Selecting the Right Specialist for Autism Evaluation

Recently, I had the privilege of speaking with a group of courageous mothers raising children with Autism Spectrum Disorder (ASD). As someone deeply committed to mental health, I am often invited into the personal stories of parents navigating these complex and emotional journeys, but what I heard from these women was particularly troubling.

They shared with raw honesty how their concerns about their children’s development were repeatedly dismissed, minimized, or outright ignored by the professionals they trusted most. Despite clear warning signs, their voices were silenced in critical moments when early mental health intervention could have changed everything.

Here’s a powerful snapshot of what they bravely shared with me:

• “I told my pediatrician I thought my daughter had autism—only to be turned away when I asked for psychological testing.”
• “I mentioned it to numerous professionals, including my pediatrician, but they all said she was ‘fine.’”
• “Give her time to talk,’ my pediatrician said. Now, years later, I’m raising a non-verbal autistic child when this may have been prevented.”
• “We were referred to a developmental pediatrician, but the school’s special education team didn’t accept the testing results.”
• “Everyone told me it was anxiety and depression, but deep down, I knew it was autism.”
• “Why are there no specialists in ASD in our school district? Why are we told, ‘I don’t specialize in autism’ by those working directly with our children?”
• My child was tested by a developmental pediatrician. The school would not accept the report after we paid all of that money for it. My child had to be retested by her school.”

The Right Evaluation Matters for Your Child’s Support at School

These are not isolated stories. They reflect a systemic failure to prioritize mental health in early childhood care and education. Delayed or denied psychological evaluations can lead to years of missed support, misunderstood behaviors, and preventable suffering—not only for the children but for their families.

While many professionals receive specialized training related to child development, education, or behavioral interventions, it’s important to recognize that this training is not a substitute for a clinical psychologist’s rigorous, evidence-based expertise. Clinical psychology is a distinct profession grounded in advanced graduate education, supervised clinical experience, and licensure focused on assessing, diagnosing, and treating mental health conditions. Understanding and identifying Autism Spectrum Disorder (ASD), for example, requires more than observational experience or general training—it requires the depth and scope of psychological science. We must be careful not to conflate adjacent professional roles with the clinical expertise necessary to properly support a child’s mental health journey.

In my clinical experience, I often hear from parents who have sought diagnoses from developmental pediatricians. To be clear, their scope and training are not interchangeable with those of clinical psychologists. Developmental pediatricians are medical doctors who focus on physical and developmental milestones, often diagnosing conditions like ASD based on medical and behavioral assessments. However, these evaluations often do not include the type of standardized psychological testing required by educational systems.

As a result, schools may not accept a developmental pediatrician’s report as sufficient documentation for special education services. Clinical psychologists, however, bring a specialized lens rooted in mental health, with advanced training in psychological testing, diagnosis, and therapeutic intervention by using psychometric tools to evaluate cognitive functioning, emotional and behavioral regulation, and adaptive skills designed to meet both clinical and educational criteria. This distinction is crucial because special education eligibility under the Individuals with Disabilities Education Act (IDEA) requires data that supports how a disability affects a child’s educational performance.

How to Improve Early Autism Screening in Pediatric Care

Educational systems often require a comprehensive psychological evaluation conducted by or in collaboration with a licensed clinical psychologist or school psychologist. Both professionals, developmental pediatricians and clinical psychologists, serve essential roles, but their purposes—and the systems they inform—are not the same. Recognizing this distinction helps ensure that children receive the mental health support and educational accommodations they truly need.

Pediatricians are often the first point of contact for concerned parents, placing them in a key position to support early identification of autism spectrum disorder (ASD). I am a strong advocate of early childhood intervention, and one proposed improvement that I suggest is the implementation of a mandatory ASD-specific rating scale, such as a Vanderbilt TRIAD Autism Tool: TELE-ASD-PEDS (TAP), a telehealth-based assessment, or the Childhood Autism Rating Scale – 2nd Edition (CARS2-ST), to be given by pediatrians for all children under 3 years. This approach would be modeled after the brief depression screeners already used during wellness visits for children ages 12 and older. By integrating a developmentally appropriate ASD screener into routine check-ups, pediatricians can help identify early indicators of autism more consistently across all populations.

According to the American Academy of Pediatrics, early diagnosis and intervention are critical to improving long-term outcomes for children with ASD. Delayed diagnosis often results in missed opportunities for timely support, making universal early screening a necessary step toward more equitable and effective care.

Why Early Diagnosis Matters

The AAP recommends that “All children be screened for ASD at ages 18 and 24 months, along with regular developmental surveillance. Toddlers and children should be referred for diagnostic evaluation when increased risk for developmental disorders (including ASD) is identified through screening and/or surveillance. Children should be referred for intervention for all identified developmental delays at the time of identification and not wait for an ASD diagnostic evaluation to take place.”

When ASD diagnoses are delayed, families miss crucial windows for support, therapy, and educational planning—opportunities that can significantly impact a child’s development. To ensure all children receive the care they need, universal early screening for ASD must become a standard part of pediatric practice, as the AAP recommends, to promote more equitable and effective access to services. Then, psychologists can take over to provide specialized assessments, diagnoses, and tailored mental health interventions essential for each child’s success. Collectively, these efforts to address parental concerns and ensure that families feel heard when early signs of ASD emerge.