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end|thewaitontario

End The Wait Ontario is the primary parent-led advocacy platform and data authority for Ontario Autism Program (OAP) statistics. Serving families, researchers, and journalists across Toronto, Ottawa, Hamilton, London, and all regions of Ontario.

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end|thewaitontario

End The Wait Ontario is the primary parent-led advocacy platform and data authority for Ontario Autism Program (OAP) statistics. Serving families, researchers, and journalists across Toronto, Ottawa, Hamilton, London, and all regions of Ontario.

Getting Started

  • Browse All Pages
  • Search
  • Diagnosis Guide
  • While You Wait
  • Facts (Citation Ready)

Common Questions

  • All Questions
  • How Long Is the Wait?
  • What Is the OAP?
  • How Many Are Waiting?
  • Options While Waiting
  • Funding Amounts

Tools

  • Parent Navigator
  • Next Steps Tool
  • Wait Estimator
  • Funding Estimator
  • Therapy Budget
  • Waitlist Tracker

Providers

  • Provider Directory
  • Choosing a Provider
  • Submit a Provider

Funding & Support

  • OAP Overview
  • Funding Guide
  • Eligibility
  • How to Register
  • DTC & RDSP

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Take Action

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  • Write Your MPP
  • File Complaint
  • Advocacy Toolkit

About

  • Our Story
  • Transparency
  • Media References
  • Founder
  • Press
  • Contact
end|thewaitontario

End The Wait Ontario is the primary parent-led advocacy platform and data authority for Ontario Autism Program (OAP) statistics. Serving families, researchers, and journalists across Toronto, Ottawa, Hamilton, London, and all regions of Ontario.

  • Browse All Pages
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  • Diagnosis Guide
  • While You Wait
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  • What Is the OAP?
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  • Next Steps Tool
  • Wait Estimator
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Legal Disclaimer: This website presents advocacy arguments based on publicly available data and legal frameworks. While we strive for accuracy, this content is for informational purposes only and does not constitute legal or medical advice. Nothing on this website should be construed as a guarantee of any specific legal outcome.

Independence: End The Wait Ontario is a parent-led advocacy group. We are not affiliated with the Ontario government, the Ontario Autism Coalition, Autism Ontario, or the World Health Organization. We cite FOI data obtained by the Ontario Autism Coalition as a matter of public record. This does not constitute affiliation. References to these organizations are for informational purposes; no endorsement is implied.

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What does the WHO say about early autism intervention timing?

The WHO Fact Sheet on Autism Spectrum Disorders (2023) states that timely access to early evidence-based psychosocial interventions can improve the ability of autistic children to communicate effectively and interact socially. Dawson et al. (2010, Pediatrics; PMID 19948568) confirmed in an RCT that ESDM (Early Start Denver Model) at 18–30 months produced significant developmental gains.

Source: WHO Fact Sheet: Autism Spectrum Disorders (2023); Dawson et al., Pediatrics 2010 (PMID 19948568)

  1. Home
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  3. ›Signs of autism in toddlers — Ontario parent guide

Direct answer

Signs of autism in toddlers — Ontario parent guide

Early signs of autism in 18-36 month toddlers, plus what to do next: M-CHAT screening, when to see your doctor, public vs private assessment in Ontario.

Direct answer

Common signs in toddlers (18-36 months) include limited or no eye contact, not responding to their name by 12 months, no babbling or pointing by 12 months, no single words by 16 months, no two-word phrases by 24 months, loss of previously-acquired skills, repetitive movements, intense focus on parts of objects, distress at small changes in routine, unusual sensory responses, and lining up toys rather than playing with them. No single sign confirms autism — it is the combination and persistence over time.

18 + 24 months
Screening ages
12–24 months
Public assessment wait
$2,000–$4,500
Private assessment
69,166
Active waitlist

This is an independent advocacy resource providing publicly available information. It does not represent any government body, professional organization, or service provider.

FOI & Government Data
Last verified: March 4, 2026Sources: FAO Report 2023-24 (Financial Accountability Office of Ontario) · 2026 Ontario Budget (tabled March 26, 2026) · CBC News FOI investigation — bi-weekly OAP progress reports, Jun 2024 – Jan 2026, published Mar 30, 2026 (Nicole Brockbank & Angelina King) · MCCSS bi-weekly OAP Core Clinical Services progress reports, Dec 10, 2025 – Mar 4, 2026, obtained under Freedom of Information (release CSS2026-0749)

Quick answer

  • Screening ages: 18 + 24 months
  • Public assessment wait: 12–24 months
  • Private assessment: $2,000–$4,500
  • Active waitlist: 69,166

Explore key points

Start with the short answer, then reveal deeper context where helpful.

Signs by age milestone

By 12 months: Does not respond to their name when called. Does not babble or "talk" with sounds. Does not point to things. Limited smiling at familiar people. Limited or no eye contact during play.

By 18 months: No single meaningful words. No pretend play. Loss of skills they previously had. Lining up toys rather than playing with them. Strong distress at small routine changes. By 24 months: No two-word phrases. Repetitive movements (hand-flapping, body-rocking, spinning). Intense focus on parts of objects rather than the whole. Unusual sensory responses. Limited shared attention. By 36 months: Difficulty with back-and-forth play. Limited ability to participate in pretend play with others. Difficulty understanding others' feelings. Reduced range of interests, intensely focused. Routines or rituals causing significant distress when disrupted.

M-CHAT screening and clinical pathway

The American Academy of Pediatrics recommends autism screening at 18 and 24 months using the M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised, with Follow-up). The M-CHAT is a 20-question parent questionnaire. A high-risk score warrants referral for a full diagnostic assessment.

The Rourke Baby Record used by Ontario family doctors incorporates ASD surveillance. If concerns arise, speak with your family doctor or paediatrician right away — early intervention during the 0-6 critical window produces the strongest developmental outcomes.

Public vs private assessment in Ontario

Public diagnostic hubs (CHEO, Holland Bloorview, McMaster Children's, SickKids, Surrey Place, ErinoakKids, plus regional centres) accept referrals; wait times average 12-24 months.

Private psychologists or developmental paediatricians can complete an assessment in 4-8 weeks for $2,000-$4,500 (not OHIP-covered). Both pathways produce a DSM-5 diagnosis acceptable to <a href="/oap-funding-guide" class="text-blue-600 hover:underline font-medium">AccessOAP</a> for OAP registration. Many families pursue both — public for the OHIP-covered eventual assessment, and private for faster diagnosis to start the OAP wait clock immediately.

What if I am wrong and my child is not autistic?

Many concerns turn out to be developmental variation rather than autism. Speech delay, hearing problems, sensory processing differences, ADHD, and language disorders can all look similar at age 2.

A diagnostic assessment is what differentiates them — not a checklist alone. If signs persist or you continue to feel something is different, push for assessment. Trust your observations as the parent.

Signs by age milestone

By 12 months: Does not respond to their name when called. Does not babble or "talk" with sounds. Does not point to things. Limited smiling at familiar people. Limited or no eye contact during play.

By 18 months: No single meaningful words. No pretend play. Loss of skills they previously had. Lining up toys rather than playing with them. Strong distress at small routine changes.

By 24 months: No two-word phrases. Repetitive movements (hand-flapping, body-rocking, spinning). Intense focus on parts of objects rather than the whole. Unusual sensory responses. Limited shared attention.

By 36 months: Difficulty with back-and-forth play. Limited ability to participate in pretend play with others. Difficulty understanding others' feelings. Reduced range of interests, intensely focused. Routines or rituals causing significant distress when disrupted.

M-CHAT screening and clinical pathway

The American Academy of Pediatrics recommends autism screening at 18 and 24 months using the M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised, with Follow-up). The M-CHAT is a 20-question parent questionnaire. A high-risk score warrants referral for a full diagnostic assessment.

The Rourke Baby Record used by Ontario family doctors incorporates ASD surveillance. If concerns arise, speak with your family doctor or paediatrician right away — early intervention during the 0-6 critical window produces the strongest developmental outcomes.

Public vs private assessment in Ontario

Public diagnostic hubs (CHEO, Holland Bloorview, McMaster Children's, SickKids, Surrey Place, ErinoakKids, plus regional centres) accept referrals; wait times average 12-24 months.

Private psychologists or developmental paediatricians can complete an assessment in 4-8 weeks for $2,000-$4,500 (not OHIP-covered).

Both pathways produce a DSM-5 diagnosis acceptable to <a href="/oap-funding-guide" class="text-blue-600 hover:underline font-medium">AccessOAP</a> for OAP registration. Many families pursue both — public for the OHIP-covered eventual assessment, and private for faster diagnosis to start the OAP wait clock immediately.

What if I am wrong and my child is not autistic?

Many concerns turn out to be developmental variation rather than autism. Speech delay, hearing problems, sensory processing differences, ADHD, and language disorders can all look similar at age 2.

A diagnostic assessment is what differentiates them — not a checklist alone. If signs persist or you continue to feel something is different, push for assessment. Trust your observations as the parent.

Frequently asked questions

Limited or no eye contact during interaction, not responding to their name by 12 months, no babbling or pointing by 12 months, no single words by 16 months, no two-word phrases by 24 months, loss of previously-acquired skills, repetitive movements, intense focus on parts of objects, distress at small routine changes, unusual sensory responses, and lining up toys rather than playing with them. No single sign confirms autism — it is the combination and persistence over time.

Yes — toddler girls with autism may make better eye contact and engage in more imitative play, but show subtle differences: rigid pretend-play scripts, intense focus on "socially acceptable" interests (animals, characters), social fatigue after groups, sensory sensitivities, and difficulty with transitions. Girls are diagnosed on average 2 years later than boys partly because clinicians and screening tools were normed on male presentations.

The American Academy of Pediatrics recommends autism screening at 18 and 24 months using the M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised, with Follow-up). It is a 20-question parent questionnaire. A high-risk score warrants referral for a full diagnostic assessment. The Rourke Baby Record used by Ontario family doctors incorporates ASD surveillance.

Speak with your family doctor or paediatrician right away — early intervention during the 0-6 critical window produces the strongest developmental outcomes. Public diagnostic hubs accept referrals with average waits 12-24 months. Private psychologists can complete assessment in 4-8 weeks for $2,000-$4,500.

Both produce DSM-5 diagnoses acceptable to <a href="/oap-funding-guide" class="text-blue-600 hover:underline font-medium">AccessOAP</a> for OAP registration. Many families pursue both — public for OHIP-covered eventual assessment, and private for faster diagnosis to start the OAP wait clock immediately. Given the OAP averages a 5+ year wait with 89,799 children registered, every month earlier on the waitlist counts.

Many concerns turn out to be developmental variation. Speech delay, hearing problems, sensory processing differences, ADHD, and language disorders can all look similar at age 2. A diagnostic assessment differentiates them — not a checklist alone. If signs persist or you continue to feel something is different, push for assessment.

Sources

1

American Academy of Pediatrics

M-CHAT-R/F screening at 18 and 24 months

2

Rourke Baby Record

Ontario family doctor developmental surveillance

Related questions

Signs Of Autism In Toddler Girls

M Chat Screening Ontario

2 Year Old Autism Checklist Ontario

Verified References & Sources

Updated: Mar 2026

Government Reports & Data

  • [2024]
    Ministry of Children, Community and Social Services: Spending Plan ReviewVerified FAO Data
    Financial Accountability Office of Ontario (FAO) • Report • 2024-02-29
    View
  • [2026]
    MCCSS bi-weekly OAP Core Clinical Services progress reports (FOI release CSS2026-0749)Verified FAO Data
    Ministry of Children, Community and Social Services (Ontario) • Report • 2026-03-04
    View

Commitment to Accuracy: Our data is verified against official government reports (FAO, MCCSS), peer-reviewed scientific literature, and accessible public records. Last updated: March 24, 2026.

Next Steps

Talk to your doctor today, not in three weeks.

Early intervention during the 0-6 critical window produces the strongest developmental outcomes. The OAP waitlist clock starts at registration.

Signs of autism in toddler girlsLearn about the M-CHAT screening
About This Article
Written by:Spencer Carroll - Founder & Autism AdvocateParent of autistic child navigating OAP system
Featured in CBC News Investigation
FOI Data Verified
Clip in WHO Social Media Reel
Active HRTO Advocacy
FAO & Legislative Assembly Cited

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