Where Do We Begin?


What do you do when you’re concerned that your child has autism? Most people would say the answer is simple. Take the child to his/her pediatrician. The American Academy of Pediatrics recommends that all children be screened for autism at 18 and 24 months. This can be done during a toddler’s regular checkup.

However, this screening has not always been routine. Too many physicians have said, ”Let’s wait and see.” But waiting is never a good option when wondering about developmental delays. Parents can, and should, push for screening. And a recent study backs this up.

The Journal of the Academy of Pediatrics recently published results of a study that validates the Modified Checklist for Autism in Toddlers (MCHAT) and the MCHAT, Revised with Follow-up (M-CHAT-R/F) as a screening tool for low-risk toddlers. The study screened more than 18,000 toddlers in metropolitan Atlanta and Connecticut during regular check-ups. If the children scored 3 initially, their parents went on to complete follow up questions. Children who scored a 2 after follow-up had a 47.5% risk of being diagnosed with autism. As a result of the screening children were given a complete evaluation with diagnosis by age three. This is two years younger than the Minnesota average age of diagnosis, which is five. Any parent can read through this screening tool and score their child, and they should. The M-CHAT-R with Follow-Up can be downloaded from the web site of the tool’s author, Diane Robins of Atlanta’s Georgia State University, here.

Upon completion the checklist can be taken to your child’s pediatrician, who might do a complete evaluation. Another good option would be an evaluation at a clinic where teams specialize in autism diagnosis. Here are some local options:

While here is no single test for autism, a good evaluation should include the following: evaluation of the child’s development, evaluation of the behavioral characteristics of autism, speech and communication evaluation, family history, evaluation of sensory processing, cognitive evaluation, and an interview with parents regarding problems with daily living – sleeping, eating, and toileting.

If a diagnosis of autism is determined, intervention should begin immediately. Research reports that intervention is most effective when it begins between two and four years. Parents are in the perfect position to push this forward.

Author: Editorial Team

A select group of our board members who have something to say, but want to say it together. We also use this byline for those who wish to write anonymously.


  1. Our son was diagnosed 16 years ago – when there was nowhere NEAR the attention on autism then that there is today. We are the ones who requested an evaluation. After the diagnosis by a team, our son’s pediatrician fully admitted that she missed signs, most notably his great fear of being in her office – every single time he went, lasting past the time he turned 2. He was high functioning so, while there were other signs, they were ones that she would not have been able to pinpoint on a checklist or observe for herself in a half hour clinical setting. His dropping of the few words he had and then not speaking at all was a HUGE red flag, and we were told to “wait and see.” Again, in 1998, even doctors didn’t know as much as they do today about autism, so we don’t blame her. Several months after his diagnosis, we brought ABA to our rural community. Ours was the pilot program and I was our son’s first teacher. His pediatrician (whom he just “left” for a family practitioner when he turned 18), was our biggest supporter and advocate and got to see before her eyes the tremendous progress our son made with ABA. It was not easy, we still employ its principles of consistency and repetition to this day (in a less structured way of course), and it saved our son’s life. He graduated from high school last year, works part-time, and volunteers 10 hrs/wk. at two different libraries. Our son is proof that early, intensive intervention is CRUCIAL and WORKS. Parents need to put aside embarrassment or fear (I admit our denial delayed our desire for an evaluation for several months – months we’ll never get back) over ANY delays their child has, and DEMAND an evaluation.

    • We, too, got the “wait and see” from our pediatrician. That was only 8 years ago. I also hear from many parents today that they still have to push and push for a good screening. But we are luckier today in that there are so many great options for early intensive intervention that are family and child centered. Thanks for sharing your story.

  2. I’ve read an article in “Star Tribune” about testing newborn Somali infants for mercury, and finding mercury content in blood much above normal. I wonder if all newborns could be administered blood test for mercury. Symptoms for mercury poisoning directly match autism symptoms. If mercury level in infant is above normal, parents need to be able to obtain thorough training from OT about infant reflex integration. Even if an infant demonstrates correct reflexes, it does not mean that with high mercury levels they will be integrated correctly. Hypo/hyper reflexes with wrong circuit are bad foundation. For example, disfunctional Robinson Grasp Reflex will impare fine motor skills. Assymetrical Tonic Neck reflex integration will affect auditory and visual processing later in life, etc.
    Parents should be advised that the immune system of their infant is compromised, and the same policies as for premature babies should be in place (breast milk instead of formula, avoiding playgrounds and crowds for the first months of life, etc.) Insurances should include mercury poisoning as the valid reason for obtaining speech therapy and OT. Now 1 out of 6 kids have developmental delays, and I think if nothing is done this numbers can increase to vast majority of new generation.

    Be aware that in some cases the child can develop normally, and pass all markers, and, yet, one day, at some unpredictable age, lose all her skills and become severely autistic onset. It can happen at 4 or 13– nobody knows. This is the case of my daughter when she was 4 years old.
    One day, her speech became slurry. I got concerned, but thought if she gets some rest it will go away. Next day, she was not able to open her mouth. All she could produce is “Moo”. She became clumsy and had very hard time on the steps. Grasp reflex was disintegrated. Instead of affectionate social chatter box inclined to be a houligan, and dreaming to be an actress, I suddenly got an unpredictable allien. Old videos of her haunted me. Her old friends rushed on the beach only to find totaly different person. With great support from Therapy Junction, I feel like I am getting my daughter back with her sense of humor and affection, so I am optimistic about her future. Sorry for a long responce.

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