We live in Texas, USA. Our son is exactl

Answer

**What the CDC 18-month card says (what 75%+ of children do by 18 months; accessed 2026-09-02).**

*Language*
- Tries to say **three or more words besides "mama" or "dada"**
- Follows one-step directions **without any gestures** ("Give it to me.")

*Social / gestures*
- **Points** to show you something interesting
- Puts hands out for you to wash them
- Looks at a few pages in a book with you
- Helps you dress him by pushing arm through sleeve or lifting up foot

*Cognitive* — copies you doing chores; plays with toys in a simple way.

*Movement — your son's strengths:* walks without holding on, scribbles, climbs on/off furniture.

Source: https://www.cdc.gov/act-early/milestones/18-months.html (accessed 2026-09-02)

**How this reads for your son, plainly.** "Mama" and "dada" are explicitly excluded from the count, so on the words line he is at 1 ("ball") against a 3+ target. Movement is on track. A child under the 75% line on one item is a reason to ask the clinician — it is not a verdict. That is exactly why a validated screen exists: the checklist is a population statement, not a personal score, and not a pass/fail at home.

**What 75%+ does and does not mean.** It is "most children do this by this age," not "every child should." Some children reach a milestone later than75% of peers and land in range at the next checkpoint; some children below the 75% line are referred on for evaluation. The screen is what tells the difference for your son — not the card, and not a family story.

**US well-child schedule at 18 months (AAP, accessed 2026-09-02).** Two screens are already standard:

- **ASQ-3** — Ages and Stages Questionnaire, parent-completed, 1–66 months, five domains (communication, gross motor, fine motor, problem-solving, personal-social). You fill it out; the clinician scores pass / monitor / refer. It is a screen, not a diagnosis.
- **M-CHAT-/F** — Modified Checklist for Autism in Toddlers, parent-report, given at 18 and 24 months. Also a screen, not a label; a positive result leads to a formal evaluation.

**Dated next step.**

| Today (2026-09-17) | At the 18-month visit |
| --- | --- |
| Note: "18 mo full-term. Vocabulary = mama, dada, ball (1 beyond mama/dada). Walks, climbs, scribbles, stacks 2 blocks." | Ask the pediatrician to run ASQ-3 and M-CHAT-/F today; if either flags monitor/refer, ask for a formal developmental evaluation referral. |

Words you can use verbatim:

> "He has only mama, dada, and ball — that's 1 word beyond mama/dada, and the 18-month card expects 3+. Please run the 18-month general developmental screen (ASQ-3) and the 18-month autism screen (M-CHAT-/F), and tell me the score in each domain. If anything comes back monitor or refer, please refer us for a formal evaluation."

If the office only offers one of the two, ask which tool they use for the missing one and ask for the formal screening referral. The 18-month visit is the on-schedule point for both — no need to wait for the next visit.

**Texas side.** For children under 3 you can also self-refer to Texas Early Childhood Intervention (ECI) — a doctor's referral is not required. CDC's FindEI page lets you look up the local program by ZIP:
https://www.cdc.gov/act-early/early-intervention/index.html (accessed 2026-09-02)

**Honest limits.** A checklist does not diagnose. A screen does not diagnose. A diagnosis, if any, comes from a formal evaluation by qualified clinicians, after the screen — never from a checklist alone, and not from this reply.

Does he point at things with his index finger to show you something interesting, or use other gestures — waving, handing you a toy to show it, putting his hands out to be washed?