After an autism diagnosis in India: what next, and a plan for the first 90 days

Nothing here has to happen in a particular week, and a family with a school admission or a move coming up will reorder it. As a rough shape, though, the first 90 days fall into four stages.

Parents describe the days after a diagnosis in very different ways: relief at an explanation, grief, fear for the future, guilt, anger, or all of them in one afternoon. Two parents may react differently and at different speeds, and relatives may add opinions of their own. None of this needs resolving in the first fortnight, and no decision about therapy, school or money has to be made in it. The child who came home from the clinic is the same child who went in.

Look after yourselves in practical ways. Share the load between the adults at home, so that one parent is not carrying the appointments, the reading and the relatives alone. Sleep. Talk to someone you trust, and consider a counsellor or psychologist for yourselves if the weight is not lifting after a few weeks. Other parents of autistic children are a good source of local knowledge, but treat any recommendation of a paid service as the start of your questions, not the end. Much of what appears online after a diagnosis is selling something, so keep your reading to a few careful sources.

Diagnostic reports are written for other professionals as much as for families, and many parents leave the appointment with a document they cannot fully follow. Book time with the clinician who made the diagnosis, whether a developmental paediatrician, child psychiatrist or clinical psychologist, specifically to go through it. Write your questions down beforehand, bring a second adult to take notes, and ask for anything unclear to be explained again in plain words.

• What does the report say, in plain words, about how my child communicates, plays, learns and copes with sound, touch and change?
• What are my child's strengths, according to the assessment?
• Which recommendations matter most in the next three months, and which can wait?
• Which professionals should my child see first, and how will we know whether it is helping?
• What can we start at home this week?
• What should we tell the school, and would you write a short note for it?
• When will you see my child again, and what will you look at then?

The question about priorities is the one to insist on. A report may list six recommendations, and a family that tries to start all six in the same month usually manages none of them well. Keep this report, and every later one, dated and in a single file, on paper and on your phone.

The clinicians will usually recommend a combination of professionals, and it helps to know what each does before the appointments begin. A speech-language pathologist works on communication; an occupational therapist on sensory processing, daily living and movement; a clinical or child psychologist on behaviour, emotions and learning, sometimes alongside a behaviour analyst; and the developmental paediatrician or child psychiatrist oversees the child's health and development. A special educator carries their plans into ordinary days at home, and a shadow teacher does the same in school where one is needed.

Which of these your child needs, in what order and how often, is for the clinicians to say. What the family decides is the practical shape: session times the child can manage alongside school and the commute, and one person, often a parent or a special educator, who keeps a shared record and, with your consent, makes sure each professional knows what the others are doing. Special educator or therapist: who does what explains the roles in more detail.

If your child is already at school, the school may have raised the concern that led to the assessment, and it will want to know the outcome. You decide what to share and when. Many families share a summary of what helps and what is hard, with a short note from the clinician, rather than the whole report. Ask for a planned meeting with the class teacher and the coordinator, not a word at the gate, and bring the recommendations that concern the school day.

Use the meeting to ask what the school can offer: an individual plan, time with its special educator or resource room, adjustments in class, and whether it would accept a shadow teacher if the clinicians recommend one. If your child is not yet at school, the diagnosis will shape the choice of school, and the same questions belong on every visit. Telling the school about your child's diagnosis covers what to say, when to say it and how to handle the response.

Families are often told about a disability certificate and the UDID card soon after a diagnosis. Whether to apply, when and how are questions whose answers depend on your state and your child, and they do not need settling in the first week. The UDID card and disability certificate for a child explains them. Ask the clinician which of their reports you are likely to need, and whether they would need to write anything further.

Start a file now, whatever you decide: the diagnostic report, every therapy report, school reports and notes from meetings, each dated, with copies given out rather than originals. Schools, therapists and offices will ask for these for years, and a file you can find in a minute saves repeated appointments.

Start small at home. Take one routine that often goes wrong, such as the morning or bedtime, and show it as a short visual schedule; use the same few words for the same moments every day; warn before changes. Use the pictures and words the speech-language pathologist recommends, so that home and therapy match. Visual schedules and social stories at home shows how to make a schedule, and the occupational therapist can advise on the sensory side of the house.

A routine only works if every adult who looks after the child follows it: grandparents, whoever helps in the home, whoever does the school run. Relatives may meet the diagnosis with doubt, blame, remedies they have heard about, or worry that comes out as criticism. Give each of them one specific thing to do, such as the same words at bedtime, rather than a lecture on autism. How much to tell the wider family is yours to decide; one consistent plan across the whole household covers the briefing.

Families with a new diagnosis are an easy market, and some providers know it. Be cautious of anything described as a cure or a recovery, guaranteed results, large payments in advance, pressure to decide today, and testimonials offered in place of an explanation. Anything that involves a medicine, a supplement, a special diet or a procedure is a question for the child's doctor before it is a question of money. Before paying for any therapy or programme, ask the provider these questions.

• What exactly will you do, how often, and who will do it, with what qualification?
• What will change for my child, and how will you measure it?
• What is the total cost, including assessments and materials, and what is refunded if we stop?
• How will you work with my child's other clinicians and the school?
• Can I have the plan in writing to show my child's doctor?

Then take the answers to your child's developmental paediatrician or psychologist and ask whether they would recommend it for your child, and why. A genuine provider welcomes that step. One who discourages it, or says the doctors do not understand their method, has answered your question.

A special educator at home often turns the clinicians' recommendations into an ordinary day: the visual schedule, the communication targets practised at meals and play, the sensory plan in the morning routine, the household briefed, and a record each therapist can use. They do not diagnose, assess or deliver therapy, and they work to the clinicians' plan rather than writing their own. A good time to bring one in is once the first clinical plan is clear, so there is something specific to carry into the day.

A shadow teacher is for the school day, arranged with the school's agreement, when a child needs an adult close by to follow the lesson, manage transitions and join in. Special Minds introduces vetted special educators and shadow teachers in Mumbai, Delhi NCR, Bengaluru, Hyderabad, Chennai, Kolkata, Pune and Ahmedabad, starting with a child-support profile written with the family, which is a plain description of the child rather than a diagnosis or an assessment.