Autism Evaluations

Autism, or autism spectrum disorder (ASD) is a developmental disability that affects a child’s social skills, including how they interact and communicate with others. The term spectrum refers to the wide range of symptoms and degree to which children may be affected. For example, some children with ASD can talk, while others cannot; some children with ASD may be able to learn at the same pace as their peers with little or no assistance, while others may need assistance; and some children with ASD may be able to live on their own as adults, while others may not. 

About 1 in 31 U.S. children (3.2%) are identified as autistic by the time they are 8 years old, according to a 2025 report from the Autism and Developmental Disabilities Monitoring Network. The report was based on data collected at 16 sites throughout the United States in 2022.

A diagnosis of autism is made based on several factors. These include your description of your child's development, plus careful observations of certain behaviors by your pediatrician, autism experts, medical tests and your child's history.

The American Academy of Pediatrics (AAP) recommends all children be screened for autism at their 18- and 24-month well-child checkup. We also recommend that all children have regular developmental screening to check for differences or delays in areas such as language/speech, gross motor, fine motor and social-emotional development.

We know that early diagnosis of autism is good for children and families. You can start to get the support your child needs sooner and better understand how your child thinks and communicates.

If you have concerns or questions about how your child is developing, it is OK to ask your doctor about what screening your child has had. They can discuss with you what the measures show. You can also access information and tools to monitor your own child's development through the CDC. Additional resources and supports are available through organizations such as your state or jurisdiction Family to Family Health Information Center.

Partnering with your child's pediatrician

Early diagnosis of autism requires a partnership between parents and pediatricians.

Within this partnership, you should feel comfortable bringing up anything you are noticing about your child's behavior or development—the way your child plays, learns, speaks and acts.

Sharing what you've observed

Likewise, the pediatrician's role in the partnership is to listen and act on your observations and concerns. If you feel you are not being heard or your concerns are not being taken seriously, get a second opinion. HealthyChildren.org also offers resources to help you find another pediatrician who is a member of AAP.

Asking & answering questions

During your child's visits, the pediatrician may ask specific questions or complete a questionnaire about your child's development. Pediatricians take these steps because they understand the value of early diagnosis and services. They also know where to refer you for further assessment and support. The importance of this partnership cannot be stressed enough.

Behavioral testing

If your child is showing features of autism, your pediatrician can help you get further testing. An autism diagnosis generally requires specific behavioral testing and observations. It also involves getting lots of information from your family about your child.

Primary care pediatricians can diagnose autism, or your pediatrician may refer you to a developmental pediatrician, child psychologist, or other autism specialist to complete testing.

There is no single, common reason why children and adults are autistic. Many factors may lead to a diagnosis of ASD. Scientists continue to learn more about what causes ASD. 

We currently know that-

• Families do not cause ASD. 
• Vaccines do not cause ASD.
• Family medical history may tell us something. If a family already has a child diagnosed with ASD, the chance that a sibling might also have ASD is 10 to 20 times higher than for the general population. Studies have shown that relatives of children with ASD are more likely to share some similar social and behavioral characteristics to those seen among children with ASD. However, these characteristics may not be severe enough to merit a diagnosis.
• Most children with ASD do not have a specific medical condition or genetic condition that explains their ASD. However, ASD may occur more often in children with certain medical conditions or high risk factors. These medical conditions can include fragile X syndrome, tuberous sclerosis complex, Down syndrome, or other genetic disorders. Infants born preterm are another high-risk group. Considering whether a child with ASD has a genetic condition is an important part of the initial evaluation. Research so far points to multiple influences, much of it genetic, and also environmental factors.
• There are specific differences in brain function between a child with ASD and a child without ASD.
• Potential environmental factors are also an important area of research and are not yet well understood.