My doctor said to wait and see. What do I do?

Ask the reasons for the suggestion and how follow-up will be organized. You can also ask for a referral and for your concern to be documented in the file. The study cited associates reassuring or passive responses with a longer delay before diagnosis; it cannot predict your child's path. You can contact your CLSC directly about Agir tôt, without a diagnosis or a medical referral for this first step.

Do I need a doctor's referral to start the autism process in Quebec?

You can contact your CLSC directly, or call 811 for information, about developmental screening and Agir tôt. The diagnosis itself is made by a physician or a psychologist. Referral requirements for the specialized assessment should be confirmed with the service concerned; do not assume every territory follows exactly the same procedure.

What to say to your doctor about autism concerns in Quebec

Q: What should I say to my pediatrician if I think my child might be autistic?

Describe two or three things you have noticed with approximate dates, mention any screening that was done, then ask for a developmental assessment and a hearing test. Ask that your concern and your request be documented in the file, even if the doctor suggests a period of observation.

You have the appointment, or you are getting ready to book it. You want to be able to explain what you have noticed and leave with a clear next step. This page offers wording, documents to prepare, and Quebec access points that do not require waiting for a diagnosis.

When you are offered to wait

Development varies from one child to another. A professional who suggests reassessing in a few months may be trying to reassure you. You can still ask how your concerns will be followed up.

A study of more than 1,400 autistic children found that their parents were less likely than parents of children with other developmental conditions to get a proactive response to their first concern, and more likely to get a reassuring or passive one. A proactive response was associated with an earlier diagnosis; reassuring responses were associated with a longer delay. This association does not, on its own, show a causal link. ¹

The Canadian survey reports a median autism diagnosis age of 3.7 years. Separately, the M-CHAT-R/F validation study screened children at 18- and 24-month visits. ^{2, 3} These figures come from different populations; they do not explain an individual child's diagnostic path.

Parents' observations are part of the information used in screening. The M-CHAT-R/F is a parent questionnaire; its authors call for a referral when results indicate risk, following the instructions for use and follow-up. ³ You do not have to make a diagnosis yourself. Describe what you have noticed and ask for it to be documented in the file.

Wording for the appointment

Adapt these examples to your situation, keeping three parts: what you noticed, what you have already done, and what you are asking for.

What I noticed. "Since about [age], I've noticed that [child's name] [does not point to show me things / does not turn when I call their name / has stopped using words they had / plays alone and lines things up]. I've written down these observations and the dates."

What I've done. "I filled in the M-CHAT-R/F at home. The score was [number]." (If not done, or if the tool is not suited to your child, skip this line. Ask the clinician which tool is appropriate.)

What I'm asking for. "I'd like a referral for a developmental assessment and a hearing test. Could you document my concern and this request in the file today?"

If waiting is suggested. "I understand the assessment may not show any difficulty. I'd still like my request documented today and to discuss the referral now. If the situation resolves, we can revisit whether the request is still needed."

You can print this wording and read from it during the appointment. It is fine to rely on notes.

What to bring

A dated list, a few lines per observation. Also describe your child's strengths and abilities to give a complete picture.
Two or three short videos, older and recent, if you have them, especially of play or of how your child reacts when you call their name.
Any screening results, if an appropriate tool was used. Ask the clinician to explain what the result means and what follow-up is needed. See M-CHAT-R/F explained.
Observations from daycare, for example about play, transitions and taking part in the group. A short email from the educator can be a starting point.
Relevant family history. The clinician may ask about autism and ADHD in the family. See Is that me?.
Your questions, written down, so you can refer back to them during the appointment.

First steps in Quebec

Two access points can be used in parallel.

Your family doctor or pediatrician

The doctor can refer your child to a specialized assessment in the public network. In Quebec, physicians and psychologists can conclude an autism diagnosis, often with input from a multidisciplinary team. ⁷ According to Autisme Montréal, waits for a public assessment on the island of Montreal are roughly 6 to 24 months. This is an estimate that changes, not a guaranteed timeline; confirm it on the organization's page and with the service concerned. ⁸

Your CLSC and the Agir tôt program

The Agir tôt program is for children under 7 and their families. Taking part is voluntary and free; a diagnosis is not required. The official page invites parents who are concerned about their child's development to contact their CLSC. A caseworker discusses your concerns and your child's needs are assessed. Screening can include questionnaires on a digital platform and a consultation. Early intervention services can be offered if difficulties are identified. ⁵

If you do not know which CLSC to contact, 811 can tell you. Info-Santé 811 is a free service available at all times. ⁶ The Fédération québécoise de l'autisme notes that screening steps through the CLSC do not require a medical referral. ⁷

A specialized assessment and developmental support are not the same process. See Agir tôt, CLSC, CPE and school to understand the role of each service, and Public or private assessment in Quebec to prepare your questions about assessment options.

Elsewhere in Canada, talk with your family doctor or pediatrician about early intervention services in your province. Access conditions and the organizations responsible may differ.

If no next step was agreed

Here are steps you can take.

Contact the CLSC directly to ask about developmental screening and Agir tôt. Mention that no medical referral was made.
Ask for a second opinion, with a different physician if possible, and bring the same observations.
Write to the clinic to summarize the concerns you raised and the request you made, so there is a record of it.
Keep recording your observations, for example with a dated note and a short video from time to time. If your concerns continue or grow, you can book a new appointment; you do not need to wait for a set period.

The aim is to make it easier to share your observations and follow up on your request, without assuming any conflict with the care team.

This week

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Adapt the wording to your situation and keep it with your dated observations and any relevant screening results.
Book an appointment with the doctor, and ask your CLSC or 811 about Agir tôt.
Ask daycare for a short description of your child's play and transitions.