The letter about the autism assessment said the wait is fourteen months.
You read it twice, worked out how old your child will be by then, and felt something drop. Fourteen months of doing nothing, while the thing everyone told you was time-critical goes on happening.
That framing is wrong, and it is the most useful thing in this article, so it goes first. Almost everything that will help your child in the next fourteen months does not require a diagnosis, is not gated behind that appointment, and in most cases costs nothing. The assessment gives you a name and a set of doors. It does not give you the support. The support is available now and most families waiting on a list have no idea.
What can I do while waiting for an autism assessment?
Two things, in this order. Start the free evaluations that do not need a diagnosis: Early Intervention if your child is under three, your school district if they are three or over. Those run on a separate track and can deliver actual therapy while the diagnostic list crawls. Then set up a documentation system, because the appointment you are waiting for will depend on what you can evidence about the last year.
Everything else is optional. Those two are not.
The free routes nobody tells you about
In the US there are two publicly funded systems that assess and support children with developmental concerns, and neither requires an autism diagnosis, a doctor's referral, or a positive screen.
Under three: Early Intervention. Every state runs a programme under Part C of federal special education law, and you can refer your own child by phone. The evaluation is free by law. If your child qualifies you get an individualised family service plan, which can include speech-language therapy, occupational therapy and developmental support, often at home. Services are free or on a sliding scale.
Three and over: your school district. Write to the district's special education office requesting an evaluation. No diagnosis, no referral, no cost, and the district has a legally defined window to respond. If your child qualifies you get an individualised education programme with services at school.
Neither system decides whether your child is autistic. They decide whether your child needs support, a different and much lower bar, and one many children on autism waiting lists clear easily.
The letter that starts the evaluation clock
Write it today. Here is the whole thing:
"I am requesting a full evaluation for my child, [name], date of birth [date], under IDEA. I have concerns about their communication and development. Please confirm receipt of this request and advise on next steps and timelines. I am available at [phone] and [email]."
Send it by email so you have a timestamp. That sentence starts a legal clock. A phone call does not.
If you are not in the US
The acronyms do not transfer but the principle does: publicly funded support is allocated on assessed need, not on a diagnosis. Three routes worth asking about. Your health service's speech and language therapy referral, which a parent can usually request directly. The school or nursery's internal special needs process. Your local authority or its regional equivalent, which tends to hold the early years budget.
The ask is the same everywhere. "I am requesting support on the basis of my child's communication needs, not on the basis of a diagnosis."
The documentation system
Nine months from now a clinician will ask you when your child last used a new word, whether they point to share things, and how often meltdowns happen. You will say "um" and you will guess, and your guess will shape the outcome of the appointment.
So build the record now. It takes about five minutes a week once it is running.
1. The word list. A note on your phone. One line per word: the word, the date you first heard it used meaningfully, and whether it is still in use. Never delete a word. If it stops appearing, add the date it stopped, because lost vocabulary is clinically significant and easy to forget. Include signs, approximations and consistent sounds that mean something. "Buh" for bottle counts.
2. The dated video folder. Six to ten clips over the waiting period, thirty to sixty seconds each. Shoot the ordinary rather than the dramatic: playing alone, playing with you, a mealtime, a transition out of the house. Do not narrate and do not prompt them to perform. Clinicians say this footage is one of the most useful things a parent brings, and almost nobody brings it.
3. The frequency log. Not a diary. A tally. One line: date, what, how long, what preceded it. Track two or three things only.
4. The other-people file. Anything in writing from anyone else who sees your child: nursery observations, a teacher's email, the paediatrician's letter. Ask for specifics. "Do they start conversations with other children, or respond when other children start them?" gets you evidence. "How are they doing?" gets you "lovely".
5. The one-page summary. Why you sought the assessment in three sentences, then your top six observations with an example and a date for each. Print two copies and hand one over at the start.
Start communication support now
You do not need to know why a child is not communicating to start supporting communication. The strategies that help an autistic toddler and those that help a late-talking non-autistic toddler overlap almost entirely, and none will hurt a child who needs neither.
Most of us refill the silence in two seconds and never find out what would have happened.
Comment far more than you question, too. A running narration beats a quiz, because questions demand a performance and comments offer language for free. And if your child has little or no reliable speech, raise augmentative communication at the first appointment you get rather than the fifth. ASHA's autism practice portal is clear that AAC does not prevent or delay speech. The myth persists anyway. Nobody has to fail at speech first.
Short daily practice beats long weekly practice, and it works best when it does not feel like practice. Verbalyft is one option, and free speech therapy resources rounds up others, several of them free.
What not to spend money on
You are about to be advertised to, heavily and precisely, by an industry that knows exactly what a frightened parent on a waiting list looks like. Some of it is well-meaning. Some of it is not.
You will know the ones that are not by the deadline.
One thing that is worth money if you have it: a few sessions with a speech-language pathologist experienced in autism, even sporadically. Highest-value paid item on this list by a distance.
Do not leave the list
Autism evaluation wait times vary enormously by region and by provider, which is why the queue is worth working. Starting Early Intervention, seeing a private SLP, or watching your child make progress are all reasons to feel better. None is a reason to come off the list.
Ring every few months, politely, and ask two questions: where you are in the queue, and whether they hold a cancellation list. Then ask them to record on your file that you can attend at under 48 hours' notice. Cancellation lists are worked in file order, and that note is what moves you up it.
If your child regresses while you are waiting, losing words or losing skills that were solidly there, call and say that specific word. Regression usually changes triage priority, and it should.
FAQ
What if Early Intervention says my child does not qualify?
Common, and not the end of it. Thresholds vary by state and near-misses happen constantly. Ask for the eligibility determination and the scores in writing, and ask one specific question: did you assess communication, or only overall development? A child can clear a global cutoff and still have a real communication need. You can then ask for a reassessment after a set period, or go to a private speech-language evaluation, which does not need the diagnosis either.
Should I pay for a private assessment?
Sometimes it is the right call, particularly with a very long public wait or where a diagnosis is the gate on something time-sensitive like a school placement. Check first that the report will be accepted by your school district, health system, and insurer. A report nobody accepts is an expensive piece of paper.
Will starting therapy before the assessment affect the result?
No, and it is a common worry. Nobody will conclude your child is not autistic because you supported their communication. Bring a note of what support they have had; the assessing team will want to know.
What if the assessment says my child is not autistic?
Then you will have a much clearer picture, and the support you started will still have been the right support. Everything here helps a child regardless of the answer. That is the point of it.