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We start screening your baby for signs of developmental or communication challenges like autism spectrum disorder (ASD) from his or her very first well-child visit. We ask parents a lot of questions and also observe how your baby giggles, looks to you for reassurance, tries to regain your attention during a conversation, points or waves, responds to his or her name, and cries.

Those observations in combination with family history, health examinations, and parental perspectives remain extremely valuable in helping identify children at risk for ASD.

Formalized Autism Screening Recommended at the 18- and 24-Month Well-Child Visits:

The American Academy of Pediatrics (AAP) recommends screening all children for autism at the 18 and 24-month well-child visits in addition to regular developmental surveillance. This type of screening can identify children with significant developmental and behavioral challenges early, when they may benefit most from intervention, as well as those with other developmental difficulties. For screening to be effective, it must be applied to all children – not only those with symptoms.

Modified Checklist for Autism in Toddlers (M-CHAT): In most offices, pediatricians use the M-CHAT, a 23-point questionnaire filled out by parents. Most families find it easy to fill out. Using this standardized screening, pediatricians can pick up children at risk for ASD and will be prompted to start conversations about language delay, concerns about behavior, or possible next steps for a child at risk with additional genetic, neurologic, or developmental testing.

Screening Isn’t Diagnosing!

It’s important to note that screening isn’t diagnosing. If your child has a positive screen for an ASD, it doesn’t mean he or she will be diagnosed on the spectrum. And further, if your child screens normally but you continue to worry about ASD, don’t be shy. Screening tests are just that—screening—and don’t identify all children with ASD. The rate of success for the M-CHAT, for example, isn’t 100%, so it is used in combination with health and family history to identify children at risk. Your opinions as a parent are irreplaceable and of the most importance.

If You Are Concerned and Your Child Has Not Been Formally Screened:

Talk with your pediatrician about doing a formal screening. Many screening tools are available.

But know this: If you are concerned about your child’s communication or behavior due to a family hi​story of ASD, the way he or she talks or acts, or other people’s comments about his or her behavior, don’t wait to talk with your pediatrician about doing more. If the first doctor doesn’t respond to you or take you seriously, get a second opinion.

Additional Information:

Adapted from Mama Doc Medicine: Finding Calm and Confidence in Parenting, Child Health, and Work-Life Balance (Copyright © 2014 Wendy Sue Swanson)