Educational note: This guide is original Nesto Autism Care educational content. Screening information is not a diagnosis or treatment plan. If you are worried about your child, consult a qualified pediatrician, developmental specialist, psychologist, or therapist in your country.

What is ASD Screening?

Screening is not a diagnosis. It is an early check — a structured way for doctors (and parents) to identify children who may benefit from a fuller developmental evaluation. Think of it as a first filter: it helps decide whether further investigation is needed.

Screening systems differ by country. Some families are screened during routine pediatric visits, while others need to actively request screening. In many regions, with India as one example, awareness is growing and more pediatricians are using standardised tools.

Important distinction: Screening ≠ Diagnosis. A positive screen means "this child should be evaluated further" — not "this child has autism." Only a qualified specialist can make a diagnosis.

When Should Screening Happen?

According to the American Academy of Pediatrics and WHO guidelines, developmental screening should happen at regular intervals during early childhood:

18 moFirst ASD-specific screening recommended
24 moSecond routine ASD screen
Any ageIf a parent or doctor has concerns

Don't wait for scheduled visits if you are concerned. Contact your paediatrician any time you notice the red flags described in our Early Signs guide.

The M-CHAT-R: A Common Toddler Screening Tool

The Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) is a 20-question parent-report questionnaire used for children aged 16–30 months. It is free, validated, and widely used by paediatricians and developmental professionals in many countries.

What the M-CHAT-R assesses:

  • Does the child point to show interest in something?
  • Does the child make eye contact?
  • Does the child respond to their name?
  • Does the child engage in pretend play?
  • Does the child follow your pointing gesture?

Each question has a Yes/No answer. Scores are calculated to determine low, medium, or high risk. Medium and high-risk results require a follow-up interview with a clinician.

Nesto's screening tool is inspired by validated screening frameworks and available in 19 languages — making it accessible to families worldwide who may prefer guidance in a familiar language.

The Evaluation Process

If a screening suggests the need for further evaluation, the exact pathway depends on your country, but the process often looks like this:

  • 1
    Paediatrician referral

    Your child's doctor refers you to a developmental paediatrician, child psychologist, or a centre with an ASD evaluation team.

  • 2
    Comprehensive developmental assessment

    A specialist conducts structured observation, standardised tests (such as CARS, ADOS, or ISAA), and parent interviews. This typically takes 2–3 sessions.

  • 3
    Speech and language evaluation

    A speech-language pathologist assesses communication skills, which informs both diagnosis and support planning.

  • 4
    Occupational therapy assessment

    Evaluates sensory processing, fine motor skills, and daily living skill development.

  • 5
    Diagnosis and report

    The team provides a written report with diagnosis (if applicable), support needs profile, and recommendations for therapy and home support.

Where to Get Evaluated

Your child's doctor or pediatrician

Start with your primary doctor, who can check hearing, development, and referrals available in your country or region.

Developmental or autism assessment centres

Many countries have child development centres, autism clinics, hospital teams, or private multidisciplinary assessment services.

Country-specific public services

Local public options vary. In India, families may explore NIMHANS Bengaluru, AIIMS New Delhi, District Early Intervention Centres, and trained developmental pediatricians.

School or early intervention services

In many countries, schools or local early intervention programs can guide assessment, accommodations, and therapy referrals.

What Parents Can Do While Waiting

Waiting lists for specialist evaluation can be long — sometimes months. This waiting period does not have to be passive:

  • Continue structured home activities (communication practice, sensory play, daily routines)
  • Keep detailed notes of behaviours — frequency, context, what helps
  • Use Nesto's home screening tool and knowledge library to understand your child's support profile
  • Connect with other parents through community support groups
  • Contact local early intervention services; in India, this may include your nearest DEIC

Sources & References

  • WHO (2022). Autism Spectrum Disorders. World Health Organization Fact Sheet.
  • NIMHANS (2021). Clinical Practice Guidelines for ASD. National Institute of Mental Health and Neurosciences, Bengaluru.
  • Robins, D.L. et al. (2014). M-CHAT-R/F Validation Study. Journal of Pediatrics.
  • National Health Mission India (2020). District Early Intervention Centres: Operational Guidelines.