Autism Spectrum: Early Signs & Screening in Hilo & Across Hawaiʻi — Medicaid (QUEST) Accepted

Autism spectrum disorder is a common neurodevelopmental difference in how a child communicates, interacts, plays, and experiences the world. It is not caused by parenting, and recognizing it early opens the door to support that helps children thrive. At Ohana Care Clinic in Hilo, we screen for autism as a routine part of well-child care and guide families with aloha.

Early signs to notice

Signs can appear in the first two years and vary widely from child to child. Some things parents may notice include limited eye contact, not responding to their name, delayed or unusual speech, limited pointing or showing to share interest, repetitive movements or strong routines, and intense focus on specific objects or topics. Differences in how a child plays or connects socially are often among the earliest clues. Every child is unique, and these signs are reasons to look closer, not to panic.

Screening and evaluation

The American Academy of Pediatrics and the Centers for Disease Control and Prevention recommend screening all children for autism at the 18- and 24-month well-child visits, along with ongoing developmental surveillance at every visit. We use a validated tool such as the M-CHAT and, when screening or your observations raise a concern, we guide you toward a fuller evaluation, because autism can be reliably identified as early as 18 months and earlier support leads to better outcomes.

Support that honors your child

An autism diagnosis is the beginning of understanding, not a limit. Many children with autism also have related needs such as anxiety, sleep, or attention differences, and because we integrate primary care and behavioral health, we can support the whole child and connect you with services. We honor each child’s strengths and your family’s values throughout.

Culturally grounded care

We care for the whole child, in the spirit of lōkahi — balance and harmony among the connected parts of life: the body, the mind and emotions, the spirit, the ʻohana (family), and our relationship with the ʻāina (land) and community. In a Native Hawaiian understanding of health, these are not separate, and neither is our care. To mālama (care for and protect) your keiki and to raise them pono (in balance and rightness), we listen to your family’s story, welcome your ʻohana into every visit, and honor the values and traditions that ground you. Offering kōkua (help given freely, with aloha) in a way that respects your family is at the heart of how we practice.

Insurance and how we see your keiki

We accept Medicare and Medicaid, including the Hawaiʻi QUEST Integration plans (AlohaCare, the Hawaiʻi Medical Service Association (HMSA), ʻOhana Health Plan, and UnitedHealthcare Community Plan), along with most commercial insurance, and we are accepting new pediatric patients in Hilo. Your child’s first primary-care visit is in person at our Hilo clinic. We see children in person for well-child exams, vaccines, and hands-on care, and we use telehealth for follow-ups and questions. Pediatric behavioral health with our mental-health providers can begin by video; care from our primary-care team starts with an in-office visit.

Common questions about autism spectrum and screening

What are early signs of autism?

Signs vary widely but can include limited eye contact, not responding to their name, delayed or unusual speech, limited pointing or sharing, repetitive movements or strong routines, and differences in play and social connection. These are reasons to look closer, not to panic.

When should my child be screened for autism?

The American Academy of Pediatrics and the CDC recommend screening all children for autism at the 18- and 24-month well-child visits, with developmental check-ins at every visit. We use a validated tool such as the M-CHAT.

Why does early identification matter?

Autism can be reliably identified as early as 18 months, and earlier support is linked to better long-term outcomes. Identifying it early opens the door to services that help your child thrive.

What insurance do you accept for pediatric care?

We accept Medicare and Medicaid, including the Hawaii QUEST Integration plans (AlohaCare, HMSA, Ohana Health Plan, and UnitedHealthcare Community Plan), along with most commercial insurance. We are accepting new pediatric patients in Hilo.

References

Hyman, S. L., Levy, S. E., & Myers, S. M. (2020). Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics, 145(1), e20193447. https://publications.aap.org/pediatrics/article/145/1/e20193447/36917/Identification-Evaluation-and-Management-of

Centers for Disease Control and Prevention. (n.d.). Clinical screening for autism spectrum disorder. Retrieved June 29, 2026, from https://www.cdc.gov/autism/hcp/diagnosis/screening.html

Papa Ola Lōkahi. (n.d.). Native Hawaiian health. Retrieved June 29, 2026, from https://www.papaolalokahi.org/

This page is general health education from Ohana Care Clinic, reviewed by Donna Leonard, MSN, APRN, FNP-C, and written by George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP. It is not a substitute for a personal evaluation by a qualified clinician who knows your child’s situation, and reading it does not create a provider–patient relationship. If you are worried about your child’s health, reach out to us or another licensed provider. In an emergency, call 911.

Donna Leonard, MSN, APRN, FNP-C, and George Mackel, MSN, APRN, NP-C, PMHNP-BC, CARN-AP — President & Owner