You notice how she lines up her blocks. How she startles at the blender. How she would rather study the ceiling fan than look at the new aunt cooing over her.
And something in you goes quiet, because you recognize it. Maybe from her older brother. Maybe from your partner. Maybe, if you are honest, from yourself.
You do not want to overreact. You also do not want to wait three years for someone to take you seriously.
You do not have to choose between those two things.
The short answer: The American Academy of Pediatrics recommends autism screening for every child at the 18- and 24-month well-child visits. When a parent or sibling is autistic, or ADHD runs in the family, closer watching from infancy is reasonable. Screening is not a diagnosis. It identifies children who should have a fuller evaluation, and it helps families reach support early.
Why family history matters
Autism and ADHD both run in families. Pediatric screening guidance lists a sibling with autism as a risk factor that calls for closer attention, as summarized in this AAP screening guide for primary care. And many mothers, especially women diagnosed later in life, first recognize their own neurodivergence while watching their child grow.
When should screening happen?
The American Academy of Pediatrics recommends autism screening for all children at 18 and 24 months, with developmental watching at every visit. A widely used parent questionnaire, the M-CHAT, is designed for toddlers up to 30 months, according to an American Family Physician summary of AAP guidance.
Why early matters so much
The CDC's 2025 surveillance report found that about 1 in 31 eight-year-olds is identified as autistic, and the median age of diagnosis was about 47 months, according to Maryland's Pathfinders for Autism. Only about half of children were diagnosed by age 3.
That is years of waiting for families who often knew something much sooner. Earlier identification opens the door to speech, occupational and developmental supports while the brain is at its most adaptable.
Signs worth mentioning early
- Limited eye contact, smiling back, or response to their name by around 12 months
- Little pointing or showing things to share interest
- Losing words or social skills they once had
- Intense distress with sensory input, or a strong need for sameness
- Repetitive movements or very focused play patterns
Screening is a door, not a verdict
A screen looks for signs that need a closer look. A full diagnostic evaluation is longer, uses structured observation, and may involve a psychologist or developmental specialist. A positive screen is a next step, nothing more.
How I can help
Within maternal-infant and early childhood mental health care at Dr. Joanne Psychiatry, I provide early autism screening for children ages 0 to 5 as part of a developmental and relational assessment using the DC:0-5 framework. I completed autism diagnostic training at the Emory Autism Center. When a full evaluation is needed, I coordinate the referral and stay involved in your family's care. Full autism assessments in my practice are offered for adults, so if you are wondering about yourself, too, we can talk about that.
Frequently asked questions
Is my baby too young to screen? Formal tools start around 16 to 18 months, but developmental watching starts at birth, and your concerns count at any age.
I am autistic. Will my child be? Not necessarily. Family history raises the likelihood. It does not decide it.
Can this happen by video? Yes. Watching your child at home, in their own routines, often tells me more than a clinic room.
Written by Dr. Joanne Patterson, DNP, MSN, PMHNP-BC, APHN-BC, board-certified Psychiatric Mental Health Nurse Practitioner. About Dr. Joanne
This article is educational and is not medical advice. If you have concerns about your child's development, talk with your pediatric provider.
Sources
- Dr. Joanne Psychiatry
- Autism, HealthyChildren.org (American Academy of Pediatrics)
- Autism Spectrum Disorder: Updated Guidelines from the AAP, American Family Physician
- Autism Prevalence Update 2025, Pathfinders for Autism
- Screening Guidelines for Autism in Primary Care Practice
- About DC:0-5, Barnard Center, University of Washington