Early Identification, Screening, Referral, and Diagnosis

Diagnosing autism spectrum and nerodevelopmental disorder (ASD/NDD) can be difficult, since there is no medical test, like a blood test, to diagnose the disorders. Doctors look at the child’s behavior and development to make a diagnosis. ASD/NDD can sometimes be detected at 18 months or younger. By age 2, a diagnosis by an experienced professional can be considered very reliable. However, many children do not receive a final diagnosis until much older as some aspects of ASD/NDD appear as a child grows.

Diagnosing an Autism Spectrum /Neurodevelopmental Disorders takes two steps:

  • Developmental Screening
  • Comprehensive Diagnostic Evaluation

As a parent, you know your child best. If your child is not meeting the milestones for his or her age, or if you think there could be a concern with the way your child plays, learns, speaks, acts, and moves, talk to your child’s doctor and share your concerns. Don’t wait.

 How to Help Your Child (English and Spanish) 

 How to Talk with the Doctor (English and Spanish)

Milestones Checklist

Curious or concerned about your child’s development? Skills such as taking a first step, smiling for the first time, and waving “bye bye” are called developmental milestones. Children reach milestones in how they play, learn, speak, act, and move (crawling, walking, etc.). The Milestones Checklist is available to help you to track your child’s development. Print it out and share it with your child’s doctor or nurse at the next visit.

Ask About Developmental Screening

Well-child visits allow your doctor to have regular contact with your child and keep track of his or her health and development. Your doctor might ask you some questions or talk and play with your child during an examination to see how he or she plays, learns, speaks, behaves, and moves. Click for more information about what these areas of development are – Developmental Screening.

A delay in any of these areas could be a sign of a problem which may or may not be ASD/NDD. By doing this your doctor is performing a developmental screening, a short test, to tell if a child is learning basic skills when he or she should, or if there are delays. Developmental screening can also be done by other professionals in health care, community, or school settings.

The American Academy of Pediatrics recommends that children be screened for general development at 9, 18, and 24 or 30 months and for autism at 18 and 24 months or whenever a parent or provider has a concern. Ask your child’s doctor about your child’s developmental screening.

Developmental Screening Podcast – NH Family Voices staff sits down with Dr. Nina Sand-Loud, Developmental Behavioral Pediatrician at Children’s Hospital at Dartmouth Hitchcock Medical Center and has a conversation about developmental screening, tools and questionnaires used, the role of parents, and the benefits it provides to growing children.

(Podcast Transcript –Developmental Screening)

Watch Me Grow (WMG) helps NH families to track his or her child’s growth and development. It is NH’s developmental screening, referral and information system for families of children ages birth to six years. WMG offers families:

  • Information about children’s health and development.
  • Developmental screening questionnaires based on the child’s age. (Ages & Stages Questionnaires® (ASQ)- paper or online accessibility) through the Family Resource Centers.
  • Tips on how to help children grow and learn.
  • Timely connections to appropriate services, supports, and resources when needed.

Another option for families is this online access form Easter Seals, through support from the CVS Caremark Charitable Trust, which provides parents with free access to the Ages & Stages Questionnaires®, a general developmental screening tool

Be sure to copy the results and share the completed questionnaire and results with your child’s doctor.

Ask For a Referral

If you or the doctor thinks there might be a delay, ask the doctor for a referral to a specialist who can do a more in-depth evaluation of your child.

Doctors your child might be referred to include:

  • Developmental Pediatricians/Developmental Clinics. These doctors/professionals have special training in child development and children with special needs.
  • Child neurologists. These doctors work on the brain, spine, and nerves.
  • Child psychologists or psychiatrists. These doctors know about the human mind.

Get an Evaluation

When you ask the doctor for a referral to a specialist, you should also call NH’s Family Centered Early Supports and Services (FCESS), the public early childhood system, to request a free evaluation to find out if your child qualifies for intervention services. You do not need to wait for a doctor’s referral or a medical diagnosis to make this call.

Where to call for a free evaluation depends on your child’s age:

  • Children 0-3 Years Old:  If your child is younger than 3 years old, contact FCESS at (603) 271-5034
  • Children 3 Years Old or Older: If your child is 3 years old or older, contact your local public school system. Even if your child is not old enough for kindergarten or enrolled in a public school, call your local elementary school and ask to speak with someone who can help you have your child evaluated. This is referred to as ‘Child Find‘.

NH Child Development Clinics – Child Development Clinics (0-6 yrs) provide comprehensive diagnostic evaluations to assist families who have children with developmental and behavioral differences in making informed decisions regarding medical, developmental, and educational needs.The team consist of a Intake Coordinator, Clinic Coordinator, Developmental Pediatrician and Child Psychologist/Developmental Specialist.

Locations and contact information:

Keene (603-296-9208      Manchester (603) 296-9249    Lakes Region (603) 524-8444   North Country (603) 788-5304

Tips & Tools

What to Say Here are tips if you’re not sure what to say when you talk with your child’s doctor or when you call to request an evaluation.

While You Wait: Unfortunately, families may have to wait many weeks before they are able to get an appointment to see a specialist or start intervention services for their child’s developmental problem. This can be a frustrating time for parents who want answers and help now.

If you find yourself in this situation, know that there are some simple things you can do today and every day to help your child’s development. Make the most of playtime. Interact with your child as much as possible. Read books, sing songs, play with toys, make crafts, do household chores, and play outside together. Talk to your child: label items, point out interesting things, tell stories, comment about what you see and how you feel, and explain how things work and why things happen. Your child may not always seem to be listening, but he or she may be hearing more than you think.

Resource: Vroom is a set of tools and resources from the Bezos Family Foundation designed to inspire families to turn everyday moments into “brain building moments” by layering activities that are essential to healthy brain development onto existing routines. Vroom’s website offers a variety of tools to download for free, as well as a mobile app that provides easy access to daily “brain building” activities. Many resources are available in English and Spanish.

Resource suggestions from our Lending Library