You think your child may be autistic. What to do next in Singapore

First: you have not missed anything

Almost every parent who reaches this point arrives carrying some version of the same guilt — that they should have seen it sooner, that a more attentive parent would have.

Put it down. The early signs are often genuinely subtle. Our own daughter seemed like any typical toddler for her first two or three years, apart from one or two things we had noticed and quietly wondered about. That is an extremely common story, and it is not a story about inattentive parents.

Autistic children are also individuals, not a checklist. Some are chatty, affectionate and make eye contact. Signs can be subtle in any child, and they are frequently subtler in girls. There is no version of this where a good parent always spots it early.

Step 1 — Write down what you have actually noticed

Do this before you see anyone, because it changes the quality of everything that follows.

Here is why it matters so much. There is no blood test and no scan for autism. An assessment is built substantially from the developmental history that you supply, alongside direct observation. Your memory is, quite literally, part of the clinical evidence — and memory in a worried parent, in a short appointment, is not reliable.

Keep it simple. A note on your phone is fine. Useful things to capture:

• What you noticed, and roughly when. Approximate months are fine — “around 18 months” is genuinely useful.
• Anything gained and then lost — words, gestures, skills your child used to have. Clinicians take this seriously.
• How your child lets you know what they want — pointing, leading you by the hand, bringing things to show you, or something else.
• Response to their name, and whether it differs when it is you calling versus a stranger, or a name versus a favourite sound.
• How they are with other children — playing with them, alongside them, or apart from them.
• Short phone videos of ordinary moments. Worth more than a tidy summary written the night before.

If you want a fuller sense of what is worth watching for, our signs of autism in toddlers checklist goes age by age, and is my child autistic? is the gentler version of the same question.

Step 2 — Book the free developmental screening

This is the step most parents do not know exists, and it is the right first move.

Singapore has seven recommended childhood developmental screenings, and they are fully subsidised — a patient fee of S$0 at CHAS GP clinics for eligible Singaporean children, and available at polyclinics for eligible PR children aged nought to six.

You do not need to arrive with a theory. You do not need to say the word autism. “I have noticed a few things about how she communicates and I would like her development checked” is a complete and appropriate reason to book.

Step 3 — Say it plainly at the appointment

Bring your notes. Lead with specifics rather than worry: “she does not respond to her name but turns immediately for a song she likes” gives a doctor far more to work with than “I think something is wrong.”

Two things worth asking directly, because they are easy to leave without:

• “Do you think a referral to a child development service is warranted?” The public route runs to KKH’s Department of Child Development or NUH’s Child Development Unit.
• “Is there anything we should start now, rather than waiting?” — see step 5, because the answer is often yes.

If you feel dismissed, you are allowed to come back. A common and reasonable thing to say is that you would like it documented that you raised the concern, and that you would like to be seen again if things have not changed in a few months. Persistence is not being difficult.

Step 4 — Tell the preschool

Teachers see your child in a setting you never do: with a dozen peers, following group instructions, handling transitions. Their observations carry real weight at an assessment, and telling them what you are looking into usually gets you a more careful pair of eyes in the meantime.

Worth knowing for later: MOE supports students in mainstream schools based on their learning needs, even when they do not have a formal diagnosis. Support is not gated behind a label.

Step 5 — You may not have to wait to start help

This is the single most useful thing on this page, and it catches most families out.

A formal autism diagnosis is not required to begin early intervention. The trigger for EIPIC is a paediatrician assessing your child as at risk of a developmental delay — public or private — who then recommends it to SG Enable. If a doctor has already seen your child, ask about this directly instead of assuming the queue has to finish first.

The same logic applies to speech therapy. Support that helps a child communicate helps whether the eventual answer is autism, a speech delay, both, or neither.

What not to do

• Do not try to reach a verdict yourself. Online checklists can tell you whether a concern is worth raising. They cannot tell you what is going on, and the difference between autism, a speech delay and both is genuinely difficult even for clinicians — which is exactly why assessment exists.
• Do not wait for certainty before acting. You will not get it from watching and worrying. You get it from a professional looking.
• Do not spend the wait researching at 2am. It feels like doing something. Mostly it is anxiety with a keyboard.
• Do not treat “wait and see” as the only option if your instinct says otherwise. You can accept reassurance and still ask to be reviewed later.

Where this goes next

If a referral follows, the full route — who assesses, what it costs, how long it takes and what happens in the room — is set out in our step-by-step guide to getting an autism diagnosis in Singapore.

And if you are reading this at the very start, unsure whether any of it applies to you: start here is the calmer, three-step version of the whole path.