The earliest years of a child’s life are among the most neurologically dynamic. It’s a period when the brain is developing at an extraordinary pace and when early intervention, if needed, can make the greatest possible difference. When a parent senses that something may be different about their infant or toddler’s development, in how they communicate, respond, connect, or engage with the world, acting on that instinct matters.
Early autism screening and evaluation are not about labeling a young child. It is about understanding them as completely and as early as possible, so that the support they need is in place during the years when it has the highest impact.
At Old Town Psychology, we provide specialized autism evaluations for infants and toddlers in Alexandria, VA, beginning at 16 months of age.
What Is Autism?
Autism Spectrum Disorder (ASD) is a neurodevelopmental condition that affects how a person communicates, processes sensory information, relates to others, and experiences the world around them. It is called a spectrum because it presents in an enormous range of ways. Across different individuals and at different ages, autism can look very different.
In the United States, autism affects approximately 1 in 36 children, making it one of the most common neurodevelopmental conditions diagnosed in childhood. It is also highly heritable, with genetics accounting for an estimated 80% of cases, though no single definitive cause has been identified. Autism is present from birth (It does not develop in response to parenting, vaccines, or environmental factors), but its signs become apparent at different ages and in different ways depending on the child.
For infants and toddlers, the earliest signs of autism often emerge in the first two years of life and center on social communication, attention, sensory responses, and the development of language and play. The American Academy of Pediatrics recommends universal autism screening for all children at 18 and 24 months. But if you have concerns before those scheduled screenings, or if a screening has raised a flag that warrants formal evaluation, an early autism evaluation is the appropriate and clinically recommended next step.
Early identification and early intervention produce dramatically better outcomes for children with autism than identification that occurs later in childhood. The earlier a child receives an accurate evaluation and, if indicated, appropriate intervention, the more effectively that support can shape the developmental trajectory that follows.
Signs Your Infant or Toddler Needs an Autism Evaluation
Autism can be reliably identified in children as young as 16 months with the right tools and expertise. The signs in infants and toddlers are often subtle and easy to miss, particularly for first-time parents who may not have a clear developmental baseline for comparison. The following are early signs that may indicate an autism evaluation is warranted:
Social communication and connection:
- Not responding to their name being called by 12 months
- Limited or absent eye contact, or eye contact that feels qualitatively different; fleeting, inconsistent, or difficult to establish
- Not showing things to caregivers by pointing, holding up objects, or using gaze to share interest by 14 months
- Not waving goodbye, reaching to be picked up, or using other common social gestures
- Limited smiling in response to a caregiver’s smile or expressions
- Appearing unaware of or uninterested in other people, including familiar caregivers
Language and communication development:
- No babbling by 12 months
- No single words by 16 months
- No two-word spontaneous phrases (other than imitating or repeating) by 24 months
- Loss of previously acquired language or social skills at any age, even a partial regression warrants prompt evaluation
- Repeating words or phrases heard on television or from others (echolalia) without apparent communicative intent
Play and exploration:
- Limited or absent pretend or imaginative play
- Unusual, repetitive use of toys, such as spinning wheels, lining objects up, or staring at moving parts, rather than engaging with toys functionally
- Strong attachment to unusual objects or materials
- Limited interest in other children or in interactive play with caregivers
Sensory responses and repetitive behaviors:
- Unusual reactions to sensory input, including extreme distress in response to everyday sounds, lights, or textures, or apparent unawareness of pain or temperature
- Repetitive body movements such as hand-flapping, rocking, spinning, or toe-walking
- Intense focus on specific objects, patterns, or stimuli to the exclusion of other engagement
- Significant distress in response to minor changes in routine or environment
General developmental concerns:
- A general sense that your infant or toddler is not developing on the same trajectory as other children their age
- Concerns raised by a pediatrician, early intervention specialist, or childcare provider
- A family history of autism spectrum disorder
Trust your instincts. Parents are often the first to notice that something is different, and their observations are clinically meaningful. If something feels off, an evaluation is the right next step.
What Does an Infant & Toddler Autism Evaluation Help With?
Early autism evaluation for infants and toddlers is not simply about reaching a diagnosis. It is about generating the information needed to give a young child the most effective support during a window of development that will not come again. Some ways an evaluation can help include:
Early diagnosis and intervention access
An early autism diagnosis opens the door to early intervention services, including Applied Behavior Analysis (ABA), speech-language therapy, occupational therapy, and developmental play-based therapies, that have the strongest evidence base when initiated in the toddler years. In Virginia, a formal ASD diagnosis gained through evaluation is the gateway to accessing these services through public programs and private providers.
Ruling out or distinguishing developmental delay from autism
Not all developmental differences are autism, and not all developmental delay presents as autism. A comprehensive early evaluation distinguishes between ASD, global developmental delay, language delay, sensory processing differences, and other conditions, ensuring that a child receives the right support rather than a best guess.
Early Part C Early Intervention and special education services
In Virginia, children under three years of age who have a developmental delay or disability are eligible for Part C Early Intervention services through the state. A formal evaluation provides the documentation needed to initiate or support this process, giving families access to the services their child is entitled to as early as possible.
A roadmap for family support
An accurate early evaluation equips parents with a clear understanding of their child’s strengths, challenges, and specific developmental profile and provides practical, personalized recommendations for how to support their child’s development at home and in childcare or preschool settings.
Peace of mind and clarity
For many families, an evaluation replaces the anxiety of not knowing with a clear clinical picture. Even when an evaluation does not result in an autism diagnosis, it provides valuable information about a child’s development and lays out a path forward.
What Does an Infant & Toddler Autism Evaluation Look Like?
At Old Town Psychology, infant and toddler autism evaluations are conducted by licensed psychologists with specialized expertise in early childhood assessment. We understand that evaluating very young children requires a different approach than evaluating older children or adults; one that is flexible and grounded in a deep understanding of early development.
Parent Interview
Every evaluation begins with a comprehensive clinical interview with you as the parent or caregiver. We gather a detailed developmental history covering pregnancy and birth, early developmental milestones, current communication and social behaviors, sensory responses, medical history, and family history. Your observations and concerns are a clinically essential component of the evaluation. You know your child better than anyone, and that knowledge shapes how the assessment is conducted and how the findings are interpreted.
Standardized Testing and Direct Observation
We use three gold-standard, research-validated instruments specifically designed or appropriate for infant and toddler autism evaluation:
- EarliPoint: An FDA-authorized, eye-tracking-based technology that objectively measures how a young child responds to social and non-social stimuli. EarliPoint is one of the most innovative tools available for early autism detection, providing objective data that is not dependent on a child’s compliance or verbal ability. It is particularly powerful for evaluating children in the 16 to 30-month age range, well before many behavioral assessment tools can be reliably administered. EarliPoint complements clinical observation by providing a quantitative, biological measure of early autism-related differences in social attention.
- ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition), Toddler Module: The global gold standard in autism assessment, the ADOS-2 includes a module specifically designed for toddlers who are not yet using phrase speech. This structured and semi-structured observational assessment allows our clinicians to directly evaluate social communication, joint attention, reciprocity, play, and repetitive behaviors in a naturalistic, child-friendly format.
- Bayley-4 (Bayley Scales of Infant and Toddler Development, Fourth Edition): A comprehensive developmental assessment that measures a young child’s functioning across cognitive, language, motor, social-emotional, and adaptive behavior domains. The Bayley-4 provides a detailed developmental profile that contextualizes the autism-specific findings, helping distinguish between global developmental delay and ASD, identify areas of strength and challenge, and inform intervention planning.
Comprehensive Report and Feedback Session
Once all data has been gathered and integrated, we prepare a detailed written report documenting the findings across every assessment domain, providing a clear diagnostic determination, and outlining specific, actionable recommendations tailored to your child’s profile. We then meet with you in a dedicated feedback session to walk through the report, answer every question you have, and ensure you leave with a clear understanding of the results and a concrete sense of next steps, including intervention recommendations, referrals, and guidance on accessing services.
"We brought our daughter in for testing and the OTP team was amazing. They were so kind, caring and great with children. My daughter is shy and takes a little time to warm up when first meeting someone new. The Doctor was patient and encouraging and my daughter had a wonderful time. They also provide fast results and meet with you to explain everything in the report. I would definitely recommend them."
"Very prompt response to our inquiry. Welcoming environment and very professional, thorough communication. The staff genuinely seems to care that your needs are met."
"Excellent service, knowledgeable staff, incredible responsiveness, diligence and follow through -- we feel lucky we found such a great therapy practice. We cannot recommend them highly enough!"
“My daughter took WISC-V test there and we are very pleased with our experience. They are professional, patient and wonderful throughout the entire process. My daughter had such a great time that she hardly felt that was a test - she even asked when she could take it again. I would highly recommend them to whoever needs child IQ testing services.”
“I took my children here for TAG testing. Both of my kids actually enjoyed their assessments. I was very pleased with the time and care taken to assess my children, the thoroughness of the report, and the fact that there was a follow-up session to discuss any questions that I had relative to the assessment included. Also-- the tea selection in the waiting room is top tier :)”
“Very prompt response to our inquiry. Welcoming environment and very professional, thorough communication. The staff genuinely seems to care that your needs are met.”
Take the Next Step
If something about your infant or toddler’s development is giving you pause, trust that instinct. Early evaluation is one of the most powerful things you can do for your child, and at Old Town Psychology, you do not have to wait to access it. We maintain immediate availability for infant and toddler autism evaluations, with no lengthy waitlist standing between your family and answers.
To schedule an infant or toddler autism evaluation or to ask any questions, contact us today.
