If you have waited months for an autism evaluation, you already know how long every second feels. You noticed something about how your child plays, communicates, or takes in the world. You asked for help. Then you were told the next opening is a year out.
That wait is not your fault, and it is not rare. On this week’s episode of Autism Weekly, host Jeff Skibitsky talks with Dr. Cheryl Tierney about why the wait exists and what is starting to shorten it.
Dr. Tierney is a board-certified, fellowship-trained developmental pediatrician, a Professor of Pediatrics at Penn State, and Chief Medical Officer at EarliPoint Health. She has spent 26 years evaluating children for autism, learning, speech, language, attention, and sleep differences. She is also raising an autistic son who is now an adult.
What a developmental pediatrician does that a general pediatrician does not
Dr. Tierney describes her specialty as a supercharged version of primary care.
General pediatricians train mostly in physical health. They get far less training in sleep, feeding, toileting, attention, learning, friendships, and behavior support. Those are exactly the areas where families have the most questions.
Developmental pediatricians train in those areas, and their visits are built to be longer. Tierney says the time is the point. These questions rarely have a quick answer you can carry home in 10 minutes.
Why evaluations take so long
A traditional autism evaluation often runs several hours. It can include the ADOS, which many clinicians treat as the standard observational assessment, plus cognitive testing. Scoring and writing the report take hours more.
There are not enough developmental pediatricians and psychologists to meet demand. So waits stretch, and some pediatricians take a wait-and-see approach rather than referring early.
Tierney’s view is that many families do not need that full workup. By her estimate, roughly 60 percent of children referred for assessment are straightforward enough to be evaluated without hours of testing. The goal is to route those families to an answer sooner, so specialists can focus on the more complex evaluations that genuinely need them.
How the eye tracking assessment works
EarliPoint is an FDA-cleared eye tracking system. It looks like a tablet in a sturdy case, and it sits on a table in front of the child.
Your child watches up to 12 minutes of video. The clips show ordinary scenes, such as children in a daycare, on a playground, and interacting with adults. These are not cartoons or entertainment videos.
There is nothing for your child to do. No questions, no instructions, no performance. The system measures where they look to gather social information from a natural scene.
The eye tracking collects 120 data points per second. A child who watches all 12 minutes generates more than 86,000 data points. Tierney contrasts that with a clinician observing a child for 30 minutes and capturing perhaps 100 moments to assess.
A trained technician runs the assessment, and the provider interprets the results. It works like an x-ray in that sense, which frees up clinician time for the parts that require their training.
Tierney is direct about the distinction. The assessment is not scoring whether your child looks people in the eye. It looks at how a child uses their gaze to learn from what is happening around them. This is worth stating plainly, because forced eye contact has caused real harm in the autistic community.
She says autistic adults in her own family and community have raised this, and it comes up in her conversations often. She also notes that autistic caregivers raising autistic children are among the people most interested in earlier access to support, because they remember what was not available to them.
What it does not replace
Tierney is clear that this is not a standalone test and not a substitute for clinical judgment.
It is cleared for use when a concern already exists, meaning a family raised one, a provider raised one, or a screener flagged one. She says positive results in that group are highly accurate, with very few false positives.
Borderline results are different. She estimates about a 20 percent chance of a false negative in that range. If you get a borderline result and you still have concerns, those concerns are valid and worth pursuing with more testing. Say so to your provider.
Tracking progress after a diagnosis
The assessment was first cleared for children up to 30 months. It is now cleared through age eight, which opens up a second use: watching how a child is developing over time.
Results are compared to how children of the same age typically look at the same scenes, so each assessment uses a new age-based comparison. It offers a proxy for social learning, receptive language, and nonverbal problem solving.
Tierney compares it to the fuel light in your car. It is an early signal, not a verdict. If a child is not moving toward age expectations, the team can adjust the approach in three months instead of finding out in two years.
She and her colleagues completed a longitudinal study in September of 2025 with more than 600 children tested monthly over six months. Those results are being prepared for publication.
How to find a provider
Early]iPoint is currently in 29 states and more than 200 locations, and the technology does not depend on spoken language, which has made it useful in rural areas and in homes where English is not the primary language. Their website, earlipointhealth.com, has a search tool for finding the nearest provider, along with their published research.
If there is no provider near you, that search still registers. Tierney says the company uses those searches to reach out to practices in areas where families are looking.
