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Referrals for children presenting with social, communication and behavioural differences have risen sharply in recent years, creating unprecedented demand for autism assessments. Waiting times now frequently exceed 2 years, placing considerable strain on diagnostic services and families. While autism is common, many children presenting with these differences have alternative or co-occurring explanations that require timely recognition and tailored support. This article presents a practical child-centred framework to guide clinicians involved in early assessment or referral decision-making when diagnostic uncertainty exists. It also supports earlier and more equitable access to strengths and needs informed care, regardless of diagnostic outcome.