Autism Assessment for Toddlers & Preschoolers

Parent Q&A

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  • Hello. We are seeking recommendations for two types of medical services for our 2-year old. The first is for a specialist who can perform an autism spectrum disorder (ASD) screening (e.g. developmental pediatrician, child psychologist).  The second is for a speech language pathologist who can supplement our son's existing therapy and who has significant experience with developmental delays and/or disabilities.  We are based in Oakland but willing to travel. Any tips or advice would be most welcome (I already have screening referrals through Kaiser and to our Regional Center).  

    Thank you!

    I would contact the Summit Center in Walnut Creek. They are a full service assessment center. 

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Questions


Late blooming 18mo vs. Autism, can specialists tell?

Jan 2013

My son didn't have any words at his 18-month well check and also didn't have all the right boxes checked on the M-CHAT (autism red flags), so we were referred to a speech therapist for an evaluation. By the time we had that visit, about 6 weeks later, he had about 15 words and we thought he was fine, but decided to go anyway. We were shocked to have her tell us he was very delayed and needed to be evaluated at the Regional Center for other issues involving play/social development. After sending paperwork to the Regional Center at the beginning of December, we are still waiting to hear from them. In the meantime (he is now 21 months old), he is using new words every day (including daddy and mama, waving hi and bye), pretends to feed tea to his dolls, has a social laugh, plays with cars like they are cars, etc...basically the stuff we were told he was behind on he seems to be caught up with. I've re-taken the M-CHAT online and it said ''no cause for concern.'' My gut tells me he's a late bloomer, but I know we need to get the evaluation done with the Regional Center to be sure. My question is - can they tell whether a kid is a late bloomer or needs intervention? If he really does have a problem, I know we need to deal with it, but will someone be willing to say he is just off to a slow start? I read developmental charts and he does seem to be behind, but I feel like he's catching up - anyone else go through this? Can a kid can be slower than average to reach milestones and still catch up? He stacks blocks, makes eye contact, points...but he did those things when we saw the speech therapist and she still thought he needed 20-30 hours a week of developmental therapy. Thanks for any advice.


Yes, specialists can tell the difference between autism and late bloomers. I take from your post that you are afraid of the diagnosis. I understand that. Ideally your child would indeed just be a late bloomer. But you can only gain from an evaluation: Either the confirmation that he is fine, just a bit behind, or you get a diagnosis - doesn't have to be autism - and can start intervention. Should there be a need for it, starting intervention earlier rather than later is definitely going to be beneficial for your child. Best wishes


My son who is 19 yrs old was a lot like your toddler, late at everything, no talking until pretty late, very cautious to try new things. He had a speech problem and went to speech therapist until he was 8(from little i remember). There was no doubt by his interactions at that time that he was even a bit of autistic or asperger... I let him be, not pushing him, he grew into a great young man, confident, smart, good student (in college now) anon


Getting your child a diagnosis can only help because the interventions are like a highly-enriched preschool tailored to what your child needs. The testing is like observation and playing games. Many of these problems can be greatly remediated in early childhood because the brain is very flexible, so treatment is very effective; and if he is just a ''late-bloomer'' therapy will only help his language skills. anon


Autism diagnosis before 18 months?

July 2012

Hi, I'm feeling a little overwhelmed. I am having really gut feelings that my 14 month old boy displays signs of autism. We have a newphew and cousin who have autism, so I am aware of the symptoms. I tried calling early intervention to have him evaluated, but they say they don't evaluate for autism until 18 months. I know early intervention is very important in terms of outcome, and I'm wondering if there are any families out there that were able to get services for their child at a younger age. If I get him evaluated by a developmental pediatrician and get a diagnosis can we start a program through early intervention? I know 14 months is very young and many people will tell me to wait, but I can't just sit back and do nothing when I really feel like something is going on. I'm already looking into dietary changes, adding some basic supplements, homeopathy, and cranial sacral. Thanks in advance for any advice. anon


Yes, you can get a diagnosis before 18 months and it's important so you can start necessary therapies (speech/language, occupational, etc.) The Regional Center can evaluate and provide services before age three years. (After three years, school districts generally take over.) Also, you might try Easter Seals; I know they evaluate kids starting at 14 months. Go with your instincts and don't let anyone dissuade you from demanding early intervention--it's crucial. Not all pediatricians recognize the signs and many advise to wait and see. Not a good idea when early therapies are necessary. Good luck! Mom and professional in the field


hi there. i'm a developmental psychologist and provide early intervention services to an array of young children aged birth-3 years, some of whom have a diagnosis of autism. i understand your frustration in wanting to have your child diagnosed as soon as possible. one of the reasons they typically wait is because you want to be sure the child is old enough to actually have some language (in order to assess for language delay, which is part of the diagnosis) as well as some socialization opportunities. if your child has other developmental delays prior to 3 years of age (fine motor skills, language, cognitive dev, etc.), you can be referred to one of the CA Regional Centers for an intake assessment and developmental evaluation - which would determine if s/he qualifies for early intervention services. they would also assess for autistic spectrum disorders (again, probably not until 18 months or later) if there are red flags, concerns, etc. this is probably the best route to take and would not cost you anything for the initial intake assessment or any other ongoing services. hope this helps! care


My youngest son was diagnosed with autism at 16 months by a team at Alta Regional Center. HIs pediatrician was also very knowledgeable on the topic, unlike so many others I have come across. I would call regional center again and ask to have him assessed. I didn't specifically ask for my son to be assessed for autism, just for delays, and I didn't get an runaround. My experience with RCEB has not been as positive, though it hasn't been horrible, either. You are right that there is no reason to wait and everything to be gained through early intervention, whether or not he is on the spectrum. I would push them for another evaluation and get one from a dev. ped only as a last resort. It is expensive and I have found we have received whatever services he needed through his regional center eval. SPED teacher mom


Yes, children can be diagnosed with autism prior to 18 months. My son was diagnosed at 15 months, though the diagnosis at the time was considered provisional because the primary tool used to assess autism, the ADOS, had not yet been validated for children so young. However, I believe there is a newer version of the ADOS for children under 18 months now, and there is some good research data indicating that children as young as 14 or 15 months can be accurately diagnosed with autism. As a mother and a mental health professional, I urge you to see a qualified developmental pediatrician or a clinical psychologist with expertise in diagnosing young children on the spectrum. If your child is found to be on the spectrum, please consider pushing the regional center to provide you with at least 25 hours a week of ABA. You can self-refer to the regional center, but it is better to have a developmental pediatrician or other professional refer you. Best wishes. R.


Daycare thinks my 2-year-old may be autistic

Jan 2010

I am seeking help and lost at the moment as it relates to my son's primary care provider believes my 2 year old has autism. I am looking for advice on where to proceed from here. My son's doctor didn't have much to say other than you have a lot of work to do and don't let him see tv. If you have advice as to local groups, daycare, centers, etc in the Castro Valley (Eastbay Area) please email me. Thank you for reading my post. Patrick


I wanted to share my experiences on what I did when I suspected that my son was on the autistic spectrum. The first step you should take is to contact the Regional Center. The phone numbers/contact information are found at: http://www.rceb.org/ The Regional Center is then required to evaluate your son. I will warn you that it does take quite a bit of time for the Regional Center to get back to you (I believe for me, it took two months - but it could take longer now), so if you do have the financial resources, I would suggest getting an independent evaluation from a developmental pediatrician. There are some good referrals in the archives of the BPN (by the way, I also recommend that you find another pediatrician for your son, as it sounds like your current doctor is not qualified based on the advice he/she provided to you). After my son got the diagnosis of autism at age 2 1/2, the Regional Center provided in-home ABA therapy, occupational therapy and speech therapy. The Regional Center will provide you with recommendations on therapists, but I highly suggest that you do your own research on who the best therapists are, and then ask the Regional Center if they will fund them. I also put my son on a Gluten Free/Casein Free diet. Many people don't believe it works, but many also do thinks it works. In our case, my son had severe constipation, and we found the diet to really help that. I don't want to overwhelm you with too much information, but I think those are the main things to consider/get started with. I also wanted to say that even though it can feel overwhelming and stressful, it is well worth the effort to get help for your son at this early stage. I'm happy to say that after two years of therapies, etc., my son is doing very well. He is in a typical preschool, and is a social and happy little guy. J


I am really hoping someone can help this person. It just breaks my heart, that all he took from his ''dr'' regarding an Autism Dx is that you have a lot of work to do, and that his son cannot watch anymore Television ?? Hoping someone can guide this person is the right direction - for his son's sake. anon


Wait for Regional Center evaluation for 29-month-old?

Aug 2008

My son (29 months) is receiving speech therapy and OT for speech delays and sensory issues, and both therapists have recommended an evaluation for ASD/PPD. We're working with RCEB (Oakland) but he cannot get into see a neuro/psychologist until late October -- at which point it seems the docs won't see him because they are limiting their testing to 18-30 month old toddlers. Anyway, we have the means to have him evaluated privately, although I understand from speaking with out pediatrician that the wait will be several months regardless of which route we take. My question is -- for those of you with experience with RCEB/otherwise -- would you wait and go with the RCEB provider or work toward getting a private developmental pediatrician? Interested to hear about your experiences. Thanks. in limbo. . .


Regional Center needs to evaluate your child NOW. ASDs need early intervention, so you need information ASAP. You can appeal, you can push them to do the evaluation sooner. Regional Center is supposed to provide treatment for ASDs from birth to three years, then the school district takes over if special education services are deemed necessary (you can get this free evaluation from your local school district just before your child turns three years. You might consider using a private evaluation to bolster your demands for services from Reg. Ctr. Be warned: you might get conflicting results from the evaluations--but at least you've started the process. In my experience (personal and professional), parents do best when they know their child's rights (ADA, IDEA, etc.) and don't take no (or ''we'll do it later'') for an answer. wrightslaw.com has some helpful info. Good luck! A mom and psychologist


I'm a little confused about your situation and have a lot of questions, but I'll just say that in general, if you have the means, absolutely do NOT wait. If you're headed for a diagnosis, get it and start services BEFORE he turns 3 and leaves the caseload of the Regional Center because, if you thought the RC bureaucracy was bad, wait until you hit the school districts!

My son was diagnosed privately and it just made the RC eval process that much easier. They still provided services, but since we already had the dx we were able to skip a lot of the steps and head straight for them. I recommend Dr. Erica Buhrmann in Albany (510) 540-5320 Feel free to contact me directly. Jill


If you can afford private evaluations, get them. It doesn't prevent you from getting an evaluation from the RCEB, too. So get both. My experience is that RCEB services are inadequate. My son's presenting issue was a speech delay (he didn't speak any words except mama until 3 1/2 years old). They evaluated him twice only for speech even though I requested other evaluations. At 3.5 he qualified for twice weekly group speech therapy for the school year. At 4.5 years we moved to another area where he received a full evaluation of speech, occupational, physical and cognitive areas. He had a spectrum of issues beyond speech and presented at a borderline mentally retarded level. They placed him in a therapeutic preschool. His cognitive development is now way beyond the borderline stage, his speech is about 80 per cent understandable, he uses full, complicated sentences, has a strong vocabulary, can write his name and can read simple words like ''and'' and the names of his friends. Amazing progress! These are services we never would have received through the RCEB--partly because they delayed evaluating him even though I pushed and pushed. He's fully ready academically and socially to start Kindergarten on time this fall--until last year I was planning on a late Kindergarten start.

Perhaps with the opinion of the other therapists, you will have better RCEB experiences to report. (My son's pediatrician never accepted my conviction that he had significant delays, instead insisting he was developing normally.) But my sense is the RCEB is overwhelmed or underfunded, handle their limited resources by stalling evaluations for services, and once services are given, they aren't adequate. Not a RCEB fan


We were in your shoes and we got the private evaluation. You can show the results to the RC and most likely they will adopt them. If your son is on the spectrum and could use some additional services, those services are paid for by the RC until age 3 - 36 months. If you do not get a dx by 3, or are too close to 3, they will not start paying for the services. It is best to have those service in place if only for five to six months (like was the case with us) when you move on to dealing with the SD at age 3. You have a better chance of retaining them. Been there


Diagnosis for 3-year-old who shows signs of PDD-NOS

Feb 2008

I am seeking advice about diagnosis and treatment for my 3 year old son, who may show some symptoms of mild Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS). One one hand, his intellectual development seems very strong: at 3 he can read almost anything. On the other hand, he seems unable to participate in a spontaneous, two way conversation. Instead, he usually repeats the question asked of him. Other possible signs of PDD include: lack of any imaginative play (when we suggest it, it upsets him); mixes the pronouns ''I'' and ''you''; and strong adherence to routines. Do you have recommendations for assessments, such as a developmental pedatrician and/or recommendations for seeking treatment for a relatively young child. Thanks much. Elizabeth


You can request a free evaluation from your local school district. What you describe does sound like PDD-NOS, and the language delay alone would make your son eligible for special education services (language/speech therapy and possibly a special preschool). Early intervention is essential, so please call right away. A mother and professional in the field


it's important to be evaluated by a neuropsychologist...elea bernou phd in lafayette is quite good...maybe berkeley therapy institute might have a referral...there are a lot of alternative therapy options but it's important to first get tested..this sets the stage for the bulk of therapy which will be at school...the younger therapy is started, the better gregory


Once he is 3, the school district is responsible for providing services to him if he qualifies. They will do an evaluation, but they do not give a diagnosis. I believe you can still ask the Regional Center for an assessment, otherwise ask your doctor for a referral to a developmental pediatrician. (If your health insurance is like mine, they might try to weasel out of paying for the assessment even if it is supposed to be covered.) I would pursue the school district evaluation and a regional center or private assessment simultaneously, since the wait is so long (the school district has to do their eval within 60 days of request, other asssessments can take 2 - 3 months) but, if the school district does agree that he qualifies for services, I would try to stall the IEP meeting until you have the final assessment from your own doctor, which hopefully will be more thorough. Although I am happy with the services that my son is getting through the school district, I just wish I had gone into it feeling more informed and in control, and he did have some issues that were not being addressed initially that I had to press for later.

As for other treatments, there is a lot available out there. A full developmental assessment can help you decide which ones you need to pursue. The traits you described sound consistent with hyperlexia, but again, I really recommend a full assessment by a professional. Anon


Where to Get an Assessment for Autism for 4yo

Jan 2001

I am looking for information to help an autistic 4-year-old boy. The mother does not have much community/school support. But she really wants to try her best to help her kid at home and possibly to educate the preschool teachers as well. Her son has language delay and some other characteristics of autism but seems to be high-functioning kind. Any information and advice you have on this topic is much appreciated. Thanks a lot. Lily


July 2001

My pediatrician thinks that my 3 year 1 month old daughter is mildly autistic and wants us to have a developmental assessment. I have been looking into this and the wait times for this are extremely long when we are feeling so anxious. We are getting on the waiting list at Children's Child Development Center and have also contacted the East Bay Regional Center. Has anyone had experiences good or bad at these two places? Does anyone have any experience with this type of evaluation they are willing to share? What can I expect? What can I expect with this type of diagnosis? Can anyone recommend a really sensitive great child psychologist who could do the assessment privately? If you would be willing to talk to me about your experience with this I would greatly appreciate it. We are pretty terrified at this point. My daughter is very outgoing and interactive with adults and children (although not with her pediatrician!), has some problems with limits and has been having trouble with language and pronunciation. Her speech is indistinct and words she used to pronounce correctly are sometimes now slurred. She used words earlier than her peers but then progress seemed to slow down and now her inteligibility is not good. Strangers often do not understand her. Frankly, I don't view her as autistic but I am worried about the amount of rhyming that she does. She does it interactively with us and also babbles and rhymes talking to herself alot. She sometimes uses a singsong tone that people have commented on. (We are on the wait list for a speech eval. at Herrick.) many thanks


For a developmental / psch-ed assesment, you might want to try the Raskob Institute in Oakland (at Holy Names College) ph. # 436-1275 For a speech and language assessment, try Sue Diamond. holly


For an evaluation try Brad Berman, the PDD clinic at Children's Hospital, Behavior Analysis (I think that they are in Concord, they are associated with STARS school in Walnut Creek), Bryna Seigal at UCSF. The Regional Center is a good thing to hook up with, but I believe that you need a diagnosis before you can receive services. CALL ME, I have an 11-year-old autistic son. Jean


Mary Crittenden, Ph.D. in the Department of Behavioral and Developmental Pediatrics at UCSF is very experienced and knowledgeable and wonderful with young children (and parents).

Carolyn Johnson, Ph.D. at Children's Hospital, Oakland's Department of Psychiatry, also wonderful with small children, is an excellent neuropsychologist who works in an interdisciplinary team that has a lot of experience with autism spectrum disorders.

I have worked with both of them and would bring my own child to them without a second thought. I don't know if either do private assessments, but if you couldn't get in through UCSF or CHO, it's worth investigating.


I recommend getting a referral from the pediatrician to a private psychologist or developmental pediatrician and speech therapy team. There is an excellent team at the UCSF Mount Zion Pediatric Group. Autism is actually pretty complicated to diagnose and in any event, you want to know as precisely as possible what is happening with your daughter's speech, and how to intervene. Be pushy and avoid waiting, if you can. Some people believe that early intervention is important with autism. The East Bay Regional Center can provide various kinds of resources if you need them.


In response to parents seeking professional diagnosis and consultation for Aspergers Syndrome and autism, I'd like to recommend Dr. Edward Ritvo, an internationally recognized researcher and diagnostician in the field. Dr. Ritvo has studied autism for over thirty years while at the Neuro-Psychiatric Institute at UCLA, and now he and his wife Riva run the Ritvo Clinic, in Los Angeles. He is one of the absolute best in his field, and may be reached at 310 476-5109.