Diagnosis for Children

There is a difference between a medical diagnosis, an educational assessment (for special education services) and a Regional Center assessment.  It is possible to have a medical diagnosis and not qualify for services.  We recommend you seek out a formal medical diagnosis through your health care provider as soon as possible.  A medical diagnosis may give you access to certain services covered under your health insurance, and it may provide an outside source of information if you choose to pursue services through the school or Regional Center.

There are no medical tests for diagnosing autism. An accurate diagnosis must be based on observation of the individual’s communication, behavior, and developmental levels. Because many of the behaviors associated with autism are shared by other disorders, various medical tests may be ordered to rule out or identify other possible causes of the symptoms being exhibited. A developmental pediatrician, a psychiatrist or psychologist, or a neurologist can assist in making a diagnosis.

This brochure was developed in collaboration with community partners to help explain the roles of medical insurance, Regional Center, and school districts as parents work on attaining a diagnosis and services for their child or adult.

Autism can sometimes be detected at 12 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable. However, many children do not receive a final diagnosis until much older which means they miss out on important early intervention.

Even if your child does not have all the symptoms of autism, they may be considered developmentally delayed.  If the delay is considered severe enough, they may qualify for free early intervention services.  Children from birth to 36 months can be assessed for free and may receive free services like ABA, Speech Therapy and Occupational Therapy through the Regional Center system. Parents may also be able to qualify for services through their health insurance.

It is not uncommon for us to receive calls from adults who are just discovering they may have autism. The oldest we have heard of is 78 years old! Depending on your insurance, you may need to see a neurologist or a psychologist for an evaluation.

We have compiled these resources below to help an adult who may be on the autism spectrum:

OASIS: Online Asperger’s Syndrome Information and Support. Diagnostic information and resources for treatment. Support areas for families affected by Asperger’s Syndrome.

Liane Holliday – Willey. Professor Liane Holliday Willey is an author, autism consultant, academic researcher, avid horsewoman and owner of an equestrian barn. She has a Doctorate of Education with a specialty in psycholinguistics and learning style differences. Liane likes to share her experiences of living with Asperger’s syndrome with audiences world wide, bringing to each presentation her humor and positive insight along with the real and not so happy memories she has gathered over the years during her stints as a university professor, writer, manure scooper, French fry maker, community volunteer, wife and mother.

Dr. Tony Attwood – author of several books on Asperger’s including Asperger’s Syndrome: A Guide for Parents and Professionals, provides information on diagnosis, problems of social relations, sensory issues, motor control and other typical issues which face people with Asperger’s and their support networks. The book has now been translated into 20 languages.

People with Autism often have problems with social, emotional, and communication skills. They might repeat certain behaviors and might not want change in their daily activities. Many people with ASD also have different ways of learning, paying attention, or reacting to things. Signs of ASD begin during early childhood and typically last throughout a person’s life. Children or adults with ASD might:

  • not point at objects to show interest (for example, not point at an airplane flying over)
  • not look at objects when another person points at them
  • have trouble relating to others or not have an interest in other people at all
  • avoid eye contact and want to be alone
  • have trouble understanding other people’s feelings or talking about their own feelings
  • prefer not to be held or cuddled, or might cuddle only when they want to
  • appear to be unaware when people talk to them, but respond to other sounds
  • be very interested in people, but not know how to talk, play, or relate to them
  • repeat or echo words or phrases said to them, or repeat words or phrases in place of normal language
  • have trouble expressing their needs using typical words or motions
  • not play “pretend” games (for example, not pretend to “feed” a doll)
  • repeat actions over and over again
  • have trouble adapting when a routine changes
  • have unusual reactions to the way things smell, taste, look, feel, or sound
  • lose skills they once had (for example, stop saying words they were using)

Currently, there are no medical test that can diagnose autism. Instead, trained physicians and psychologists administer autism-specific behavioral evaluations.

All children should be screened for developmental delays and disabilities during regular well-child doctor visits at 9 months, 18 months, 24 or 30 months and should be screened specifically for ASD during regular well-child doctor visits at 18 months and 24 months. A developmental screening is a short test to tell if children are learning basic skills when they should, or if they might have delays. During developmental screening the doctor might ask the parent some questions or talk and play with the child during an exam to see how she learns, speaks, behaves, and moves. A delay in any of these areas could be a sign of a problem.

If the doctor have a concern, he or she may send the child for a comprehensive diagnostic evaluation. This thorough review may include looking at the child’s behavior and development and interviewing the parents. It may also include a hearing and vision screening, genetic testing, neurological testing, and other medical testing.

In many areas of California, including the Inland Empire, there is a shortage of physicians who can diagnose Autism. Under the law, patients have the right to schedule with a specialist within three weeks.  It is common for it to take 3 – 9 months before you can get an appointment.  This is too long!

The Autism Health Insurance Project has created a sample appeal letter that you may customize to request a single-case agreement with another qualified autism evaluator. With minor edits, this letter can be adapted to address a need for immediate treatment with a speech, occupational, or other therapists.

According to the California criteria for BHT services you DO NOT have to have a formal autism diagnosis to be eligible to BHT services (ABA therapies).  You do have to meet the following coverage criteria:
1) Be under 21 years of age.
2) Have a recommendation from a licensed physician and surgeon or a licensed psychologist that evidence-based BHT services are medically necessary.
3) Be medically stable.
4) Be without a need for 24-hour medical/nursing monitoring or procedures provided in a hospital or intermediate care facility for persons with intellectual disabilities

The licensed physician and surgeon or licensed psychologist. would be able to make the referral citing that the ABA services were medically necessary to correct or ameliorate behavioral conditions as defined in Section 1905(r).


Developmental Milestones

Every child is different, but experts have a clear idea about the range of normal development from birth to age 5 and signs that a child might have a developmental delay.


Autism Friendly Doctors

We have compiled a list of local doctors and clinics who have extensive experience diagnosing autism. Check out our Resource Guide pages

Diagnosis, Doctors, and Dentist