Autism assessment in India: who to see, what happens, and how to prepare

The Indian Academy of Pediatrics (IAP) describes autism assessment as team work. A developmental paediatrician or paediatrician usually coordinates it, with a clinical psychologist, a speech-language pathologist and an occupational therapist each looking at a part of the picture, and the diagnosis is confirmed by a developmental paediatrician, a developmental neurologist or a child psychiatrist. In practice the first door may be any of them: a child psychiatry clinic in a medical college, a paediatric neurologist your paediatrician trusts, or a child development centre where the whole team works under one roof.

A developmental paediatrician is a paediatrician with further training in development and behaviour. It is a small, fellowship-based field in India, so many cities have only a few, and waiting lists are common. A paediatric neurologist is often brought in when a child has lost skills, has seizures or presents a puzzle; a clinical psychologist usually carries out the developmental, cognitive and autism-specific tests.

Two quick checks are worth doing before you book. Doctors, including developmental paediatricians, are registered medical practitioners, so you can check them through the State Medical Council or the National Medical Commission's registers. Clinical psychologists and speech-language pathologists must be registered with the Rehabilitation Council of India (RCI), whose Central Rehabilitation Register can be searched online.

No, and mixing them up leads to wasted visits. Screening is a short check, often a parent questionnaire such as the M-CHAT-R/F, that says only whether to look further. IAP guidance recommends autism screening for all toddlers, at around 18 and 24 months, but a child of any age can be referred. An online quiz, however long, is a screen at best, and a reassuring score does not overrule a worry that you or the school keep having.

Diagnosis is the full clinical assessment this guide describes, done by qualified professionals against the DSM-5 criteria, and it ends in a report with recommendations. Disability certification is a third step under the Rights of Persons with Disabilities (RPwD) Act, 2016: a certificate and UDID card issued by a medical authority the state has notified. Different people do each step, for different purposes, and a family may need one, two or all three.

Start with your child's paediatrician. They know the local routes, can refer you with a letter, and can rule out other causes of what you are seeing. The main options are below; most families end up using a mix, for example a government clinic for the assessment and private therapy afterwards, or the other way round.

Put your name on more than one waiting list if you can, and ask to be called if a slot opens. Then do not simply wait. The IAP's autism guidance says intervention should start as early as possible and that a definitive diagnosis is not needed to begin it. Ask the paediatrician what can start now; early intervention in India explains the public services for young children.

Expect questions first. The clinician will ask about pregnancy and birth, when your child sat, walked, babbled and spoke, whether any skills were lost, and how they play, sleep, eat and cope with change, noise and other children. They will ask which languages your child hears at home and from whom, because a fair assessment looks at communication in all of them. Both parents, and a grandparent who spends the day with the child, can add things the other has not seen.

Then the clinicians watch and play. They look at how your child communicates, whether they respond to their name, share attention and enjoy back-and-forth play, and what they do with toys. Some of this is free play and some uses standardised tools. Which tools a clinic uses is its choice: IAP documents name, among others, the ADOS-2, CARS, the INCLEN tool INDT-ASD and parent interviews such as the ADI-R. No single tool suits every child; the tools support the clinician's judgement rather than replace it.

• A physical examination, and hearing and vision checks, which IAP recommends for every child assessed for autism.
• Blood tests such as a blood count and thyroid function, which IAP's treatment guidelines recommend.
• Developmental or cognitive testing, usually by a clinical psychologist.
• An adaptive behaviour assessment: how your child manages everyday tasks at home.
• A speech and language assessment by a speech-language pathologist.
• An occupational therapy or sensory evaluation.
• A feedback meeting with the family, and a written report, sometimes a few days or weeks later.

IAP guidelines do not recommend routine metabolic, biomarker or toxin testing for autism. If a clinic offers expensive tests of this kind, ask why they are needed for your child, and ask your paediatrician before agreeing.

A clinic sees your child for an hour or two in a strange room, often after a long commute through Mumbai or Bengaluru traffic, and your child may be quieter, louder or more anxious than usual. What you bring fills the gap between that hour and ordinary life. Put it in one folder, with copies the clinic can keep.

• Short phone videos from home: your child playing, eating, responding when called, with other children, and during the moments that worry you, filmed only when it is safe and kind to do so.
• Milestone notes: when your child sat, walked, babbled, said first words and put words together, and any skills that were lost.
• Medical records: the birth discharge summary, the newborn hearing screen result, any earlier hearing tests and letters from other doctors.
• Preschool or school reports, the teacher's remarks in the school diary, and a short note from the class teacher if the school will write one.
• Any earlier speech therapy, occupational therapy or psychology reports.
• A note of the languages spoken at home, by whom and how often.
• Your questions and main worries, written down, with the three that matter most at the top.
• For your child: water, familiar snacks, a favourite toy, spare clothes and something calm to do in the waiting room.

Book a time of day when your child is usually at their best, not straight after school or a long van ride. Tell them simply where they are going: a place with toys and a person who wants to play and talk. If your child uses pictures, show a photograph of the building or make a short story about the visit, as described in visual schedules and social stories at home. Do not coach or rehearse answers; the clinicians need to see your child as they are.

Take two adults if possible, one to be with the child and one to listen and write notes. Agree beforehand which relatives come; a large group in a small room makes it harder for everyone. If your child has a very different day from usual, tell the clinician, and offer the videos. If your child is at school, the clinic may send a questionnaire for the teacher. Deciding what to share with the school, and when, is covered in telling the school about your child's diagnosis.

No. A diagnosis is a clinical opinion in a report. A disability certificate is a statutory document under the RPwD Act, issued by a medical authority the state government has notified. At the time of writing (September 2026), certificates and UDID cards have been issued only through the UDID portal, swavlambancard.gov.in, since 1 June 2021. A private clinic's report does not by itself produce a certificate, although the medical board may ask to see it.

Families often hear about the ISAA, the Indian Scale for Assessment of Autism, and assume it is the diagnostic test. It is mainly used to grade the extent of disability for certification, not to diagnose. Peer-reviewed commentaries on the current guidelines, S.O. 1338(E) of 12 March 2024, describe INDT-ASD being used for diagnosis and ISAA for severity in the certification process, and researchers have noted that ISAA works less well in children under five. The rules change, so confirm the current process with your medical authority. The UDID card and disability certificate explains how to apply.

The feedback meeting is the moment to get what you will need for the next months. Ask for anything you do not understand to be said again in plain words, and do not leave without knowing when you will receive the written report.

1. What did you find, in plain words, and how confident are you?
2. What are my child's strengths, according to the assessment?
3. Which recommendations matter most in the next three months?
4. Which professionals should we see first, and can you refer us?
5. Is anything else worth checking, such as hearing, sleep or seizures?
6. What should we tell the school, and will you write a short note for it?
7. When should we come back, and what will you look at then?

What happens next, from building the team to school and paperwork, is set out in after an autism diagnosis in India. Special Minds does not assess, diagnose or certify. Once a family has a plan from its clinicians, it introduces vetted special educators and shadow teachers who carry that plan into home and school; our autism support page describes how.