Tests and diagnosis

By Mayo Clinic Staff

Your child's doctor will look for signs of developmental delays at regular checkups. If your child shows some signs of autism, you may be referred to a specialist who treats children with autism. This specialist, working with a team of professionals, can perform a formal evaluation.

Because autism varies widely in severity, making a diagnosis may be difficult. There isn't a specific medical test to determine the disorder. Instead, an autism specialist may:

  • Observe your child and ask how your child's social skills, language skills and behavior have developed and changed over time
  • Give your child developmental tests covering speech, language, developmental level, and social and behavioral issues
  • Present structured social and communication interactions to your child and score the performance

Signs of autism often appear early in development when there are obvious delays in language skills and social interactions. Diagnosis is usually made before age 3. Early diagnosis and intervention is most helpful and can improve skill and language development.

Diagnostic criteria for autism

For your child to be diagnosed with autism, he or she must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment.

To be diagnosed with autism, your child must have six or more of the following symptoms, and two or more of those symptoms must fall under the social skills category.

Social skills

  • Has difficulty with nonverbal behaviors, such as making eye contact, making facial expressions or using gestures
  • Has difficulty forming friendships with peers and seems to prefer playing alone
  • Doesn't share experiences or emotions with other people, such as sharing achievements or pointing out objects or other interests
  • Appears unaware of others' feelings

Communication skills

  • Doesn't speak or has delayed speech and doesn't make an attempt to communicate with gestures or miming
  • Can't start a conversation or keep one going
  • May repeat words or phrases verbatim, but doesn't understand how to use them
  • Doesn't play make-believe or doesn't imitate the behavior of adults when playing


  • Develops interests in objects or topics that are abnormal in intensity, detail or focus
  • Performs repetitive movements, such as rocking, spinning or hand-flapping
  • Becomes disturbed at the slightest change in routines or rituals
  • May be fascinated by parts of an object, such as the spinning wheels of a toy car
Oct. 06, 2012