When Should I Screen My Child?

Parents often ask, "Is it too early to screen my child?" In many situations, screening is a safe first step. A screening result does not diagnose ADHD, autism, or any developmental condition. It simply helps parents notice patterns and decide whether to talk with a pediatrician, teacher, therapist, or specialist.

If a screening shows no concern, parents may feel reassured and continue watching milestones. If a screening shows possible concern, parents can take action earlier instead of waiting months or years while the same struggles continue.

Why screening matters

• Screening helps parents move from worry to clarity. Instead of guessing whether a behavior is normal, parents can look at patterns in a more structured way.
• Screening can support earlier conversations. Pediatricians and specialists can respond better when parents bring specific examples, screening results, teacher notes, and timeline details.
• Screening may identify support needs even when it is not autism or ADHD. A child may screen positive and later not receive an autism or ADHD diagnosis, but may still need help with speech, behavior, learning, sensory needs, sleep, anxiety, or social skills.
• Screening is low-risk and low-cost. The result is a data point, not a label. It helps guide the next step.
• Waiting can make daily life harder. When concerns continue for a long time, children may experience repeated frustration at home, daycare, or school. Families may also feel more stressed because they do not know what kind of help to request.

When to screen for autism

Autism screening is commonly recommended during toddler well-child visits, especially around 18 and 24 months. The M-CHAT-R is designed for toddlers 16-30 months old. If parents have concerns at any age, they should discuss them with the pediatrician.

Possible signs by age:

By 12 months

• Does not babble or use early sounds often
• Does not respond to name consistently
• Does not point, wave, or share attention with you
• Does not smile back or share facial expressions often

By 18 months

• No single words or very limited speech
• Does not imitate simple actions like waving or clapping
• Does not look where you point
• Limited pretend play or social play

By 24 months

• No two-word phrases, not counting repeated phrases
• Limited interest in other children
• Very strong distress with routine changes
• Strong reactions to everyday sounds, textures, lights, or clothing

Important: Any loss of language, social skills, or play skills should be discussed with a pediatrician promptly, regardless of age.

When to screen for ADHD

ADHD concerns are usually easier to evaluate in school-age children because attention, activity level, and impulsive behavior can be compared across settings such as home and school over time. Tools such as the Vanderbilt rating scales are commonly used for school-age children, often ages 6-12.

For younger children, high energy and short attention can be developmentally typical. Still, parents can start an ADHD-aware conversation with the pediatrician earlier when the behavior is intense, repeated, and affects safety, learning, daycare, school, or family routines.

• Teachers or daycare providers repeatedly raise the same concern
• Activity level is much more intense than same-age peers
• The child is removed from daycare, class, sports, or programs due to behavior
• The child often acts before thinking and safety becomes a concern
• There is a family history of ADHD and the child is showing repeated struggles

For children under 6 with significant ADHD symptoms, parent training in behavior management is often recommended before medication discussions. Parents should talk with their pediatrician about the right next step for their child.

But what if the screening is wrong?

Screening tools can have false positives and false negatives. A positive screen means, "Please talk to a professional," not "Your child definitely has this condition." A negative screen means, "No major concern was detected by this tool today," not "Ignore all concerns."

Think of screening like a blood pressure check: one helpful data point. It does not tell the whole story, but it can help you decide what to do next.

Simple next steps for parents

1. Write down 3-5 examples of the behavior you are seeing.
2. Notice where it happens: home, daycare, school, playground, family events, or all settings.
3. Ask teachers or caregivers if they see the same pattern.
4. Save or print the screening result.
5. Book a pediatrician visit and ask whether evaluation, therapy, school support, or early intervention is appropriate.

A gentle reminder

Screening is not about labeling a child. It is about understanding what support may help the child thrive. If you are worried, it is reasonable to ask questions early.