Is it Time to Seek Out a Diagnostic Evaluation for my Child?

• As a parent/caregiver you feel like you want more answers about your child’s development.
• Your child did not meet expected early developmental milestones in the areas of non-verbal communication (e.g., not using gestures such as waving and/or pointing).
• Your family has seen a regression in language development.
• You have been hearing from your child’s daycare provider that your child is not as engaging in the classroom activities and/or prefers to play by herself for long periods of time.
• Early on in her development, she was not as interested in babbling back and forth, or playing peek-a-boo or rolling a ball back and forth (e.g., reciprocal play).
• As a caregiver, you see that your child can be quite inflexible and wants to do her own thing and this takes up a significant part of the day impacting the daily routine and eating and/or transitions.
• Your child loves to only talk about and play with certain topics/toys more than you think is expected for her age.
• As a parent you see that your child has strong sensory differences such as sensitivities/sensory aversions (e.g., does not like vacuum, loud noises, busy environments) or sensory seeking behaviors (e.g., needing to move more, likes deep pressure and seeks it out with hugs for example).
• You hear your child repeating what you say often or repeating back what she hears either a teacher say or the television for example.

The next step is to seek out consultation with your pediatrician.

Prior to meeting with your child’s pediatrician, it may be important to document your child’s behaviors, write out a list of questions as well as your concerns. You may want to gather additional information about your family’s history, and current videos of your child.

• Ask your pediatrician about the clinical diagnosis of autism and what that would look like at your child’s age.
• Discuss your questions and concerns with your pediatrician and talk about if your pediatrician sees any of the characteristics of an autistic child in your child.
• Consider having the pediatrician do additional testing in the office such as the MCHAT or Ages and Stages Questionnaire (https://agesandstages.com/products-pricing/asq3/).
• Ask your pediatrician about a short-term plan and steps along the way to figure out what is best for your child and her development. If your sixth sense is to move forward but your pediatrician is hesitant, we would suggest going with your gut feeling.

• This is an important step in that regardless if your child is autistic or not, if delays are present, then early intervention is proven in the literature to help, the earlier this happens the better (https://www.zerotothree.org/resource/what-you-need-to-know-early-intervention/).
• Ask your pediatrician for resources in your area as to where to find information on early intervention through your county and private practice practitioners who perform speech therapy, occupational therapy and physical therapy in your community.
• Find out where you can obtain an autism evaluation, and how to go about getting on waitlists if needed. You can obtain an evaluation through local hospitals and universities for example and/or go through private providers. Your pediatrician likely has a list of both.

Generally the process for an autism evaluation involves a parent completing paperwork about the child’s developmental history and current functioning and then the examiner getting more in depth information about the child in a clinical intake. After this, the examiner meets your family and the evaluation should be at least 1-2 hours since young children can take time to warm up.

You will be with your child for this portion of the evaluation which is a semi-structured play based assessment. During this, the examiner should be making sure to make your child as comfortable as possible and checking in throughout that your child is acting like he/she does at home for the most part.

You will be given some measures to complete to further understand your child’s development (especially her strengths), daily living skills, and behaviors. A feedback session should occur about 2-4 weeks after the evaluation with the clinician giving you her impressions and developing a short-term plan of care.

We do all of the above, while making sure that your family is clear on what we are doing. Our approach is caring, careful and comprehensive. The Ally clinicians meet your family where you are and focus on the strengths of your child as well as helping you understand what you child may need moving forward.

Dr. Sharon Singh, PhD, is a developmental psychologist with over 17 years of experience conducting comprehensive developmental and diagnostic evaluations for young children. Originally from Arlington, TX, Dr. Singh is passionate about making a difference in the lives of families as early as possible so that their child has the best outcome for the future. Alongside Ally Behavior’s team of developmental pediatricians and clinical psychologists, Dr. Singh prioritizes helping families feel comfortable, understood, and empowered to advocate for their child.