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Signs, evaluation and diagnosis

Waiting for an autism evaluation? What you can do now

Updated 13 minute readApplies to: United States

Sourced and dated ยท professional review pending

In short

While you wait for an autism evaluation, you can get help for your child now, because early intervention and school evaluations don't need a medical diagnosis. If your child is under 3, call your state's early intervention program yourself. If they are 3 or older, ask your public school district for an evaluation. At home, start visual supports and simple communication strategies, and keep notes to share with the evaluator.

Key points

  • Early intervention and school evaluations don't need a medical diagnosis.
  • Under 3: call your state's early intervention program yourself. No doctor's referral is needed.
  • Early intervention must evaluate your child and hold the first planning meeting within 45 days of the referral.
  • From age 3: ask your public school district, in writing, for a special education evaluation.
  • Check what your insurance or Medicaid covers before you book a private evaluation.
  • If your child loses skills, may be having seizures or is losing weight, see the pediatrician promptly.
On this page
  1. In short
  2. How long is the wait for an autism evaluation?
  3. Do you need a diagnosis to get help?
  4. How do I get early intervention for a child under 3?
  5. How do I ask the school district for an evaluation?
  6. How does the route to a medical diagnosis work?
  7. What will an evaluation cost, and what should I check?
  8. What can I start at home now?
  9. When should I call the pediatrician right away?
  10. How do I look after myself, and where can I find support?
  11. Questions parents ask
  12. How this guide was made
  13. Sources

How long is the wait for an autism evaluation?

Waits are often long, and there is no official national figure. In a survey of over 100 US autism centers, run from November 2022 to March 2023, 61% had waits longer than 4 months, and 15% had waits over a year or had stopped taking new referrals. A quarter said one evaluation takes more than 8 hours (Kraft and colleagues). Only about 1 in 9 centers replied, and the survey was sponsored by Cognoa, a company that sells an autism diagnosis device (Fierce Healthcare), so treat these figures as a rough guide.

Clinicians at a St. Louis children's hospital wrote in 2024 that the wait for an autism evaluation "commonly exceeds a year" (Braddock and colleagues, 2024). Ask each service for its current wait. The rest of this guide is about what you can do in the meantime.

Do you need a diagnosis to get help?

No. Early intervention and school special education services can evaluate your child and start help without a medical diagnosis. The American Academy of Pediatrics (AAP) says that while you wait for an evaluation appointment, "there are lots of steps that you can take to support your child even before a diagnostic evaluation" (AAP, HealthyChildren.org).

What you can do now Who to contact Do you need a diagnosis?
Early intervention evaluation (under 3) Your state's early intervention program No, and no doctor's referral
Special education evaluation (3 and up) Your local public school district No
Speech or occupational therapy Your pediatrician, who may prescribe medically necessary therapy No
Hearing screening Your pediatrician No
Visual supports and communication strategies at home You No
Notes and a one-page profile You No
Help with forms, meetings and your rights Your state's Parent Center No

The AAP says your pediatrician "may prescribe medically necessary therapy", such as speech therapy and occupational therapy, and suggests asking whether your child's hearing has been screened (same source).

How do I get early intervention for a child under 3?

Early intervention (Part C of IDEA, the federal special education law) is each state's program for babies and toddlers with developmental delays. You can refer your child yourself. Federal rules list parents as a primary referral source (34 CFR 303.303), and CDC says "A doctor's referral is not necessary" (CDC).

  1. Find your state's program on CDC's list (same source), or through our help page.
  2. Call and say you have concerns about your child's development and would like your child evaluated for early intervention, as CDC suggests. Write down the date you called.
  3. The screening, evaluation, assessments and first planning meeting must be completed within 45 days of the program receiving the referral (34 CFR 303.310). That meeting writes your family's IFSP (Individualized Family Service Plan).
  4. The evaluation, service coordination and the IFSP are free. States may charge fees for some services, but families who meet the state's definition of "inability to pay" get all Part C services free (34 CFR 303.521).

Each state sets its own eligibility rules for developmental delay, and some also serve children at risk of delays (ECTA). If your child is found not eligible, ask for the decision in writing, and ask your Parent Center what to do next.

If your child is getting close to 3 and may be eligible for preschool special education, the program must, with your approval, hold a transition conference at least 90 days (and, if everyone agrees, up to 9 months) before their third birthday, to plan the move to preschool services (34 CFR 303.209).

How do I ask the school district for an evaluation?

From age 3, including school-age children, the route is your local public school district. Child Find requires states to identify, locate and evaluate every child with a disability who needs special education, "regardless of the severity of their disability" (federal Child Find rule).

  1. Contact your local public elementary school, or your child's own school. For a preschooler, CDC suggests saying you would like your child evaluated through the school system for preschool special education services, and asking for the special education director if needed (CDC).
  2. Put your request in writing, date it and keep a copy.
  3. Once you give consent, the district must finish the evaluation within 60 days, or within your state's own timeframe (34 CFR 300.301).
  4. If your child is eligible, the team must meet within 30 days to write an IEP (Individualized Education Program) (34 CFR 300.323).
  5. If your child doesn't qualify for an IEP, ask about a 504 plan. Understood explains that "a student who doesn't qualify for an IEP might still be able to get a 504 plan" (Understood).

A school evaluation decides whether your child qualifies for special education. It is not a medical diagnosis. Federal law doesn't require children to be classified by their disability, as long as a child who needs special education is treated as a child with a disability (federal Child Find rule). You may want both, and neither has to wait for the other.

State rules differ: Texas gives districts 15 school days to respond to a written request and 45 school days after written consent to evaluate, and calls the IEP team the ARD committee (Texas Education Code). In California, a 2024 AAP California Chapter 1 article says Regional Centers must evaluate young children for early intervention for free within 45 calendar days, but often send families back to their pediatrician and insurance for the autism assessment, which can take months (AAP California Chapter 1).

How does the route to a medical diagnosis work?

Usually through your pediatrician. The AAP recommends developmental screening at the 9, 18 and 30 month checkups, and autism screening at 18 and 24 months (CDC). A common tool is the M-CHAT, a questionnaire parents fill in, "designed to identify children at risk for autism" (same source). A screening result is not a diagnosis.

If you're worried, or the pediatrician is, ask for a referral for a diagnostic evaluation. The pediatrician will help you find the right place, and some evaluations use a team of psychologists, speech therapists, occupational therapists and physicians (AAP). The physician may be a developmental-behavioral pediatrician.

To make the wait shorter:

  • Ask your pediatrician to refer you to more than one evaluator, if your insurance allows it.
  • Ask each clinic whether it keeps a cancellation list, and how you'll hear about openings.
  • Tell the clinic in writing if your child's needs change.

What will an evaluation cost, and what should I check?

It depends on your insurance. By 2019, every state and Washington, D.C. required some insurance coverage for autism treatment, but self-funded employer plans, which covered about 90 million people at the time, aren't regulated by states (Disability Scoop, 2019). If your child has Medicaid, its EPSDT benefit for under-21s covers screening and "medically necessary diagnostic and treatment services" (CMS, 2014). Finding an evaluator can be harder: only 56% of the autism centers in the survey above accepted Medicaid (Kraft and colleagues).

We found no reliable national price for a private evaluation, so get the cost in writing before you book. Check:

  1. With your plan: whether the evaluation is covered, whether you need a referral or prior approval, which evaluators are in network, and what you will pay.
  2. With the evaluator: the total price, what it includes (interviews, testing, a written report and a feedback meeting), when you'll get the report, and whether they take your insurance or Medicaid.
  3. Their license: look up a psychologist through your state's licensing board (ASPPB), and a pediatrician's board certification through the American Board of Pediatrics (ABP).
  4. What comes next: ask whether the report will include what your insurer needs if you later ask it to cover therapy.

What can I start at home now?

You can start today with approaches used widely with autistic children. None needs special equipment.

Visual supports

Visual supports are pictures, objects or written words that show your child what is happening and what comes next. A large US review counted 65 studies supporting them (NCAEP 2020), although most studies in that review were small (Hume and colleagues, 2021).

  1. Make a first-then board: one picture for what happens first and one for what comes next. Our printable first-then board is free.
  2. Use photos of your child's own things if symbols are hard to understand, and add things they enjoy, not only tasks they dislike.
  3. When that works, try a visual schedule for part of the day, using our printable visual schedule.

See our guides to first-then boards and visual schedules.

Communication strategies

You don't need to wait for speech therapy to start. AAC (augmentative and alternative communication) means pictures, signs, or a device or app that speaks. A review of studies with autistic children found that AAC did not hold back speech, and that gains in speech were modest (Schlosser and Wendt, 2008).

Try ten minutes of "together time" each day, when your child is calm:

  • Get down to their level and watch what interests them. Don't ask for eye contact.
  • Join in by copying what they do, with a similar toy of your own (Hanen Centre).
  • Wait. Stop talking, lean in and give them time: the Hanen Centre suggests up to 10 seconds (Hanen Centre).
  • Treat any look, sound, reach, sign or word as a turn, and answer it.
  • Play simple games with a pause, such as "Ready, set..." and wait for any signal before "go".

See will my autistic child talk? for more.

A calm bedtime routine

Sleep is often hard for autistic children. A review of 11 studies found that behavioral sleep programs that include training for parents were "generally effective and valued by parents" (Kirkpatrick and colleagues, 2019). Do the same few steps in the same order every night, and show them as pictures. The AAP suggests screen-free zones, starting with bedrooms and mealtimes, especially in the hour before bed (AAP, HealthyChildren.org). Tell your pediatrician if your child snores loudly, chokes or seems to stop breathing in their sleep.

Notes and a one-page profile

Notes help the evaluator see your child's everyday life, not just one appointment. CDC's free milestone checklists and Milestone Tracker app can help you track what your child can do (CDC).

Try this: For two weeks, jot down a few lines each day: what happened, where, what came just before, how your child showed you how they felt, and what helped. Add short phone videos of things an evaluator may not see, kept private. Note sleep, first words and any lost skills too.

A one-page profile is a short summary of your child: what they love, how they communicate, what upsets them and what helps them feel calm. Our one-page profile template is free to print.

When should I call the pediatrician right away?

Some changes shouldn't wait for the evaluation. CDC says: "Don't wait. If your child is not meeting one or more milestones, has lost skills he or she once had, or you have other concerns, act early" (CDC). See your pediatrician promptly, and tell the evaluation clinic in writing, if your child:

  • loses words, social skills or other skills they used to have
  • may be having seizures
  • is hurting themselves, or getting injured often
  • is eating very few foods, losing weight or not growing as expected
  • snores loudly, chokes or seems to stop breathing when asleep
  • is often sent home from daycare, preschool or school, or your family is reaching breaking point

Get help now: Call 911 in an emergency, or if anyone's life is at risk. If your child is missing, call 911 at once, then the National Center for Missing & Exploited Children. If your child loses skills, may be having seizures, is losing weight or is getting hurt, see your pediatrician promptly. If your child may have swallowed something harmful, call Poison Help at 1-800-222-1222. If you're thinking about suicide, or worried about someone who is, call, text or chat 988.

How do I look after myself, and where can I find support?

Waiting is hard, and your well-being matters too.

  • Get help with the system. Parent Centers help families of children with disabilities from birth to 26, including with early intervention and school. There are nearly 100, and you can find yours on a state map (CPIR). Each state and territory also has a Protection and Advocacy agency (NDRN).
  • Ask about Medicaid waivers early. HCBS waivers pay for support at home and in the community, but waiting lists are long. In 2025, over 600,000 people were on waiting or interest lists in 41 states, and waivers for autistic people had an average wait of 63 months (KFF, November 2025). Ask your state's Medicaid agency whether your child can join a waiting list now.
  • Talk to someone. The National Parent & Youth Helpline offers emotional support at 1-855-427-2736 by call, text or chat, 24 hours a day (National Parent & Youth Helpline). The Autism Society National Helpline, 1-800-328-8476, gives information and referrals, and is not a crisis line (Autism Society). Dial 211 for local help with bills, food and caregiver support (211).
  • If you're struggling, talk to your own doctor. You can call, text or chat the 988 Suicide & Crisis Lifeline at any time.

Questions parents ask

What should I do while waiting for an autism evaluation?

Start the help that doesn't need a diagnosis. If your child is under 3, call your state's early intervention program: you don't need a doctor's referral. If your child is 3 or older, ask your local public school district for a special education evaluation. At home, try visual supports and simple communication strategies, and keep notes and short videos to share with the evaluator. Check what your insurance or Medicaid covers, and contact your state's Parent Center if you'd like help with any of these steps.

Do you need an autism diagnosis for early intervention?

No. Parents can refer their own child, and a doctor's referral is not necessary. Each state sets its own eligibility rules, based on developmental delay and some diagnosed conditions, so a child can qualify without an autism diagnosis. The evaluation, service coordination and the family's plan are free, and the evaluation and first planning meeting must be done within 45 days of the referral. States may charge fees for some services, but families who meet the state's definition of inability to pay get all services free.

How long is the wait for an autism evaluation?

There is no official national figure, and waits vary a lot by area and insurance. In a 2022 to 2023 survey of over 100 US autism centers, sponsored by a company that sells an autism diagnosis device, 61% had waits longer than 4 months and 15% had waits over a year or had stopped taking new referrals. Ask each service for its current wait, and whether it keeps a cancellation list.

Does Medicaid cover an autism evaluation?

For children under 21, Medicaid's EPSDT benefit covers screening and medically necessary diagnostic and treatment services, including for autism. The harder part can be finding an evaluator who takes Medicaid: only 56% of the autism centers in one 2022 to 2023 survey accepted it. Ask your pediatrician and your Medicaid plan for evaluators who take it, and join more than one waiting list if you can.

Does insurance cover an autism evaluation?

It depends on your plan. By 2019, every state and Washington, D.C. required some insurance coverage for autism treatment, but self-funded employer plans, which covered about 90 million people at the time, aren't regulated by states. Before you book, call your plan and ask whether the evaluation is covered, whether you need a referral or prior approval, which evaluators are in network, and what you will pay.

Is a school evaluation the same as an autism diagnosis?

No. A school evaluation decides whether your child is eligible for special education and related services. It is separate from a medical diagnosis made by a doctor or psychologist. Federal law doesn't require schools to classify children by their disability, as long as a child who needs special education is treated as a child with a disability. You may want both, and one doesn't have to wait for the other.

How this guide was made

Written by
The Rocks Make Pebbles editorial team, using the 38 sources listed below.
How
We researched the topic from US guidance, federal law and published research, drafted the guide with the help of AI tools, and checked it against its sources on September 29, 2026. Read our editorial policy.
Professional review
Not yet reviewed. This guide is waiting for review by a developmental-behavioral pediatrician or licensed psychologist and Parent Center (PTI) staff or special education advocate. We will show their name and the date here once they have checked it.
Last updated
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Sources

Every fact in this guide links to one of these. We checked each link when we last updated the guide.

  1. Wait times and processes for autism diagnostic evaluations: a first report survey of autism centers in the U.S. (Kraft and colleagues) Hosted by the Centers for Medicare & Medicaid Services, 2023
  2. New report on the state of autism care reveals barriers to diagnosis Fierce Healthcare, November 10, 2023
  3. Improving access to autism evaluation: a coordinated developmental-behavioral pediatrics and pediatric neurology diagnostic pathway (Braddock and colleagues) Missouri Medicine, 2024
  4. If autism is suspected, what's next? American Academy of Pediatrics (HealthyChildren.org), April 3, 2025
  5. If you're concerned: early intervention contacts by state Centers for Disease Control and Prevention, February 17, 2026
  6. 34 CFR 303.303: referral procedures eCFR, September 25, 2026
  7. 34 CFR 303.310: post-referral timeline (45 days) eCFR, September 25, 2026
  8. 34 CFR 303.521: system of payments and fees eCFR, September 25, 2026
  9. Part C eligibility Early Childhood Technical Assistance Center (ECTA)
  10. 34 CFR 303.209: transition to preschool and other programs eCFR, September 25, 2026
  11. 34 CFR 300.111: child find eCFR, September 25, 2026
  12. 34 CFR 300.301: initial evaluations eCFR, September 25, 2026
  13. 34 CFR 300.323: when IEPs must be in effect eCFR, September 25, 2026
  14. The difference between IEPs and 504 plans Understood, March 12, 2026
  15. Texas Education Code, chapter 29: educational programs Texas Legislature
  16. Waiting times for autism assessments American Academy of Pediatrics, California Chapter 1, June 10, 2024
  17. Screening and diagnosis of autism spectrum disorder: clinical screening Centers for Disease Control and Prevention, April 15, 2025
  18. Autism insurance coverage now required in all 50 states Disability Scoop, October 1, 2019
  19. Clarification of Medicaid coverage of services to children with autism (informational bulletin) Centers for Medicare & Medicaid Services, July 7, 2014
  20. Contact a licensing board Association of State and Provincial Psychology Boards (ASPPB)
  21. Verify certification American Board of Pediatrics
  22. Evidence-based practices for children, youth and young adults with autism (NCAEP report) National Clearinghouse on Autism Evidence and Practice, 2020
  23. Evidence-based practices for children, youth, and young adults with autism: third generation review (Hume and colleagues) Journal of Autism and Developmental Disorders, 2021
  24. Effects of AAC intervention on speech production in children with autism: a systematic review (Schlosser and Wendt) American Journal of Speech-Language Pathology, 2008
  25. Imitate to connect The Hanen Centre, June 2023
  26. Waiting: the key to supporting your child's communication The Hanen Centre, May 2024
  27. Systematic review of parent training in behavioral sleep interventions for autistic children and children with intellectual disability (Kirkpatrick and colleagues) Sleep Medicine, 2019
  28. Helping kids thrive in a digital world: AAP policy explained American Academy of Pediatrics (HealthyChildren.org), June 3, 2026
  29. About Learn the Signs. Act Early. Centers for Disease Control and Prevention, February 17, 2026
  30. CDC's developmental milestones Centers for Disease Control and Prevention, February 17, 2026
  31. Find your Parent Center Center for Parent Information and Resources
  32. NDRN member agencies National Disability Rights Network
  33. A look at waiting lists for Medicaid home and community-based services from 2016 to 2025 KFF, November 20, 2025
  34. Contact us Autism Society of America
  35. 211 211.org
  36. 988 Suicide & Crisis Lifeline 988 Lifeline
  37. Poison Help Health Resources and Services Administration
  38. National Parent & Youth Helpline Parents Anonymous

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