6. Centers for Disease Control and Prevention. Screening and diagnosis of autism spectrum disorder.
  7. American Academy of Pediatrics. If autism is suspected, what's next?

  8. Wiśniowiecka-Kowalnik B, Nowakowska BA. Genetics and epigenetics of autism spectrum disorder-current evidence in the field. J Appl Genet. 2019 Feb;60(1):37-47. doi:10.1007/s13353-018-00480-w PMID:30627967

Additional Reading

By Sherri Gordon
Sherri Gordon is a published author and a bullying prevention expert.