Autism, from screening to supports

What to do while you wait for the appointment

Getting a diagnosis in a county with a two-year wait

Pediatricians screen at 18 and 24 months. A positive screen means referral to a developmental pediatrician, child neurologist, or psychologist — and in South Florida, that appointment may be a year or more out. Do three things at once:

1. Take the appointment you can get and stay on the other lists. Cancellations happen. Ask to be called for one.
2. Start services now. Early Steps and school evaluations do not require an autism diagnosis. A child with a language delay qualifies for speech therapy on the delay alone.
3. Check the university and hospital clinics as well as private practices; their waitlists move differently.

UM-NSU CARD

The Center for Autism and Related Disabilities serving Miami-Dade, Broward, and Monroe provides consultation, training, and support to families at no cost — regardless of income, and without needing to be a patient. Registering as a constituent is one form. It is one of the highest-value free resources in the region and one of the least used.

Therapies, and choosing well

Florida Medicaid covers behavior analysis services with prior authorization, along with speech, occupational, and physical therapy. Behavior analysis is the most common referral and also the most debated. Whatever approach you choose, the questions that matter are the same:

• Does the program treat my child's communication — including gestures, an AAC device, or scripting — as real communication?
• Are goals about my child's quality of life, or about making them look typical?
• What happens when my child says no or becomes distressed? Ask them to describe it concretely.
• How many hours are recommended, and what is that number based on?
• Is the supervising analyst actually present, and how often?

Autistic adults have written extensively about what helped and what harmed them. Their perspective belongs in this decision alongside your clinician's. A good provider will welcome that; a defensive one tells you something.

Communication first

A child who cannot make themselves understood will find another way to communicate, and that way is usually labeled a behavior. Speech therapy, picture systems, and AAC devices are not a last resort after speech "fails" — research is clear that giving a child a robust way to communicate does not delay speech. Ask for an AAC evaluation early. Medicaid funds devices with documentation.

Wandering, and keeping a child safe

Elopement is common and, near canals and pools, dangerous. Practical layers:

• Door and window alarms, and a lock height your child can't reach
• Swim lessons adapted for autistic children — the single most protective step in this county
• ID on the child: shoe tag, bracelet, or a card in the pocket with your number and how your child communicates
• Tell the neighbors. Give them your phone number and a photo
• Notify your local police non-emergency line that a child with autism who may not respond to their name lives at your address
• Consider a tracking device; several sheriff's offices run programs for at-risk residents

When behavior is the issue at school

Ask for a functional behavior assessment and a behavior intervention plan as part of the IEP. Repeated suspensions of a student with a disability trigger legal protections — if your child is being sent home often, that is a signal the plan is wrong, not that your child is.