Getting an appointment for an autism evaluation can take months, so by the time the day arrives many parents feel both relieved and nervous. Knowing what will happen helps you prepare your child, bring the right papers and get the most out of the visit. Every clinic runs its evaluations a little differently, and the steps below describe a typical process rather than a fixed script. Ask your evaluator ahead of time how their day is organized.
How is autism diagnosed if there is no medical test?
The CDC explains that there is no medical test, such as a blood test, to diagnose autism. Instead, trained clinicians look at a child's developmental history and behavior. The process usually has two stages:
- Screening, often by your pediatrician with a questionnaire such as the M-CHAT. Screening does not provide a diagnosis. It flags whether a closer look is needed.
- A diagnostic evaluation by one or more trained specialists, such as a developmental pediatrician, child psychologist, child psychiatrist or pediatric neurologist, sometimes working with speech-language pathologists and occupational therapists.
The clinician decides whether your child meets the criteria for autism spectrum disorder in the DSM-5 (the diagnostic manual used in the United States). Those criteria cover two areas: differences in social communication and interaction, and restricted or repetitive behaviors, interests or activities.
What happens during the evaluation?
1. The parent or caregiver interview
Expect a long conversation about your child's development from pregnancy and birth onward: when they reached milestones, how they communicate, how they play, how they handle change, sleep, eating, sensory reactions and any lost skills. Some evaluators use a structured interview. One widely used example is the ADI-R (Autism Diagnostic Interview, Revised). Others use their own detailed history form. You may also complete questionnaires before or after the visit.
2. Observation with your child, often the ADOS-2
The ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition) is a standardized, semi-structured assessment of communication, social interaction, play and restricted or repetitive behaviors. To a child it mostly looks like play. According to its publisher, it has five modules, and your child gets only one, chosen by age and how much they talk:
- Toddler Module: children 12 to 30 months who do not consistently use phrase speech.
- Module 1: children 31 months and older who do not consistently use phrase speech.
- Module 2: children of any age who use phrases but are not yet verbally fluent.
- Module 3: verbally fluent children and young adolescents.
- Module 4: verbally fluent older adolescents and adults.
Each module takes about 40 to 60 minutes. For a young child, activities might include bubbles, a pretend birthday party, a snack, looking at a book together or playing with toys. The examiner watches how your child responds to their name, shares attention, uses gestures and words, plays and handles transitions. For the Toddler Module, results are given as ranges of concern rather than a yes-or-no classification. You will usually be in the room with a young child.
3. Other testing
Depending on your child's age and the questions being asked, the evaluation may also include:
- a cognitive or developmental test (thinking and problem-solving);
- a language assessment, sometimes with a speech-language pathologist;
- a measure of adaptive behavior, meaning everyday skills like communication, self-care and social skills, often through a parent interview such as the Vineland;
- questionnaires for parents and teachers about behavior, attention or anxiety.
4. Ruling out other explanations
A careful evaluation considers what else could explain what you see, such as hearing loss, a language disorder, intellectual disability, ADHD, anxiety or a medical or neurological condition. The clinician may recommend a hearing test, genetic counseling and testing, or a referral to another specialist.
5. Feedback and the written report
Some clinicians share initial impressions at the end of the visit. Others schedule a separate feedback session after scoring the tests and reviewing everything. You should receive a written report that lists the tests used, the findings, whether your child meets criteria for autism or another diagnosis, and recommendations. Our guide to reading an autism evaluation report explains what insurers look for in that report.
How long does an autism evaluation take?
It varies with the child's age, the clinic and how much testing is needed. The ADOS-2 alone takes about 40 to 60 minutes. With an interview, other testing and breaks, an evaluation can take several hours, sometimes over more than one visit, and the report can take additional days or weeks. Ask the clinic in advance:
- How many visits will there be, and how long is each?
- Will I get results the same day or at a separate feedback appointment?
- When will I receive the written report?
- Will the report include the diagnosis code and the tests used, which my insurer may need for therapy?
Why does the type of evaluation matter for insurance?
If you hope to use insurance for ABA therapy afterward, the report has to meet the plan's requirements. Payer policies we reviewed ask for a diagnosis based on DSM-5 criteria from a qualified, licensed clinician. Evernorth (Cigna) requires the diagnosing clinician's name, credentials, licensure type and the date of diagnosis, and says a diagnosis labelled "provisional" or "rule out" is not considered confirmed. A 2026 ABA policy from Lucet says screening results are not a diagnosis and that a complete evaluation must include an autism-specific standardized assessment and rule out conditions with similar symptoms, such as hearing and neurological disorders.
Florida Medicaid, for its part, requires a Comprehensive Diagnostic Evaluation performed according to national evidence-based practice standards, led by a licensed practitioner, along with a physician's order. Each plan sets its own rules, so call the number on your card before the evaluation and ask what the report needs to include.
How can I prepare my child?
Many autistic children find new places, waiting rooms and unfamiliar adults hard. A little preparation can help your child show what they can really do.
- Preview the day. Look at photos of the building or the clinic's website together. A simple picture schedule (car, waiting room, play with a new friend, snack, home) helps many children.
- Use simple, honest words. For example: we are going to play with a lady who wants to learn how you play. There are no shots.
- Time it well. Ask for a time of day when your child is usually at their best, not during nap time.
- Bring comfort items. A favorite toy, headphones, a tablet for the wait, snacks and drinks, and a change of clothes.
- Tell the evaluator what helps. If your child needs breaks, movement or a particular way of being spoken to, say so at the start.
- Do not coach. The evaluator needs to see your child as they really are. It is fine if your child has a hard moment.
What should I bring?
- Your insurance card and photo ID, and any referral or authorization the clinic asked for.
- Notes on your concerns, with examples and dates, and a list of words or skills lost.
- Short videos of behaviors that may not show up in the office.
- Reports from Early Steps, school (IEP or evaluations), speech or occupational therapy, and earlier screenings.
- Medical history: hearing and vision results, medications, family history of developmental conditions.
- Completed questionnaires the clinic sent ahead of time.
A full printable list is in preparing for your child's autism evaluation.
What happens after the evaluation?
If your child is diagnosed with autism, the report's recommendations are your starting map. They may include speech therapy, ABA therapy, occupational therapy, school supports, parent training and follow-up. If the result is not autism, the report should still explain what is going on and what may help. If you disagree with the result, you can ask questions at the feedback session or seek a second opinion.
Evaluations and ABA at Hope Center
Hope Center offers diagnostic evaluations performed by our clinical director, Aisha Albright-Jourdan, MSW, LCSW, BCBA, with a supervising licensed psychologist. The report is usually ready within about a week once parents finish all the questionnaires, and only part of the evaluation is billed to insurance, so we explain your costs before you book. Our BCBAs do not diagnose; they complete the separate assessments used to plan ABA. Learn more about autism evaluations at Hope Center and ABA assessments. To ask about an evaluation or a free benefits check, contact us or call 561-337-8865.