January 15, 2019

How Do I Know if My Child Has Autism?

The short answer from a behavioral psychologist

Child playing with blocks

Q: How do I know if my child has autism?


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A: Autism spectrum disorder (ASD) is a neurodevelopmental disorder. We diagnose it by identifying deficits in two primary areas:

  1. Socio-communication, which includes deficits in communication as well as using communication to engage socially. That may involve not using eye contact in a typical manner or not using gestures (such as pointing and waving) or other forms of nonverbal communication.
  2. Restrictive and repetitive behaviors. That can include performing repetitive actions and movements, having interest in only certain topics or saying certain words repetitively.

The severity of these symptoms can vary widely. We’re often able to detect them before the child turns 2 years old.

To diagnose ASD, we will conduct a comprehensive interview with the child’s parents or other caregivers. Then we work with the child to see how they interact with specialized materials.

We may do some structured play activities and evaluate how the child reacts to us and their family.


If the child isn’t talking yet, are they using gestures or other methods to communicate their wants? That’s how we can begin to tell the difference between a child with a language delay or ASD.

We also want to get as much information as possible from the child’s teacher and therapist. All of this information helps us get a clear picture of the child and determine if they meet the diagnostic criteria for ASD.

During the diagnosis process, families learn the severity of ASD as well as severity of developmental differences. It’s important to keep those separate. You may have a child who is exceeding their peers in cognitive development, but still have symptoms of ASD that hinder their daily function. You also may have a child whose cognitive development is far behind. In each case we need to use different interventions or levels of intervention.

Today the primary treatment for ASD is intensive behavior therapy. The earlier we can intervene, the earlier we can offset the cascade of disruptive development and close the gap in developmental differences.


Cynthia Johnson, PhD, Director of Cleveland Clinic Children’s Center for Autism

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