How to Get an Autism Evaluation for Your Child in California

Children develop on their own timelines, and no single behavior means anything on its own. What matters is the pattern, and your own sense that something has changed. The CDC's Learn the Signs. Act Early. checklists are the clearest place to start: they list what most children do by a given age, from two months through five years, in language written for parents.

The things pediatricians most want to hear about are social and communication-related rather than dramatic:

• Not responding to their name consistently by around 12 months
• Not pointing to share interest, or not bringing you things to show you
• Limited eye contact, or little back-and-forth smiling and gesturing
• Delayed or absent speech, or speech that is mostly repeated phrases
• Strong distress at small changes in routine, or intensely repetitive play
• Losing skills your child previously had — words, gestures, or social interest. This one is worth calling about the week you notice it.

Your child's pediatrician is the fastest door for most families, and the one that unlocks the others. The American Academy of Pediatrics recommends developmental screening at the 9-, 18-, and 30-month visits and autism-specific screening at the 18- and 24-month visits. The tool most offices use is the M-CHAT-R/F, a short parent-report questionnaire validated for toddlers roughly 16 to 30 months old, with a brief structured interview if answers flag. A positive screen does not mean your child has autism; it means the questionnaire found enough to justify a closer look.

What to ask for

• An autism screening at this visit, even outside the 18-to-24-month window. Your concern is a valid reason at any age.
• A referral for a comprehensive diagnostic evaluation — usually to a developmental-behavioral pediatrician, a child psychologist or neuropsychologist, a child psychiatrist, or a hospital-based autism evaluation center.
• A hearing test, since hearing loss can look like a language or social delay.
• Your concerns in the chart, in your words — send them through the patient portal before the visit.

If you have Kaiser Permanente, the pathway is internal: Kaiser Permanente Northern California runs its own autism spectrum disorder evaluation centers, and the route in is a referral from your child's Kaiser pediatrician, often followed by an intake packet. Ask how it works at your medical center, since it varies by facility. Our Kaiser ABA therapy page covers the treatment side afterward.

California funds services for people with developmental disabilities through 21 regional centers — private nonprofits under contract with the state Department of Developmental Services, each covering a set of counties. For families with young children this is often the most useful call to make: the evaluation is free, and you do not need a doctor, a diagnosis, or insurance to ask for it.

Under age three: Early Start

Early Start is California's early intervention program for children from birth to their third birthday. A child is eligible with a developmental delay of at least 25% in one or more areas of development (cognitive, communication, social or emotional, adaptive, or physical and motor), or with an established risk condition, or with a combination of biomedical risk factors identified by qualified personnel. DDS is explicit that there is no cost for evaluation, assessment, or service coordination.

Anyone can make the referral, including you. Call your regional center's intake line and ask for an Early Start evaluation. A multidisciplinary team assesses your child, and if they qualify, you and the team write an Individualized Family Service Plan naming the services your child will receive.

Age three and older: Lanterman Act eligibility

At three, Early Start ends and the question becomes eligibility under the Lanterman Act: a substantial disability that began before age 18 and is expected to continue indefinitely, with autism among the qualifying conditions. There is also a provisional eligibility route for children who are 3 or 4 and do not yet have a diagnosis, based on a disability that is not solely physical plus significant functional limitations in at least two major life activities.

In Behavia's North Bay service area, Golden Gate Regional Center covers Marin, San Francisco, and San Mateo counties, including families in San Rafael, and North Bay Regional Center covers Napa, Solano, and Sonoma counties, including Vallejo and Fairfield. Intake procedures differ, so check the current process on the DDS regional center directory before you call.

Once your child turns three, your local school district has a legal obligation to identify and evaluate children who may need special education — including children not yet enrolled anywhere. You do not need a diagnosis or a referral to ask.

Be clear about one thing first: an IEP eligibility determination is an educational decision, not a medical diagnosis. A district team can find that your child meets the special education criteria for autism without any clinician making a clinical diagnosis, and a clinical diagnosis does not automatically make a child IEP-eligible. A health plan asking for a diagnosis will not accept an IEP in its place.

How to request an evaluation

1. 1

   Put the request in writing

   Email or mail a dated letter to your district's director of special education, copying the principal if your child is enrolled. Say plainly that you are requesting an assessment for special education eligibility, and list what you have observed. The district's legal timelines start from a written request.

2. 2

   Watch for the assessment plan

   Under California Education Code section 56321, the district must give you a proposed assessment plan within 15 calendar days of receiving your written referral. That is the district's legal timeline, not a Behavia estimate. Ask for anything missing before you sign.

3. 3

   Sign and return consent

   Nothing happens until you consent. Once the district has your signed plan, Education Code section 56344 gives it 60 days to complete the assessment and hold the IEP meeting, not counting school vacations longer than five days or days school is not in session.

4. 4

   Go to the IEP meeting prepared

   Ask for the reports in advance so you can read them before the meeting rather than during it. You are a full member of the IEP team, and you can bring someone with you.

A clinical diagnostic evaluation is a covered medical benefit. Medi-Cal managed care plans and commercial plans both cover it; the practical question is which in-network clinicians actually perform them near you. Call the member services number on your child's card and ask:

1. Is a comprehensive autism diagnostic evaluation covered for my child, and what will it cost me?
2. Which in-network providers perform them — developmental-behavioral pediatricians, child psychologists, or autism evaluation centers — and which are closest to us?
3. Do I need a referral or prior authorization first, and if so, from whom?

In the North Bay and Solano County, most Medi-Cal families are covered by Partnership HealthPlan of California; our Partnership HealthPlan guide explains how it handles authorization. Behavia accepts Medi-Cal, Partnership HealthPlan of California, Aetna, Contra Costa Health Plan, Kaiser Permanente, and Alameda Alliance for Health.

Diagnostic evaluations can take a while to schedule, and families often assume that puts everything else on hold. Under Medi-Cal it does not. Since 2018 the Department of Health Care Services has required Medi-Cal managed care plans to cover Behavioral Health Treatment — the category that includes ABA — for members under 21 with or without an autism diagnosis, as long as a licensed physician, surgeon, or psychologist determines it is medically necessary. The current policy for plans is All Plan Letter 23-010.

In practice, a pediatrician concerned enough to refer your child for an evaluation can often recommend ABA at the same visit, so the two run side by side instead of end to end. Our guides on what Medi-Cal covers and how to get ABA through Medi-Cal walk through the steps, and our Medi-Cal ABA therapy page lists the plans we work with. Commercial plans set their own rules, so ask yours whether a diagnosis is required before authorization.

Evaluations go better when the clinician can see your child across settings, not only in one unfamiliar room on one unusual morning. You are the source for most of that, so write your own questions down before you go.

You will get a written report. Ask for a copy in your hands, and ask the clinician to walk you through it in plain language before you leave. It should say what was assessed and how, what the findings were, whether diagnostic criteria were met, and what the clinician recommends. That document then opens several doors at once:

• Your school district must consider outside assessments you provide. Send it to the IEP team in writing and ask for it to be added to the record.
• Your regional center uses it for eligibility and to shape the Individual Program Plan or IFSP.
• Your health plan and ABA provider use it to support authorization and to inform the treatment plan.

Then services begin. If ABA is part of the recommendation, our guide to the first month of in-home ABA describes what happens in your living room. To talk it through with a person, you can get started with Behavia online or reach us through our contact page. An evaluation in progress is no reason to wait to ask questions.

• American Academy of Pediatrics (HealthyChildren.org): How Pediatricians Screen for Autism
• CDC: Learn the Signs. Act Early. milestone checklists and Milestone Tracker app
• M-CHAT-R/F official site
• California DDS: What is Early Start and the regional center directory
• Disability Rights California: Special Education Timelines and CDE: Parents' Rights in Special Education
• DHCS All Plan Letter 23-010, the Behavioral Health Treatment policy for Medi-Cal plans