At a glance
- A pattern across communication, interaction and behavior matters more than one isolated sign.
- AAP recommends autism screening at 18 and 24 months, and whenever there is a concern.
- Loss of words or other skills needs prompt discussion; do not wait for the next routine checkup.
What early signs are worth discussing?
Examples include responding inconsistently to their name, using few gestures, or rarely pointing to share something interesting. You might notice less back-and-forth play, repetitive movements or play patterns, strong reactions to sounds or textures, or difficulty with changes in routine.
Children vary, and some children without autism show some of these behaviors. Speech delay alone does not establish autism. Share specific examples of your child's strengths as well as things that are difficult. Tell the clinician promptly if previously used words, social skills or other abilities have been lost.
What happens at autism screening?
At the 18- and 24-month visits, a pediatrician may use a standardized questionnaire along with discussion and observation. Screening identifies children who may need a fuller evaluation; it is not a diagnosis. A reassuring screen does not mean you should ignore ongoing concerns.
An assessment looks at development and medical history. The clinician may recommend hearing testing, speech-language assessment or a specialist evaluation, depending on the concern. There is no need to wait for a routine screening age to raise a question.
Can we get support while waiting for an evaluation?
Yes. In the United States, families of children younger than 3 can contact their state or territory's early intervention program directly to request an evaluation. A doctor's referral or an autism diagnosis is not required to make that request. Eligibility and available services depend on the evaluation and local program.
For a child age 3 or older, contact the local public school district about an evaluation, even if the child is not enrolled there. The pediatrician can also help arrange services for identified needs. Support can focus on communication, everyday skills and family priorities while diagnostic appointments are pending.
What should I bring to the appointment?
Write down what you have noticed, when it began and whether any skills were lost. Include examples from home and childcare, words or gestures your child uses, things they enjoy and situations they find hard. Brief videos of ordinary play can help if your clinician welcomes them. Ask who will arrange referrals and when to follow up so the next step is clear.
Common questions
Can a child make eye contact and still be autistic?
Yes. Eye contact alone cannot confirm or exclude autism. Evaluation considers the broader pattern of development and behavior.
Should we wait and see if our toddler catches up?
Discuss concerns now, especially loss of skills. Evaluation may identify autism, a different developmental need or variation that can be followed. Early support can address the child's current needs.
Sources
- CDC — Signs and symptoms of autism spectrum disorder
- CDC — Clinical screening for autism
- AAP — How pediatricians screen for autism
- CDC — Early intervention and how to request an evaluation
Written for Pedemy in our own words from the sources above; checked 2026-11-03. For education only, not medical advice. Pedemy is independent and not affiliated with or endorsed by the organizations cited.