Autism can be reliably diagnosed as early as age 2, though some children show signs earlier. The CDC recommends autism screening at 18 and 24 months during well-child visits. While autism can be diagnosed at any age (including adulthood), earlier diagnosis allows children to access intervention services during critical developmental periods.

An autism evaluation is a multi-step process where specialists use interviews, observations, and standardized tools to identify whether your child meets the diagnostic criteria for Autism Spectrum Disorder (ASD), as defined by the DSM-5. There is no single test for autism—it typically takes several appointments to build a complete picture of how your child develops, communicates, and interacts with others.

An autism evaluation helps you understand how your child experiences the world. With a diagnosis, you can access therapies, school accommodations, and support services that fit your child’s needs.

Can you get evaluated too late?
No. While earlier diagnosis means earlier intervention (which research shows improves outcomes), autism evaluation at any age provides value. Late-diagnosed teens and adults often say the diagnosis finally helped them understand themselves.

Autism screening is a brief questionnaire (like the M-CHAT) used during routine pediatric visits to identify children who may need further evaluation. It takes 5-10 minutes and flags potential concerns. The evaluation is a comprehensive, multi-hour assessment conducted by specialists that can definitively diagnose autism spectrum disorder. All children receive screening; only those with concerns proceed to full evaluation.

While the specific tools used, how long the evaluation takes, and how it’s structured will vary based on your child’s age, developmental level, and where they’re being evaluated, a quality autism evaluations should include:

Clinical interviews: In-depth conversations with parents and caregivers gather information about your child's developmental history, behavior patterns, and daily functioning from infancy to the present. During this time, clinicians often utilize the ADI-R (Autism Diagnostic Interview-Revised), a structured parent interview that explores your child’s developmental milestones, early social behaviors, communication development, repetitive behaviors or restricted interests, sensory sensitivities, and family history. This comprehensive interview can take 90 minutes to three hours.

Direct observation and interaction: Your child will engage in structured and semi-structured activities designed to assess communication, social, and behavioral skills. Clinicians often use the ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition)—considered the gold standard for observational assessment—to watch how your child initiates and responds to social bids, engages in imaginative play, handles transitions, responds to their name, makes eye contact, and navigates unexpected changes. The ADOS-2 typically takes 40–60 minutes. While widely regarded as the most comprehensive tool of its kind, clinicians may also use other observational measures and play-based assessments to gain a complete understanding of your child’s abilities.

Multiple perspectives: Input is gathered from parents, teachers, childcare providers, and other adults who interact with your child regularly to understand behavior across different environments. This multi-informant approach is crucial because autism can present differently at home versus school, or with familiar versus unfamiliar people. Clinicians use science-backed tools—most commonly the ASRS (Autism Spectrum Rating Scale)—to analyze these perspectives, along with additional behavior assessments and other standardized measures that help provide a full picture of your child’s strengths and challenges.

Comprehensive reporting: After completing all assessments, the specialist will provide a detailed written report with findings, diagnosis (if appropriate), and specific recommendations for interventions and support. Reports typically include the background information collected, the various assessment results with scores and interpretations, clinical observations, diagnostic conclusions based on DSM-5 criteria, your child's unique strengths and challenges, and concrete recommendations for therapies, educational support, and next steps.

Most commercial insurance plans cover autism evaluations when medically necessary. Coverage typically includes diagnostic evaluation, ADOS administration, clinical interviews, and report writing. Some plans require pre-authorization before the evaluation. Check with your insurance company about your specific benefits for autism assessment and whether pre-authorization is required.

How much does an autism evaluation cost?

The cost of an autism evaluation varies based on your insurance coverage. Most commercial insurance plans cover autism evaluations when medically necessary, typically including the diagnostic evaluation, ADOS administration, clinical interviews, and report writing. At Blackbird Health, we accept most major insurance plans. Contact our Care Navigators at (484) 202-0751 for specific cost information for your situation.