Where to get evaluation for 9DD?

[Anonymous]

I have a 9DD who has big emotions & anxiety (to sum up her challenges in a few words). We wanted to put her on the waitlist for a neuropsych evaluation at Children’s but received notice that they won’t accept children over 6 with a possible ASD diagnosis. They suggested Mt. Washington. Does anyone have experience with Mt Washington and if so, could you describe the experience? One of my concerns is that the center is an Autism Spectrum Center, and while I do think she needs an evaluation for ASD, she really needs a comprehensive assessment (she doesn’t really fit the criteria or any one diagnosis, that I can tell). Will they also thoroughly test for ADHD/other causes of her symptoms and do they have experience with girls? Or, should we bite the bullet and pay out of pocket (which we’d prefer not to do unless it would make a difference with accuracy).

[Anonymous]

I had a friend whose kid was diagnosed at I believe mt Washington with AuDHD. I can't imagine they wouldn't screen for ADHD. I think they had a good experience but my impression was they didn't get very tailored recommendations for services.

We did hear that the providers that don't take insurance have more time to provide truly personalized reports. We had a good experience with Dr. Rochelle Drill at CAAT. I have also heard that Lisa Lenhart is good and has reasonable prices. Lisa Martin is another one we were recommended.

[JNC]

Advocate here — the most useful thing for your situation: what you're describing (a kid who doesn't fit any one box) is exactly what a comprehensive neuropsychological evaluation is built for, and that's different from an autism-specific diagnostic. A real neuropsych eval is organized around differential diagnosis — it tests cognition/IQ, academic skills, attention and executive function, language, and emotional/behavioral functioning, precisely to sort out what's driving the symptoms (ASD vs. ADHD vs. anxiety vs. a learning disability vs. some combination). So your instinct to push for "comprehensive, not just ASD" is the right one.

On Mt. Washington: they do more than ADOS-style autism testing, but before you commit, ask the scheduler directly — "Does this evaluation include cognitive, academic, attention/executive, and emotional testing with differential diagnosis and written recommendations, or is it autism-focused?" Get the scope in writing. That one question saves families from ending up with a narrow report.

Two things the private route won't tell you that matter a lot:

1) You can request a full educational evaluation from your public school at the same time, in writing, for free. Under Child Find the district must assess in ALL areas of suspected disability — cognitive, academic, speech/language, OT, and social-emotional/behavioral. It's a separate track from a medical neuropsych and you can run both; the school eval is what actually establishes IEP eligibility and services.

2) If the school does its own eval and you disagree with it, you have the right to request an Independent Educational Evaluation (IEE) at public expense.

The insurance-vs-private-pay point above is real — private-pay evaluators usually spend more time and write more tailored, usable recommendations. Whatever you pick, ask to see the recommendations section of a sample report. That section is where the value is; a diagnosis with generic recs doesn't help you at the IEP table.

You're asking exactly the right questions. Good luck.

[Anonymous]

A private evaluation will provide more thorough testing and more indidualized/thoughtful recommendations. But depending on your child's presentation/what you're hoping to get, that may or may not be worth the money. We love Dr. Black at CAAT. His full evaluation costs about $6000 and we get about half back through insurance.