Resources · The Quebec pathway

Decoding your child's autism assessment report

6 min · Evidence: official · Updated September 3, 2026 · next review in 6 months

A report describes your child on a few days in a clinic room; it is not a forecast. The DSM-5 level is a snapshot of support needs, not a rank. The recommendations section obliges nobody to do anything automatically; it becomes powerful only when you hand it to the CLSC, the daycare, the school and Retraite Québec. Read it once, then use it.

You have read it three times and understood it less each time. Assessment reports are written for other clinicians and for the institutions that will ask for them; the parent is the reader least served by the format. This page goes through the sections in the order they usually appear and says what each one does and does not mean.

Who wrote it and why that matters

In Quebec only a physician or a psychologist, including a neuropsychologist, can conclude an autism diagnosis; speech-language pathologists and occupational therapists contribute their domain. official Check the signature block. The signing professional's order and licence number are what the CLSC, the school, Retraite Québec and the Canada Revenue Agency will look for. If the report was written by a team, the SLP and OT sections are usually the most practical parts for daily life.

Reason for referral and history

This section repeats what you told them. Read it once to check for errors of fact (wrong age of first words, wrong daycare start). Errors here get copied into every future file; ask for a correction in writing.

Tools and observations

You will see names like ADOS-2, ADI-R, a language assessment, a sensory profile, an adaptive behaviour scale, sometimes a cognitive or developmental scale. Each produced a number. Three things to hold onto:

  • The numbers describe a few hours in an unfamiliar room with an unfamiliar adult. Your child may have been at their least regulated. Clinicians know this and weigh your history and the daycare's observations too; the standardized score is one input, not the verdict.
  • A "cognitive" or "developmental" score in a toddler who did not engage with the tasks measures engagement as much as ability. It is not an IQ prediction.
  • Percentiles and standard scores compare your child with same-age children on that tool, on that day. They are useful for tracking change against the same tool later, and not much else for a parent.

The diagnosis line and the DSM-5 level

The diagnosis will be phrased as an autism spectrum disorder with specifiers. The one parents fixate on is the level. In DSM-5 the levels describe the support needed at the time of assessment, separately for social communication and for restricted, repetitive behaviours: level 1 "requiring support", level 2 "requiring substantial support", level 3 "requiring very substantial support". A child can be level 2 in one domain and level 1 in the other.

What the level is: a snapshot of support needs, written to help services plan.

What the level is not: a rank of how "severe" your child is as a person, a measure of intelligence, a fixed trait, or a forecast of speech, school or adulthood. Research on early development suggests autism is not one developmental story; earlier and later-identified children follow different paths, which argues for monitoring over time rather than trusting one early label. emerging Quebec's own government eligibility wording does not mention levels at all; it speaks of disability, significant developmental delay and social communication disorder. official

This site uses "support needs" rather than functioning labels for the same reason: the label describes the environment's job, not the child's worth.

Co-occurring notes

Most reports mention something alongside autism: a language disorder, ADHD "to be reassessed", a global developmental delay, sensory processing differences, sleep or feeding concerns, anxiety. In toddlers these overlap heavily and the labels can shift as the child grows. strong See Autism, ADHD and language delay: the overlap. Two notes are worth flagging with your CLSC now: a documented global developmental delay, which the CIUSSS reassesses at age 7, and anything the clinician wrote as "rule out" or "reassess", which is a reminder to book a follow-up rather than a second diagnosis. official

The recommendations section

This is the part institutions will read first, and the part with the most misunderstanding. The recommendations are the clinician's professional advice. On their own they oblige nobody: not the CLSC, not the daycare, not the school, not you. What creates obligations is a separate process at each door:

  • CLSC and CIUSSS access desk. The report supports the needs assessment that decides which DI-TSA-DP services open; the establishment, not the report, decides. official
  • CPE. The report supports the daycare's application for integration allowances; the gate is your child's eligibility for the Retraite Québec Supplement for Handicapped Children. official
  • School. The Education Act obliges the principal to establish a plan d'intervention with the parents, the staff and the student when capable, and to evaluate it periodically. The report is evidence for that plan; the plan is the commitment. official
  • Retraite Québec and the CRA. Both decide on functional limits in daily life, not on the diagnosis word. Retraite Québec's team reads "assessment reports and follow-up notes from health professionals" alongside daycare and school information; the CRA states that "a diagnosis itself does not qualify". official

So read the recommendations as a menu, not a prescription. If a recommendation names a therapy with a weekly hour count, that is one clinician's judgement and it is fair to ask why. See The hours myth.

Using the report without handing it to everyone

You own the report. A useful pattern: ask the clinician for a one-page summary letter with the diagnosis, the top three recommendations and "what helps" for a classroom. Give that to the daycare and, later, the school. Give the full report to the CLSC, Retraite Québec and the CRA, which need the detail. Keep a dated copy of everything you send.

Before the next assessment, whenever it comes, keep a log: new words, new play, sleep, meltdowns, what helped. The next report will be better because of it, and the same tool used twice is the only comparison that means much.

This week

  • Read the report once with this page open, and circle any factual error to correct in writing.
  • Ask the clinician for a one-page summary letter for the daycare and school.
  • Copy the recommendations into a note and write beside each one which door it belongs to: CLSC, CPE, school, Retraite Québec, CRA, or "our choice".

Sources

Questions parents ask

What do autism levels 1, 2 and 3 mean?
DSM-5 levels describe how much support a child needed at the time of assessment in two areas: social communication, and restricted or repetitive behaviours. Level 1 is 'requiring support', level 2 'substantial support', level 3 'very substantial support'. They are a snapshot, can differ between the two areas, and are not a prediction of adult life.
Does the school have to follow the recommendations in my child's autism report?
Not automatically. The report is advice from a clinician. What obliges a Quebec school is the Education Act: the principal must establish a plan d'intervention with the parents for a student with a disability, and that plan is where the recommendations get turned into commitments.
Can I share only part of the assessment report with the daycare or school?
Yes. You decide what to share. Many families ask the clinician for a one-page summary with the diagnosis, the main recommendations and what helps, and keep the full report for the CLSC, Retraite Québec and the CRA, which need the detail.

Read next

Part of: We just got a diagnosis · plain markdown ·

This page explains; it does not diagnose or replace your clinician. Services, wait times, prices and benefit amounts change: confirm on the official page before acting. Found an error? Tell us and we will correct it publicly.