Does My Child Need an Autism Evaluation? 7 Signs It’s Time to Get Answers

Written By Rachel Fein

If you’ve found yourself wondering whether your child’s development is “on track,” you’re not alone. Many parents notice small differences long before anyone else does. Sometimes those differences resolve on their own. Other times, they signal the need for a closer look.

So how do you know when it’s time to pursue an autism evaluation?

As a Child Psychologist and Board Certified Behavior Analyst specializing in the assessment of Autism, I often describe seven common signs that may indicate it is worth pursuing an autism evaluation.

1. Delayed Speech or Language Skills

One of the earliest signs parents notice is delayed speech. This might look like:

  • Not babbling by 12 months

  • Not using single words (e.g., “ball”) by 16 months

  • Not using two-word phrases (e.g., “mama up”) by 30 months

  • Continuing to repeat what others say (echolalia) after 30 months 

Some children eventually catch up, but language delays paired with social differences can be important to evaluate.

2. Limited Eye Contact or Social Engagement

Children naturally seek connection. If your child:

  • Rarely makes eye contact, avoids eye contact, or makes intense eye contact

  • Doesn’t respond to their name or seems like they can’t hear

  • Seems “in their own world” and/or prefers playing on their own

…it may indicate differences in social communication.

3. Reduced Use of Gestures

Before words, children communicate through gestures, especially when there is a speech/language delay. Here are some common early signs of autism:

  • Not pointing to show interest

  • Not waving or reaching to be picked up

  • Not clapping, nodding/shaking head, or blowing kisses

These early nonverbal skills are key building blocks of communication.

4. Repetitive Behaviors or Strong Routines

Many children enjoy routines, but autism-related patterns tend to be more intense or inflexible:

  • Lining up toys or objects 

  • Repeating phrases from television shows or movies

  • Engaging in repetitive motor movements, like hand flapping, toe walking, spinning or rocking back and forth 

  • Appearing distressed with small changes to their routine or environment

  • Difficulty with handling transitions 

These behaviors often help with self-regulation. 

5. Intense or Unusual Interests

Some children develop very focused interests, such as:

  • Fixation on parts of objects (e.g., wheels, lights, fans)

  • Deep interest in specific topics 

  • Playing in repetitive ways (e.g., lining up or stacking toys, arranging or collecting items)

This can be a strength, but it can also be part of an autism diagnosis. 

6. Sensory Sensitivities

You might notice your child:

  • Covers their ears to everyday or loud sounds

  • Avoids certain food or clothing textures 

  • Seeks out sensory input (e.g., wants tight hugs, enjoys licking/mouthing things, likes to visually inspect toys or objects)

Sensory differences are very common in children with autism.

7. You Have a Gut Feeling

This one matters more than you might think. Parents are often the first to notice when something feels different. If you’re asking the question, it’s worth exploring.

What to Do Next:

An evaluation doesn’t automatically mean a diagnosis. It simply gives you clarity.

The earlier you understand your child’s needs, the sooner you can:

  • Access appropriate supports

  • Reduce frustration (for both you and your child)

  • Build on your child’s strengths

If you're unsure, a consultation can help you decide whether a full evaluation makes sense.

I provide Autism Evaluations in Houston, TX and virtually across Texas, California and 42 other PSYPACT states. Learn more about the Autism Evaluation process here.

Rachel Fein