Who to see and in what order

The most useful thing right now is a clear route. Not "where could I make an appointment," but a step-by-step sequence. It works in Ukraine, in Poland, and in Czechia with small differences.

The general logic

You noticed signs, you turned to primary care, screening and basic assessment were done, other causes were ruled out, you received referrals to specialists, you started early support.

None of these steps should be skipped. Each next one relies on the previous.

Step 1. Pediatrician or family doctor

This is the first contact. Not a child psychiatrist, not a neurologist, not a private clinic with promises. Specifically primary care.

Why. First, the pediatrician sees the child regularly and knows their full context. Second, the PMG system has it built in that the pediatrician or family doctor conducts basic screening and further routing.

What to do at this appointment.

• Describe specific concerns.
• Ask for autism screening (M-CHAT-R/F or another tool available to the specific doctor).
• Discuss whether to check hearing and vision.
• Ask for referrals to specialist physicians.

Step 2. Hearing and vision check

If there is a speech delay, weak response to being addressed, or the impression that the child "does not hear," the doctor may refer to an audiologist or ophthalmologist. This is a usual thing.

The point is not to "explain autism through hearing." The point is to rule out other causes or find co-occurring conditions that also need attention.

Step 3. Child psychiatrist

This is the specialist who establishes the ASD diagnosis. In Ukraine you can see them without an e-referral. In Czechia also, and it is the psychiatrist or child clinical psychologist who establishes the final diagnosis.

At the appointment, the psychiatrist conducts a clinical interview with parents, observes the child, may ask for additional tests (for example, ADOS, a standardized diagnostic assessment). Sometimes they schedule several meetings to see the child in different states.

Step 4. Child neurologist

A neurologist is not always needed. They are referred when there are co-occurring conditions. Seizures, motor difficulties, regression with suspicion of a neurological cause. If a neurologist is not needed, you do not go to them just "in case."

Step 5. Speech therapist and developmental psychologist

A speech therapist evaluates speech and communication. A developmental psychologist evaluates mental functions, play, behavior.

An important detail. Speech therapy support can be started without waiting for a final diagnosis if there is an obvious delay. AAP writes about this directly as a practical recommendation.

Step 6. Early intervention (for children under 3)

Early intervention in Ukraine is comprehensive help for children from birth to age 3 with developmental disorders or the risk of such disorders. The team is multidisciplinary. The service is free.

If your child is under 3 and there are concerns about development, do not delay early intervention, even if there is no formal diagnosis yet. UNICEF Ukraine publishes a list of early intervention teams by community.

Step 7. Inclusive Resource Center

IRC is not a medical institution. It is an educational service. The task is to conduct a comprehensive psychological and pedagogical assessment, identify special educational needs, give recommendations for an individual educational trajectory.

IRC is needed when the child goes to kindergarten or school and needs environment adaptation, an assistant, an individual program.

The IRC regulation provides that assessment is carried out no later than a month after the application is submitted, and for IDP children during martial law, within a week.

Can you go to a private clinic

You can. But there are nuances.

• A private clinic does not replace the route through primary care for free services (early intervention, IRC, PMG packages).
• Screening and diagnosis at a private clinic may be faster.
• Check that the specialist has appropriate education and experience specifically with children, and uses evidence-based approaches.

Red flags of a private clinic. Promise to "cure autism," aggressive sale of packages, denial of WHO or CDC, advertising of supplements and "detoxes."

Poland and Czechia briefly

In Poland the first contact is POZ (family doctor or pediatrician). You can see a psychiatrist without a referral. Educational support is provided by a publiczna poradnia psychologiczno-pedagogiczna, an analog of the Ukrainian IRC.

In Czechia the first contact is praktický lékař pro děti a dorost. M-CHAT screening can be done by a pediatrician at a routine visit. The ASD diagnosis is established by a child psychiatrist or child clinical psychologist. For educational support, pedagogicko-psychologická poradna or speciálně pedagogické centrum.

For Ukrainian families in Czechia: children under 18 are covered by public health insurance, the state pays contributions.

What is better not to do

• Do not make appointments with five specialists at once. The route has a logic.
• Do not start with "author methodologies," "neuroprotocols," or "autism diet therapy."
• Do not go to a person without a medical education for a diagnosis, even if acquaintances recommend.

What is next

The last article in the section is "What to bring to the doctor visit." A concrete list that will make the first consultation useful.