When to Seek an Autism Assessment: A Parent’s Guide

One question I hear from parents again and again:

“My child is only two or three. Should I get an autism assessment now — or should I wait and see?”

If you have a genuine and persistent concern about your child's development, I believe it is usually better to seek professional guidance rather than waiting for the concern to become bigger.

I often hear parents say, “He is still very young,” or “Let us give him another year.”

I understand why parents feel this way. An assessment can feel frightening. Sometimes parents worry that seeking an assessment means putting a label on their child.

It does not.

An assessment is first and foremost an attempt to understand the child — how they communicate, interact, play, learn, respond to their surroundings and develop.

The early years are particularly important because development is happening rapidly during this period. My academic work has focused on early intervention, and over more than 11 years of clinical practice, I have repeatedly seen how important timely understanding and support can be.

“But my child is only two. Isn't it too early?”

No.

A child does not have to be five or six years old before developmental concerns can be evaluated.

If there are persistent concerns about communication, social interaction, play, behaviour, sensory responses or development more broadly, a developmental assessment can be considered even in the early years.

This does not mean that every young child with a developmental difference has autism. It means that the child deserves to be understood.

At two or three years of age, we are looking at the overall developmental picture rather than waiting for a particular age or a particular symptom to appear.

What makes a concern worth assessing?

There is no single behaviour that automatically means a child has autism. Instead, parents and professionals look at patterns across different areas of development.

• Limited, delayed or unusual communication
• Not consistently responding to their name
• Limited sharing of interests or enjoyment with others
• Differences in eye contact or joint attention
• Difficulty engaging socially with parents or other children
• Play that is unusually repetitive or limited
• Repetitive movements or behaviours
• Strong distress around changes in routine
• Unusual sensory responses to sounds, textures, movement, lights or other sensations
• Difficulty adapting to everyday situations
• Loss or regression of previously acquired skills

A child does not need to show all of these. And importantly, seeing one or two of these behaviours does not mean that a child has autism.

The question is whether there is a pattern that deserves to be understood.

“I'm not even sure it is autism. Should I still get an assessment?”

Yes, if the concern is persistent.

Parents do not need to know what the diagnosis is before asking for help.

Sometimes a parent simply says, “Something feels different.” That feeling should not automatically be dismissed — but it should also not automatically be interpreted as autism.

A professional assessment can help determine whether the concerns relate to autism, another developmental difficulty, a specific area of delay, or simply a variation in development that does not require intensive intervention. If accessing care remotely is more practical, an online autism assessment may also be an option where appropriate.

The purpose of assessment is understanding, not labelling.

“Does an autism assessment automatically mean my child will be diagnosed with autism?”

No.

Assessment and diagnosis are not the same thing.

A proper developmental assessment looks at the child's strengths as well as areas of difficulty.

• Autism spectrum disorder
• Another developmental or psychological concern
• A need for support in a particular area
• A recommendation for further evaluation
• Or reassurance that the child's development is progressing appropriately

Sometimes the most valuable outcome of an assessment is simply knowing what is — and what is not — happening.

Why do the early years matter so much?

This is something I feel strongly about both professionally and personally.

The early years are a period of enormous developmental opportunity.

In my clinical practice, I have seen children who were identified early and received appropriate intervention make meaningful gains in communication, learning, behaviour and adaptation.

In some cases, the overall period of intervention has also been shorter because the child's needs were understood and addressed earlier.

I have also seen children who came for assessment much later, sometimes after five or six years of age, when difficulties had already become more established.

In my clinical experience, some of these children required considerably more time to acquire foundational skills and found adaptation to a mainstream school environment more challenging.

These are clinical observations, not a prediction of what will happen to every child. Every child is different.

But they are one of the reasons I strongly advocate for timely assessment when there are genuine concerns.

What does Dr. Gurbani Kohli's research tell us about early intervention?

My belief in early assessment and intervention is not based only on what I have seen in clinical practice. My academic work has also focused on autism spectrum disorder and early intervention during my research work at SGT University, Gurugram.

In 2022, I co-authored the research paper “Calculating Impact of Age on Effectiveness of EIBI in 3–5 Years Old ASD Children in Delhi, India.” The study examined the effectiveness of Early Intensive Behavioural Intervention (EIBI) in children with autism between three and five years of age and specifically looked at the relationship between age and treatment effectiveness.

In that clinical sample, EIBI was found to be effective, and the study reported an impact of age on treatment effectiveness, with effectiveness decreasing with increasing age within the studied age range.

I also co-authored “Effectiveness of ABA on Supporting Children with ASD,” published in the International Journal of Health Sciences in 2022. The paper reviewed ABA-based intervention approaches, including their potential benefits and limitations in supporting children with autism.

My work at SGT University also included sharing clinical perspectives on early identification, diagnosis and early intervention in autism through a university workshop on autism diagnosis and treatment approaches.

These academic and clinical experiences have strengthened something I have seen repeatedly in practice: when developmental needs are identified early, families have more time to understand those needs and make informed decisions about support.

At the same time, research needs to be interpreted carefully. Early intervention does not mean that every child will have the same outcome, and it does not mean that one particular therapy is right for every child. Autism is highly individual.

When a child's developmental needs are identified early, families have more time to understand those needs, make informed decisions and provide appropriate support during an important period of development.

That is why I believe assessment should not be viewed simply as a way of obtaining a diagnosis. It is a way of obtaining direction.

“What happens if we wait?”

Sometimes nothing changes. Sometimes the difficulty becomes more noticeable as developmental demands increase.

Waiting is not always wrong. There are situations where a professional may recommend monitoring a child's development over time.

The concern is when “wait and see” becomes “wait and do nothing.”

A child who is struggling with communication at two may face very different challenges when they enter preschool. A child who is struggling socially may find increasing peer expectations difficult. A child who has difficulty adapting to change may experience greater distress as routines and academic expectations become more demanding.

And when developmental gaps become wider, parents may find themselves trying several interventions without fully understanding what their child actually needs.

That is why thoughtful assessment can be valuable even when the final diagnosis is uncertain.

“But isn't an autism assessment expensive? What if I spend the money and still need therapy?”

This is one of the most understandable concerns parents have. But the more important question is not only what the assessment costs — it is what happens when we start intervention without first understanding what we are treating.

I often explain this to parents with a simple analogy.

Imagine you have persistent lower-back pain. You keep taking medicines and trying different therapies — physiotherapy, exercises and different modalities — but the pain keeps returning. You continue changing treatments for months or even years, without really knowing what is causing the problem.

Eventually, you get the appropriate investigation and discover what is actually going on.

The investigation may have felt expensive when you first considered it. But once you have evidence about the underlying problem, treatment can become much more focused.

The same principle applies to developmental concerns.

An autism assessment may feel expensive at the beginning. But if a child is given different therapies for a prolonged period without first understanding their developmental profile and specific needs, the overall cost — financially, emotionally and in terms of time — can become much greater.

The goal of an assessment is not simply to give a diagnosis. It is to give direction.

When we understand what a child needs, intervention can be more targeted. We can identify which areas require support, what kind of intervention may be appropriate, what the child's strengths are, and what may not need intervention at all.

That is very different from trying one therapy after another and hoping something works.

In clinical practice, I have seen families spend considerable amounts of time and money on fragmented interventions before eventually seeking a comprehensive assessment.

This is why I often tell parents:

Assessment first. Evidence first. Then intervention based on what the evidence tells us.

It is not about doing every possible test or starting intervention blindly. It is about making a scientifically informed decision about what the child actually needs.

An assessment therefore needs to be looked at not simply as an additional cost, but as a decision-making tool that can help families avoid unnecessary, unfocused or prolonged intervention.

Of course, an assessment cannot guarantee a shorter treatment journey or a lower total cost for every child. Every child's developmental needs are different.

But when intervention is guided by a clear understanding of the child's needs rather than by trial and error, families are in a much stronger position to make informed choices.

“What if the concern has come from my child's teacher or preschool?”

Take the observation seriously, even if the teacher is not making a diagnosis.

Teachers see children in a very different environment from parents. They may notice how a child interacts with peers, follows instructions, manages transitions, participates in group activities or responds to classroom demands.

A teacher is not diagnosing autism. But their observations can be extremely valuable.

In my experience, listening to teachers — particularly primary school teachers — is an important part of understanding a child's functioning.

Parents sometimes feel defensive when a school raises a concern. That is understandable. But the purpose should not be to decide who is right. The purpose should be to understand the child from different environments. School-based support and teacher consultation can help bring those observations together.

“What if my child behaves differently at home and at school?”

That does not mean that the concern is not real.

Children can behave very differently in different environments.

A child may communicate more at home, become overwhelmed in school, or appear comfortable at school but show significant distress after returning home.

Different environments place different demands on children.

This is why a good assessment considers information from multiple sources rather than relying on one observation.

Parents, teachers and clinicians may each see a different part of the child's experience. Putting those pieces together can provide a much clearer picture.

“What if my child is doing well academically?”

Academic ability does not by itself rule out autism or another developmental concern.

Some children with developmental differences may have strong vocabulary, good memory, good academic skills or particular areas of exceptional ability.

The question is not simply, “Can my child learn?”

• How does the child communicate?
• How do they interact socially?
• How do they understand other people's perspectives?
• How flexible are they?
• How do they cope with change?
• How do they manage sensory experiences?
• How do they function across different environments?

A child's strengths are important. But strengths should not be used to dismiss genuine areas of difficulty.

“What happens after the assessment?”

The assessment should lead to understanding, not automatically to a predetermined treatment plan.

Depending on the findings, parents may be given a clearer understanding of:

• Their child's developmental strengths
• Areas requiring support
• Communication and social needs
• Learning or adaptive difficulties
• Behavioural or sensory concerns
• School-related needs
• Whether further assessment is required
• Whether intervention is recommended

If intervention is recommended, it should be based on the child's individual needs.

Not every child needs the same therapy. And an assessment does not mean that a child must immediately begin years of intensive intervention.

The purpose is to make informed decisions.

“What if the assessment says it isn't autism?”

That can be a very useful outcome.

If a child does not meet criteria for autism, the assessment can still help identify what may be contributing to the parent's concerns.

Perhaps there is a language difficulty. Perhaps there are attention, learning, emotional or behavioural concerns. Perhaps the child simply needs monitoring. Or perhaps the assessment provides reassurance that development is progressing appropriately.

All of these are valuable answers.

The goal was never simply to obtain an autism diagnosis. The goal was to understand the child.

“Should I wait until my child is five or six?”

If there are genuine developmental concerns, I would not recommend waiting simply because the child is young.

There is no benefit in delaying an appropriate assessment just to reach a particular age.

If the concern is present now, it can be discussed now.

An early assessment does not take away your child's future. It gives you information that can help you make better decisions about that future.

“Can my child be assessed even without an obvious speech delay?”

Yes.

Speech delay is only one possible area of concern.

Autism can involve differences in social communication, interaction, play, flexibility, sensory processing and repetitive behaviours. Sensory differences can occur for many reasons and do not by themselves indicate autism; sensory processing differences can be explored as part of the broader developmental picture.

Some children may speak very well but still experience significant social or developmental difficulties.

This is why assessment should look at the whole child rather than one symptom.

“What if my child is too young to cooperate with an assessment?”

Young children may not sit still, answer every question or behave in a perfectly structured way during an assessment. That is expected.

A developmental assessment does not depend on a child behaving like an adult in a testing room.

Clinicians use multiple sources of information, including developmental history, parent observations, behavioural observations and, where appropriate, information from school.

The child's age and developmental level are taken into account.