Because of these discrepancies in development, there are developmental guidelines for normal childhood development for birth through age 5. It is important to keep in mind that these guidelines are just that: benchmarks for development, not hard and fast rules. Parents should familiarize themselves with these guidelines in order to determine if their child is lacking in certain areas, and then bring their concerns to the attention of their child’s pediatrician.

But what if your pediatrician tells you that children just develop differently and that some are slower than others? This may well be the case: generally, pediatricians have a vast range of experience and have “seen it all” and therefore can be expected to be reliable in their assessment of your child. But there may be more to it than a simple “he’ll catch up.” If you feel there is more going on, then act quickly to advocate for your child.

It can be difficult for parents to question their child’s doctor, but parents must also trust their instincts. A pediatrician, after all, sees a child for a brief time in an artificial setting. Parents, who know their child better than anyone, know how a child behaves on a daily basis and are therefore experts on their own child.

If you have concerns about your child’s development and feel your pediatrician’s assessment is just not right, then follow up with him or her. Review developmental checklists to see whether your child is meeting the milestones for his or her age. If your pediatrician has not performed a routine developmental screening, then ask for one. Pay close attention to and record your child’s behavior at home to determine whether you can detect any specific developmental delays.

Don’t be hesitant to ask for a follow-up appointment in which you can bring your concerns to your pediatrician’s attention. The more specific detail you can share, the better.

Not all developmental delays are indicators of autism, and an autism diagnosis is made only after much more in-depth assessment by a specialist. If you remain concerned that your pediatrician may be missing some of the signs about which you are concerned, then ask for a referral to a specialist.

Trust yourself here: remember that you are the expert on your child and his or her strongest advocate. If you are not convinced that your child’s development will catch up, or that he or she is just developing slowly, don’t be afraid to push for additional testing, referrals, or a second opinion regarding your concerns.

In the case of developmental delays, including autism, early and appropriate intervention can make a world of difference in the life of your child, and obtaining that intervention starts with you.

Your child’s pediatrician should be the first source you check with if you have concerns about your child’s development. He or she will likely offer an Ages and Stages Questionnaire (ASQ) to complete at regularly scheduled well-child visits. This parent-completed set of questions is a standard screening tool used to help pediatricians get a big picture of whether a child is meeting developmental milestones such as communication, gross motor, fine motor, problem solving, and personal-social skills at particular ages. While not a diagnostic tool, the ASQ can help pediatricians and parents to determine if further evaluation is needed.

If you are concerned about the results you report on the ASQ or about any aspect of your child’s development, you should ask your pediatrician for a developmental evaluation. Developmental evaluations go farther in detail than a routine developmental screening and go beyond the usual measurements of height, weight, and vital signs. These evaluations are designed to provide an in-depth assessment of how your child functions overall. Areas that are assessed include social / emotional functioning (how does your child interact with peers or adults; how well does he or she follow directions?); adaptive functioning (e. g. dressing oneself, feeding oneself, tending to one’s own bathroom needs); gross motor development, such as running, jumping, and skipping; fine motor skills, such as drawing and cutting; and communication skills (understanding language, expressing needs or wants).

Discuss with your pediatrician who will provide the evaluation and what each assessment entails. Being able to anticipate how long the process will take, who will be involved, and where the assessment will take place means that both you and your child will be more at ease about the evaluation. Find out how long it will take to get the results, and then what the next step should be after you receive the results. Once you’ve found out all you can, make sure your child understands what to expect to the extent that his or her age allows a detailed understanding.

Finally, don’t be afraid to be assertive as you advocate for your child. Developmental evaluations can certainly help parents understand and be prepared to treat any developmental delays your child may have. Because early intervention can have a profound effect the outcome for a child who has a developmental delay, establishing intervention and treatment as early as possible is crucial.

The evaluation should provide you an overview of the strengths and weaknesses in your child’s cognitive, physical, language, and emotional and social development. Although you may have concerns about just one of these areas, a thorough assessment should give you results in each area.

You may receive from the testing facility a packet of information explaining your child’s results, an explanation of any number the testing has identified (e. g. IQ scores), and recommendations for treatment and intervention.

While the results of the test are, of course, vital, what is more important is how they may be used to direct treatment and intervention services for your child. The test administrator should be able to help you obtain appropriate services, whether they be from private providers or, for older children, through the child’s school. Individualized instruction plans, referrals to tutors, speech therapists, occupational therapists, behavioral therapists, and developmental psychologists may be part of the treatment package appropriate for your child.

Make sure you have a clear understanding of everything the evaluation results report. Ask how the test administrator will communicate with treatment providers, and be sure to obtain copies of all results.

You should come away from the evaluation with a clear sense of your child’s development across all areas of development as well as a clear understanding of how these results will shape his or her future treatment.

In addition to these questions, you may be asked to complete an Ages and Stages Questionnaire (ASQ), which is a standard set of questions parents answer to determine, for instance, if a child is climbing stairs, stacking blocks, or finishing a sequence of numbers. The questions contained in ASQs are tailored to each age and designed to determine if a child is meeting developmental milestones appropriate to the age.

While the ASQ is a widely used and highly regarded tool, it relies on parental input and is not used to diagnose delays, but rather to determine whether a child may need further screening. Parents complete the questionnaire before a routine visit, and the child’s healthcare practitioner reviews the results during the office visit.

The results of the ASQ, your answers to your pediatrician’s questions, and your own concerns about your child’s development may lead to a developmental evaluation, which is a much more in-depth assessment of your child’s strengths and weaknesses for his or her chronological age.

Evaluations are usually conducted by a team of health care professionals that can include a developmental pediatrician, nurse practitioner, psychologist, speech-language pathologist, parent educator, and physical therapist. These evaluations usually include the administration of the Childhood Autism Rating Scale (CARS) and the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth edition) criteria checklist for autism. Providers may also administer other autism-specific tests.

During these visits, the child’s medical history is taken and a physical examination done, and, depending on the child’s age, assessments are done either with or without the parent present. For babies and younger children, the assessments are designed to feel like play. Older children may take a battery of tests. All of the assessment materials are used diagnostically to evaluate a child’s development.

Screening, then, is the precursor to evaluation and the results of the screening determine whether further, more in-depth evaluation is appropriate in order to obtain a diagnosis and a treatment plan for the child.

The tools used to screen for autism are designed specifically to detect autism spectrum disorders (ASDs). They focus all three of the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders Fourth edition) criteria for autism (impairment in social interaction, impairment in communication, repetitive and stereotyped patterns of behavior, interests and activities, and delays in social interaction, social language use, and/or imaginative play). Autism screening, in short, focuses on the communication and social development of children aged 18 months and older.

A combination of observation and screening questionnaires are used to screen for autism. One such questionnaire is the Modified Checklist for Autism in Toddlers (M-CHAT), which includes 23 yes or no questions, including those that address a child’s interest in other children, enjoyment of social games, sensitivity to noises, ability to maintain eye contact, and language comprehension. The Autism Spectrum Screening Questionnaire (ASSQ) is used to screen for ASDs in children aged 4 and older.

Asperger Syndrome screening tools are designed to differentiate between Asperger Syndrome and other ASDs or developmental disorders. These tools focus on social and behavioral impairment in children aged 4 and older. The high-functioning Autism Spectrum Screening Questionnaire (ASSQ) is used to assess symptoms of Asperger syndrome; a 27-item checklist, the questionnaire is used on children and adolescents.

The Social Communication Questionnaire (SCQ) is another ASD screening tool used on children aged 4 and older. The questionnaire is answered by parents and the questions are in a yes or no format.

The Australian Scale for Asperger Syndrome (ASAS) is a questionnaire for parents in which parents rate of a scale of 0 to 6, from rarely to frequently, questions about a child’s social and emotional, cognitive, movement, specific interests, and language skills and abilities.

Screening is designed to determine the need for additional evaluation, without which treatment cannot be implemented. The procedures for screening for autism are more detailed and time-consuming than those used to screen for developmental delays, but are critical in obtaining early, appropriate intervention.

Start by asking the team of professionals who evaluated and diagnosed your child to explain to you where he or she is on the autism spectrum. You may not get as straightforward an answer as you would like because each child’s autism disorder is unique. No two children with the same diagnosis will have the same symptoms, so finding out just what is specific to your child is important here. Your child’s treatments should be individualized to his or her needs.

Research into effective treatments in ongoing, so find out whether your child can receive the most up-to-date treatment options. Treatments are tailored to specific delays and are designed to be appropriate to your child’s chronological and developmental age. Find out what types of treatments your child can expect to receive now and which of those will be ongoing.

As a matter of practicality, check with your health insurance company to determine how treatments will be covered. Inquire about services in your community to determine what services, if any, you can receive at a reduced cost. Someone from the team who evaluated your child should be able to provide materials to your child’s school that can help you establish an Individualized Education Plan (IEP) for him or her.

Your child will likely receive a number of therapies simultaneously: speech, behavioral, and occupational therapy, for instance, will become a regular part of your routine. There may be pharmacological or dietary treatments as well, depending on your child’s symptoms.

You will likely receive a lot of information about how you can incorporate elements of treatment into your home routines, so expect some changes in the way your household runs. Inform your family members of how they can help your child’s therapy to extend beyond office visits.

Expect to work through a lot of emotions once you receive a diagnosis of autism. Certainly you may feel overwhelmed, confused, disappointed, guilty for being disappointed, anxious, or some combination of all of these and more. However, remember that getting an autism diagnosis is a positive step toward treatment. Autism is not curable, but early and effective treatment and intervention can make a tremendous difference in the life of a child with autism.

You may not want to accept the diagnosis at first, which is a normal process of ultimate acceptance. You will have some grief associated with the diagnosis, but let yourself experience that sadness and express it as a way of working through the sadness and moving on.

Your sadness may yield to anger, which is a part of the process of accepting the diagnosis. Keep in mind that anger is a normal emotion, and expressing it releases tension. You may find that you are resentful or typically developing children and taking your anger out on those who are close to you.

You might experience times in which you deny what is happening to your child, which is a coping mechanism. Try to be aware of when you are experiencing denial so that you don’t stop focusing on your child’s treatment. You may also feel isolated once you receive the diagnosis, but ultimately you will get to the point where you can accept the diagnosis and become an advocate for your child.

Allow yourself to feel what you feel and try not to feel guilty about your emotions. Be patient with yourself and be sure to carve out time just for you. Reaching out to others, through a support group, for instance, may be helpful in maintaining your strength and emotional well-being.

If you get moving on your child’s treatment as soon as you can, you will feel a sense of progress and control. Educating yourself about how best to be an advocate for your child and learning all you can about his or her treatment can help you move forward.

Don’t be afraid to ask for help and to use the support group you have. Perhaps a family member or friend can help with caring for your other children, transportation, or cooking. Accepting help will help you to take care of yourself and consequently of your child.

Accepting an autism diagnosis is not easy, but by giving yourself time and respecting your emotions, you can get to a point of acceptance. Accepting the diagnosis means moving forward and getting the best help possible for your child.

Your pediatrician may use more formal measures of developmental screening, such as asking you to fill out an Ages and Stages Questionnaire (ASQ) prior to your visit. This is a standard set of questions that, depending on the child’s age, will include questions such as whether the child is walking up and down stairs, or able to grasp objects with his thumb and forefinger, or can draw a figure with distinct body parts. The questions vary with the child’s age, but the goal is the same: to determine whether a child is meeting guidelines for normal development.

Other screening tools include the ASQ : Social and Emotional, for children from birth to 60 months, which operates very similarly to the general ASQ. The Brief-Infant-Toddler Social-Emotional Assessment (BITSEA) is available for children ages 12 to 36 months, and the Child Development Inventory may be used for children ages birth through 6. Additional information about screening tools is located on the FirstSigns.org website.

In addition to formal screening tools, your pediatrician may use simple in-office tests to determine a child’s development. Asking a 3 year-old to copy a straight line, or seeing if a year-old child will play peek-a-boo with his mother, for instance, are simple developmental screening measures. Since behaviors may not be accurately replicated in the doctor’s office setting, the pediatrician may again ask questions about your child’s development or ask you to observe these behaviors at home. Parents may also receive printed information regarding delays and “red flags” that indicate a potential delay.

Screening tools are used not only by pediatricians, but also in communities and schools. If your child is in daycare, for instance, providers there may use some of these simple screening measures to help identify delays. Programs that receive state or federal funding may have someone on staff who is qualified to administer, for instance, the ASQ.

Screening is designed to determine the need for additional evaluation, assessment, or testing. Parents are generally the first to determine if a child has a developmental delay, so being proactive in asking for a screening if you have any concerns about your child’s development is crucial. The screening procedures are quick, non-invasive, and very valuable in obtaining further testing if the screening so warrants.

The results of these tests will tell you how your child is growing and how his or her basic body functions are performing.  But what about your child’s development otherwise?  His or her social, communication, gross and fine motor and emotional skills may be evaluated by using an Ages and Stages Questionnaire (ASQ), which is a standard set of questions parents answer to determine, for instance, if a child is climbing stairs, stacking blocks, feeding him-or herself, finishing a sequence of numbers, waving “bye-bye,” or speaking in complete sentences.  ASQs are tailored to each age and designed to determine if a child is meeting developmental milestones appropriate to the age.

The ASQ is a widely used and highly regarded tool.  It is not used to diagnose delays, but rather to determine whether a child may need further screening.  Parents complete the questionnaire before a routine visit, and the child’s healthcare practitioner reviews the results during the office visit.

In addition to the ASQ, your pediatrician may use simple in-office tests to determine a child’s development.  Handing a six month-old a block to see if she passes it from hand to hand, or asking a 3 year-old to copy a straight line with a pen on paper, for example, can help rule out developmental delays.

When a child exhibits social or communication delays, the behavior may not be easily or authentically replicated in the doctor’s office setting.  Your pediatrician may offer a list of behaviors to look for or suggest the parent keep a record of behaviors observed at home to determine if a delay may be present. Parents may also receive additional printed information regarding delays and “red flags” that indicate a potential delay.

Parents can do their homework by completing and ASQ prior to the office visit, keeping a record of any behaviors or skills about which they have questions, and familiarizing themselves with developmental milestones for their child’s age.  Parents should also be sure to mention to the pediatrician any concerns they may have about their child’s development and follow any recommendations given in the office visit.