You have a feeling something is different. Maybe your child is 18 months old and not pointing at things yet. Maybe they are 3 and their speech isn't coming the way other children's has. Maybe a teacher or relative said something, and now you cannot stop thinking about it.

The question "should I get my child assessed for autism?" sits with a lot of weight. And right after that question comes a harder one: how do I even do that?

This guide walks you through the process step by step � what happens, who is involved, and how the pathway works in India, the UK, the USA, Australia, and the UAE.

Step 1: Recognise and Document What You Are Seeing

Before you contact any professional, write down what you have noticed and when. The more specific, the better. Clinicians ask parents for this information at every assessment � coming prepared shortens the process and gives the clinician a clearer picture.

Things worth noting:

  • When did your child first say words? When did they stop, if they did?
  • Do they respond to their name when called from across the room?
  • Do they point at objects to show you something interesting?
  • How do they play � alone, with other children, with you?
  • Any strong routines or extreme distress when routines change?
  • Any sensory sensitivities � sounds, textures, lights?

Video is powerful. A 30-second clip of something you have noticed at home is worth more than trying to describe it in words during a rushed appointment.

If you want a structured way to track this, Nesto's parent observation tool lets you log behaviours with timestamps and share them directly with a professional.

Step 2: Speak to Your Child's Paediatrician or Family Doctor

In most countries, your first contact point is your child's regular doctor. This does not have to be a dramatic conversation. You can say simply: "I have noticed a few things I'd like to understand better, and I'd like a referral for a developmental assessment."

Who can actually diagnose autism?

A diagnosis of autism spectrum disorder (ASD) is made by a qualified specialist � most commonly a developmental paediatrician, child psychiatrist, or a multidisciplinary team that includes a clinical psychologist. A general practitioner can refer you to the right person but cannot make this diagnosis themselves.

If your doctor is not taking your concerns seriously, you are entitled to a second opinion. Trust your instinct. Waiting to see if a child "grows out of it" is not a clinical recommendation � it is a delay that costs the child time when early intervention is most effective.

Step 3: The Assessment � What Actually Happens

An autism assessment is not a blood test or a single session with a checklist. It is a clinical process that builds a picture of your child across multiple observations.

  • Developmental history interview

    A detailed conversation with you about your child's development from birth � milestones, early communication, feeding, sleep, behaviour, and family history. This often takes 60�90 minutes.

  • Direct observation and structured play

    The clinician interacts with your child in a structured way � presenting tasks, toys, and social situations designed to reveal how the child communicates, plays, and responds. The most widely used tool is the ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition).

  • Standardised parent questionnaires

    You may be asked to complete tools such as the ADI-R (Autism Diagnostic Interview � Revised) or the CARS-2. These are structured interviews or rating scales that help the clinician understand patterns across settings, not just in the clinic.

  • Additional evaluations (if needed)

    Depending on the child, the team may also assess speech and language, cognitive ability, sensory processing, and adaptive functioning (daily living skills). These are separate from the autism assessment but often done in the same referral process.

  • Feedback and report

    After the assessment, the clinician shares the findings with you � typically in a face-to-face meeting, followed by a written report. The report is an important document: it is what schools, therapy services, and government support systems need to provide accommodations.

How the Pathway Works in Different Countries

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India

India has two main routes � public and private. Public hospitals like NIMHANS (Bangalore), AIIMS (Delhi), and government medical college hospitals have dedicated child development units. These are low-cost but have long waiting times.

The government's DEIC (District Early Intervention Centre) scheme, under the Rashtriya Bal Swasthya Karyakram (RBSK) programme, provides free developmental screening and referral for children aged 0�18 years through government schools and Anganwadis. This is underused but accessible.

Private developmental paediatricians in major cities can typically see children within weeks. A comprehensive private assessment costs approximately ?5,000�?20,000 depending on the city and the team involved.

The RPWD Act 2016 (Rights of Persons with Disabilities) entitles children with autism to a disability certificate from a government hospital, which unlocks educational concessions, travel benefits, and priority access to services.

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United Kingdom

In the UK, autism assessments for children are provided through the NHS. The pathway begins with your GP or health visitor, who refers to a community paediatrician or Child and Adolescent Mental Health Services (CAMHS).

NHS waiting times are currently a significant challenge � in many areas, families wait 18 months to 3 years from referral to completed assessment. Private assessments at specialist centres typically cost �1,500��3,500 and can be arranged within a few months.

An EHCP (Education, Health and Care Plan) can be applied for through the local authority once concerns are identified � you do not have to wait for a formal diagnosis to request one.

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United States

In the USA, children under 3 are entitled to a free evaluation through Early Intervention (Part C of IDEA � Individuals with Disabilities Education Act). You can self-refer by calling your state's Early Intervention programme � no GP referral needed.

For children aged 3 and above, the local school district is required under IDEA Part B to evaluate any child suspected of having a disability that affects their education, at no cost to the family. Request this in writing.

Private evaluations by neuropsychologists or developmental paediatricians typically cost $2,000�$5,000 and provide more comprehensive reports, which can be useful for private therapy funding.

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Australia

In Australia, you can access a Medicare-funded autism assessment through a paediatrician or psychiatrist referral from your GP. The NDIS (National Disability Insurance Scheme) provides funding for therapies and supports once a diagnosis is confirmed.

The Better Start for Children with Disability initiative provides up to $12,000 in funding for eligible children under 7. Families often access this while waiting for the NDIS process to complete.

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UAE and Gulf Region

In the UAE, autism assessments are available at specialist centres including the Emirates Autism Society, Priory Wellbeing Centre, Camali Clinic, and at major hospitals such as Cleveland Clinic Abu Dhabi and Mediclinic. Most operate on a self-referral or GP-referral basis.

The UAE Ministry of Community Development provides a People of Determination card for children with a formal diagnosis, which enables access to subsidised therapies, educational support, and reduced government fees. Similar support cards exist in Saudi Arabia, Qatar, and Kuwait.

Assessment costs in private facilities typically range from AED 3,000�8,000 for a full evaluation.

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Singapore

In Singapore, the public pathway begins with a referral from your polyclinic doctor to KK Women's and Children's Hospital (KKH), National University Hospital (NUH), or the Institute of Mental Health (IMH). Waiting times in the public system are typically 6�12 months.

Private assessment at centres such as the Child Guidance Clinic, REACH, or specialist developmental clinics can be arranged more quickly. An autism diagnosis entitles children to apply for the Disability Development Fund (DDF) and various MOE educational support provisions.

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Other Countries

In countries with limited specialist infrastructure, international telemedicine assessment is increasingly available. Organisations such as the Autism Science Foundation maintain directories of specialist providers. In many countries, a detailed written report from an internationally recognised assessment centre is accepted by local services and schools.

Where no local specialist exists, the most practical step is a detailed parent-led observation record combined with a Nesto screening report, which can be taken to any developmental clinician as a starting point.

While You Are Waiting

Waiting for a formal assessment can feel impossible when you are worried about your child. The good news: there are things you can do right now that will help, regardless of the outcome.

  • Start a structured home observation log. Track what you see � the specific behaviours, in what contexts, how often. This makes the eventual assessment more efficient and gives you something concrete to discuss with your doctor.
  • Explore home activities focused on communication and joint attention. Activities like turn-taking games, shared reading, and parallel play support development whether or not autism is eventually diagnosed. Nesto's home activities library is designed specifically for this.
  • Do not wait for a diagnosis to request school support. In most countries, schools can begin accommodations and additional support based on documented need � a diagnosis is not always a prerequisite.
  • Connect with other parents. Families who have been through the process are often the most practical source of local knowledge � which clinicians are thorough, which services have shorter waits, which community groups exist.
A note on early action

Research consistently shows that early intervention � before age 5, and ideally before age 3 � produces the best outcomes for autistic children. This is not about rushing to a diagnosis. It is about not letting uncertainty delay support. A developmental assessment provides clarity, whether or not autism is the conclusion.

What the Diagnosis Report Should Include

A good assessment report is a working document � not just a label. It should tell you:

  • The diagnostic conclusion (whether ASD criteria are met, and if so, any co-occurring conditions identified)
  • The specific tools and assessments used
  • A summary of strengths as well as areas of difficulty
  • Specific therapy recommendations (speech therapy, occupational therapy, ABA, etc.)
  • Educational recommendations for the school or setting
  • A review plan � how and when the child's progress should be reassessed

If your report does not include these elements, you can ask the clinician to provide them. The report is yours � you can share it with any school, therapist, or support service you choose.

After the Assessment

A diagnosis � or a conclusion that criteria are not met � is a beginning, not an end. Either outcome gives you clearer ground to stand on.

If your child is diagnosed with ASD, the next step is building a support plan. Nesto's guide to the period after diagnosis covers this in detail � what therapies to prioritise, how to tell family and school, and how to build a daily routine that works for your child.

If the assessment concludes that autism criteria are not met, the clinician should still be able to explain what they did observe and what, if anything, would be worth monitoring or exploring further.

Track What You See Before the Assessment

Nesto's free parent observation tool helps you document your child's behaviours in a structured way � the same information clinicians ask for at assessment.

Start Free Observation

Sources

  • American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition Text Revision (DSM-5-TR). 2022.
  • Lord C, et al. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Western Psychological Services. 2012.
  • Ministry of Health and Family Welfare, India. Rashtriya Bal Swasthya Karyakram (RBSK) Programme Guidelines. 2013.
  • Rights of Persons with Disabilities Act, India. 2016.
  • NHS England. Autism in children: Getting a diagnosis. NHS.uk. 2024.
  • Individuals with Disabilities Education Act (IDEA). U.S. Department of Education. 2004.
  • National Disability Insurance Scheme (NDIS). Australian Government. 2013.
  • UAE Ministry of Community Development. People of Determination Card Programme. 2018.
  • Zwaigenbaum L, et al. Early identification of autism spectrum disorder: Recommendations for practice and research. Pediatrics. 2015.

If you are concerned about your child's development, consult a qualified developmental paediatrician or specialist in your country. This guide is for informational purposes and does not replace professional clinical assessment.