When to Have Your Child Evaluated for Autism

painting of boy on bricks

Your toddler or preschooler is developing differently. His speech is delayed, he has some odd behaviors, and he loves to do the same things over and over again. He has a tough time with loud noises and has difficulty interacting with his same age peers.

Is he autistic? The answer, of course, is maybe.

Is now the right time to ask for an evaluation from a developmental pediatrician or medical team that could, potentially, lead to the label of "autism" being pinned to your child's chest for the rest of his life?

The answer to that question will depend upon a large number of factors.

How Old Is Your Child?  

Normal children really do develop at different rates. The fact that your neighbor's child is precocious doesn't mean that your child is delayed! Do check carefully to be sure that what you are perceiving as delays aren't really normal developmental variations.

How Significant Are Your Child's Symptoms?  

A diagnosis of autism is not given lightly. A child's symptoms must significantly impair their ability to communicate, take part in ordinary activities, and connect socially. Usually, serious concerns about a child's development come not only from a parent's observation but also from teachers, doctors, extended family, and others who see significant issues. If the differences you're observing are slight, or if your pediatrician sees no cause for concern, you may want to take a "watchful waiting" approach.

How Do You, Personally, Feel About a Label?  

Some parents feel that labeling a child as "autistic" is problematic, and worry that such a label could cause more harm than good. They may feel that a label pathologizes differences that are simply personal traits -- and they wish to avoid labeling as long as it is feasible. Other parents feel that a label is a useful tool for understanding, coping with, and finding support.  By giving "differences" a name, they feel, they can move forward to provide their child with helpful supports, treatments, and opportunities.

Are There Benefits to an Autism Diagnosis?  

Depending on where you live, an autism spectrum diagnosis may be the very best way to get necessary services and treatments for your child. In some areas, however, the diagnosis may access few state or local resources.  Some health insurance provides funding for children ONLY when they have the autism diagnosis; others provide services no matter what the diagnosis.

Can You Access the Same Supports and Services With or Without a Diagnosis?  

Many of the treatments that are usually offered to a child with autism can be accessed without the diagnosis -- if you have the time, money, and desire. For example, it is perfectly possible to hire a behavioral or developmental therapist privately, and it's equally possible to learn to provide a range of therapies yourself. RDI, Floortime, SCERTS, and many other well-researched developmental therapies are usually provided by parents with or without support. Occupational, speech, and physical therapy can be prescribed by your pediatrician based on specific concerns that don't rise to the level of a full autism spectrum diagnosis.

How Do Your Local Schools And/Or Early Intervention Programs Treat "Differences" Versus Diagnoses?

In theory, school districts should provide preschool or school supports to each individual child based on their needs rather than their diagnosis. In practice, however, this approach is almost impossible to manage. If you have a group of same-age children with an autism spectrum diagnosis, it makes sense to hire a teacher with experience and training specific to children with autism. If your child could benefit from such a classroom -- but does not have an autism diagnosis -- will your district agree to place your child in that setting?

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