An autism evaluation is a comprehensive multi-step assessment to determine whether a child meets the diagnostic criteria for Autism Spectrum Disorder as defined by the DSM-5, the diagnostic manual used by mental health professionals worldwide. The evaluation collects developmental, medical, and family history from parents or caregivers, testing to assess thinking, learning, and problem-solving skills, and reciprocal social communication evaluations through direct assessment. 

Important to know: There is not a single test that can detect autism in your child. Instead, clinicians use several autism-specific screening tools and assessments together to build a complete picture. These methods should be used as part of a larger assessment, and not just on their own, as the determination of autism is best completed with multiple sources of information rather than relying on any single measure.

An autism evaluation is important because it provides families a crucial lens to better understand their child and the experience that they are going through. A diagnosis opens the door for appropriate recommendations, referrals, and actionable support needed at school and at home. While no diagnosis is ever “too late,” an earlier diagnosis can benefit children in the long term by providing necessary developmental, social, and educational support for long-term success.

Some parents are concerned that a diagnosis may create perceived limits on their child’s experiences and future. However, the opposite is true, an autism evaluation can actually expand the opportunities and future for your child by identifying the resources they need to thrive.

Autism Spectrum Disorder shows up as differences in how children interact with others, communicate, and behave. The signs can look very different from one child to another in how they appear and how noticeable they are. However, some common signs include a child having trouble with interactions and communication, repetitive actions or routines over and over, and having very specific interests that take up a lot of their attention.

An autism evaluation should consider the strengths, challenges, and needs of your child across multiple areas that can impact development, social behavior, and communication, ensuring a holistic understanding of your child:

Physical health factors: Experts should look at overall physical health, including sleep patterns, appetite, and nutrition, as poor health can affect general well-being and focus.

Sensory and developmental considerations: Sensory sensitivities should be assessed, which can include selective eating habits, aversions to certain textures, and distress from specific sounds. The child’s developmental history, including information on their early development and milestones, educational history, social history, and service history.

Mental health conditions: Children with autism frequently have co-occurring conditions, such as anxiety, ADHD, and depression. These conditions can often overlap with or mask features of autism. At Blackbird, we conduct a thorough evaluation to look at all the different diagnoses together, work to understand how they may be masking or overlapping, and determine appropriate treatment using the complete picture of all strengths and challenges.

Gather information: Collect school reports, medical records, and prior evaluations. Keep detailed notes about when and where symptoms occur most often, and prepare to discuss family history of autism or related conditions.

It is recommended that parents provide their child with information about the appointment that is age-appropriate for their developmental level.

• Very young children: Explain that they will meet a therapist who will engage in play activities to learn more about them.

• School-aged children: Share that they will meet a therapist who will lead specific play-based and conversational activities. Set the expectation that the appointment will last about an hour.

Provide reassurance: Assure your child that this is not a typical doctor’s appointment; they will not be getting any shots.

Offer predictability: For children who benefit from clear expectations, you might create a social story outlining the steps involved.

Crucial preparation for separation: Prepare your child in advance that the parent or caregiver will not be in the room with them during the assessment. The clinician is able to provide specific guidance on how to best prepare the child for this separation during the initial diagnostic interview.

What to avoid: Parents are advised not to coach their children on specific activities or behaviors. The goal is to see what the child does spontaneously and how they perform on a typical day to ensure the assessment is accurate.

An autism evaluation is a comprehensive, multi-step process designed to understand your child’s unique developmental profile. While different practices may follow different processes, here’s what you can typically expect:

Key components

Semi-structured interviews: You will have in-depth interviews with a professional who will gather information about your child’s developmental history, behavior, and daily life. The goal of these interviews is to create a complete picture of your child’s development from infancy to the present.

Observation and testing: Your child’s play, communication, and behavior will be observed by the assessor through games and tasks, utilizing standardized assessment tools specifically designed for autism evaluation.

A number of perspectives: Evaluators gather input from caregivers, teachers, parents, and other professionals in order to understand your child’s behavior across different environments. This multi-perspective approach ensures the evaluation captures how your child functions in different environments, from home to school, and in social settings.

Feedback and outcomes: After the evaluation is complete, the specialist will provide you with a report of the findings, a diagnosis (if necessary), and recommendations for services and interventions based on your child’s needs.

What makes every assessment different: The specific tools, length, and structure of the evaluation may vary depending on your child’s age, level of developmental, and the evaluating practice. Some evaluations may be completed in a single session, while others may be divided across multiple appointments.

Methods differ, but the goal of every autism evaluation is the same—to provide families with clear answers and a path forward to support their child’s growth and development.

The average time to conduct an autism evaluation can vary widely between practices and due to patient needs. Evaluations are often divided into multiple sessions as they can be anywhere from 1.5 to 5 hours or more.