Getting a diagnosis

How to get a diagnosis, and how to get it sooner

A diagnosis can open doors to support at school, at work and in health care. It can also take a long time. Here's what the official sources say, in plain words. This guide is for the United States.

Children: from first worries to an evaluation

1. Ask your child's doctor about screening. The American Academy of Pediatrics recommends autism screening at the 18- and 24-month checkups, and general developmental screening at 9, 18 and 30 months. You can ask for a screening at any time you're worried. A screening doesn't diagnose; it shows whether a full evaluation is needed. CDC's free milestone checklists help you bring notes.
2. Ask for a referral to a specialist if there may be a delay.
3. Under age 3: call your state's Early Intervention program yourself. You don't need a doctor's referral or a diagnosis. The evaluation is free, and the program has 45 days from your call to finish it and hold the first planning meeting. Find your state's number on CDC's Early Intervention contact list.
4. Age 3 and up: contact your local public elementary school, even if your child doesn't go there. Say you have concerns and want an evaluation for special education. If staff don't know the process, ask for the special-education director.

School evaluations and Section 504

• You can ask at any time. A school can't use tiered-support programs (often called MTSS or RTI) to delay or deny an evaluation when a disability is suspected.
• Put it in writing. A short, dated letter that names your child, describes your concerns with examples, lists what's been tried, and includes any outside reports. Keep a copy. The federal Center for Parent Information and Resources has a sample letter.
• Know the clock. Under federal rules, the evaluation must be done within 60 days of the day you sign consent (not the day you ask), unless your state sets a different deadline.
• If the school says no, it must explain why in writing and tell you your rights. You can challenge the decision. Your state's Parent Center can help, at no cost.
• Section 504 covers students whose condition substantially limits a major life activity. A medical diagnosis isn't required, and having one doesn't guarantee a plan on its own.
• Gifted and neurodivergent (2e)? The U.S. Department of Education has said that high ability alone can't rule a child out. A child who has a disability and needs special education still qualifies, and schools must use more than one test to decide.

Who can diagnose

• Autism: developmental pediatricians, child psychologists or psychiatrists, child neurologists, often with speech and occupational therapists. For adults: a psychologist, psychiatrist or neuropsychologist with autism experience.
• ADHD: a psychologist, a psychiatrist, or a primary care provider such as a pediatrician. There's no single test; the provider gathers input from family, teachers and others, and checks hearing and vision.
• Learning differences: usually a school team (school psychologist, special-education staff, speech-language pathologist, reading specialist).
• Developmental language disorder: a speech-language pathologist.
• Tics and Tourette: a provider familiar with tic disorders.
• Dyspraxia: a team that may include pediatricians, neurologists and physical or occupational therapists.

Adults

• Start with your primary care provider and ask for a referral to someone experienced with adults.
• Bring your history. ADHD symptoms must have started before age 12, so school reports, old records and memories from people who knew you as a child all help.
• It's often harder for adults, because traits overlap with anxiety and other conditions, and many people, especially women and girls, were missed as children. More than half of U.S. adults with ADHD were diagnosed at 18 or older.
• At work, you may be able to ask for reasonable accommodations under the ADA. The Job Accommodation Network gives free, confidential advice: (800) 526-7234.
• Telehealth is common for adult ADHD care. Federal rules allowing some controlled medicines to be prescribed without an in-person visit are extended through December 31, 2026; check with your provider about what applies to you.

Ways to speed it up

1. Start every route at once. Ask for the medical referral, and contact Early Intervention or the school the same week.
2. Don't wait for a diagnosis to get help. Therapy for a specific need, such as speech therapy for a language delay, can often start before the evaluation.
3. Under 3, Early Intervention may be the fastest door to an evaluation.
4. Join more than one waitlist, and leave the others once one comes through.
5. Ask about university training clinics. Supervised graduate students do the testing, often on a sliding scale (many don't take insurance).
6. Ask about community evaluators and your primary care office, which can sometimes see young children sooner than big centers.
7. Check your insurance first: is the evaluation covered, and do you need a referral?
8. Bring a folder: written examples of what you've noticed, milestone checklists, school reports and any earlier evaluations.

Costs and insurance

• Free public evaluations: Early Intervention (under 3) and public-school evaluations are at no cost to families. Some later Early Intervention services may have sliding-scale fees, depending on the state.
• Medicaid covers screening, diagnosis and treatment for enrolled children and young people under 21.
• Private insurance: every state has some kind of autism coverage law, but most cover children only, and many employer plans that pay claims themselves ("self-funded" plans) are exempt. Ask your plan directly.