Steps for getting evaluated for 4 year old for potential autism

[Anonymous]

There is a lot of variability in school evals (by district and psych), so I'm not sure why these posters are insisting that something always or never happens.

Some school psychologists use the ADOS; many do not. Some rely on rating scales, some on interviews. Some are more thorough than private evals, and some are not. A school eval is free and the pathway to school services, so it is a great place to start. However, if your daughter's challenges do not seem to be impacting her at preschool, then it may not be worthwhile as they focus on educational impact.

[Anonymous]

Anonymous wrote:My daughter seems to have anxiety, difficulty in understanding social situations, highly focused special interests. What is the process for evaluation?

You may also consider scheduling an intake with a child psychologist and discussing your concerns. They may begin parent training, social skills training, etc. without a formal evaluation. This way, you can get some early intervention a lot faster and get a professional's input on your child.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Unless you are made of money, start with your county or state free evaluation which will also set you up for an IEP. If you want something more specialized most large hospitals and all childrens hospitals have autism clinics likely covered by insurance.

Yes, this is the most cost effective way. But a warning that many schools are using outdated concepts of autistic behavior that misses autism in many girls.

Sigh. No, they will perform the ADOS which is the gold standard assessment (and gender neutral). If they don’t do the ADOS then insist on it or to get an independent examination after.

I'm a special ed lawyer. I have never seen a school psychologist perform an ADOS or be certified to do so. They don't even have PhDs. What school district are you in that does the ADOS?

Child Find for 4 year olds certainly does. How do you think they assess 4 year olds?

PP can you say which county you are in where Child Find administered an ADOS that you were aware of?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Unless you are made of money, start with your county or state free evaluation which will also set you up for an IEP. If you want something more specialized most large hospitals and all childrens hospitals have autism clinics likely covered by insurance.

Yes, this is the most cost effective way. But a warning that many schools are using outdated concepts of autistic behavior that misses autism in many girls.

Sigh. No, they will perform the ADOS which is the gold standard assessment (and gender neutral). If they don’t do the ADOS then insist on it or to get an independent examination after.

Lol

Child Find told us our kid was fine. Absolutely no way they would have administered the ADOS.

And then you have a right to an independent evaluation.

We didn't explore this route for a couple of reasons but I am curious, is every single child entitled to an IEE if the parent requests it?

[Anonymous]

Anonymous wrote:Agree with CAAT. We worked with Dr. Rochelle Drill there for a similarly aged child for suspected autism and love her. We were able to get reimbursed by our insurance for part of the cost, but that depends on your plan's out of network benefits.

The main places that take insurance are Kennedy Krieger (KKI) and Children's. I have no personal experience with them, but when we were starting this process one of the providers we were recommended to consider for evaluation was Dr. Allison Mostow. The wait list might be long.

OP we like Annie Inge, the current clinical director at the Center for Autism Spectrum Disorders at Children's. She spent a few years at CAAT before taking this position. The CASD waitlist is long. When you reach the top of the wait list, they inform you which evaluator will work with your child. The only current evaluator we have experience with is Angela Bollich who can evaluate young children, but also works with teens. We had a good experience with her testing and report.

[Anonymous]

Anonymous wrote:My daughter seems to have anxiety, difficulty in understanding social situations, highly focused special interests. What is the process for evaluation?

I'm not local (so can't recommend specific providers) but here's what I'd do (my dd was dx with asd at age 4).

Call your pediatrician and ask for a referral for evaluation. My ped also referred us for a hearing evaluation-dd's hearing is fine, but it's good to rule out hearing loss/hearing related stuff. We also saw a neurologist.

Then look at your insurance and call places they cover. In my area the options were a large childrens hospital, a university and a few neuropyschological groups. I got on the waitlist for all of them, and ultimately after several months was able to schedule a neuropyschological evaluation with the private group. Because I went with a place covered by insurance, it cost $200.

In the meanwhile, dd was in speech and OT. OT can be helpful, usually doesn't have a long wait to get in, and my dc liked it. You could get her an OT eval and see how you feel about that.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Unless you are made of money, start with your county or state free evaluation which will also set you up for an IEP. If you want something more specialized most large hospitals and all childrens hospitals have autism clinics likely covered by insurance.

Yes, this is the most cost effective way. But a warning that many schools are using outdated concepts of autistic behavior that misses autism in many girls.

Sigh. No, they will perform the ADOS which is the gold standard assessment (and gender neutral). If they don’t do the ADOS then insist on it or to get an independent examination after.

Lol

Child Find told us our kid was fine. Absolutely no way they would have administered the ADOS.

And then you have a right to an independent evaluation.

We didn't explore this route for a couple of reasons but I am curious, is every single child entitled to an IEE if the parent requests it?

No. The IDEA says that if a parent requests an IEE, the school district needs to either grant it or file due process to defend its evaluation. Some districts are more litigious than others. Districts can also put a cap on how much they will pay, which often isn't enough for a full private neuropsych.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My daughter seems to have anxiety, difficulty in understanding social situations, highly focused special interests. What is the process for evaluation?

I'm not local (so can't recommend specific providers) but here's what I'd do (my dd was dx with asd at age 4).

Call your pediatrician and ask for a referral for evaluation. My ped also referred us for a hearing evaluation-dd's hearing is fine, but it's good to rule out hearing loss/hearing related stuff. We also saw a neurologist.

Then look at your insurance and call places they cover. In my area the options were a large childrens hospital, a university and a few neuropyschological groups. I got on the waitlist for all of them, and ultimately after several months was able to schedule a neuropyschological evaluation with the private group. Because I went with a place covered by insurance, it cost $200.

In the meanwhile, dd was in speech and OT. OT can be helpful, usually doesn't have a long wait to get in, and my dc liked it. You could get her an OT eval and see how you feel about that.

You only need a referral from the pediatrician if your insurance requires that. Otherwise you can self refer.

[Anonymous]

Anonymous wrote:There is a lot of variability in school evals (by district and psych), so I'm not sure why these posters are insisting that something always or never happens.

Some school psychologists use the ADOS; many do not. Some rely on rating scales, some on interviews. Some are more thorough than private evals, and some are not. A school eval is free and the pathway to school services, so it is a great place to start. However, if your daughter's challenges do not seem to be impacting her at preschool, then it may not be worthwhile as they focus on educational impact.

The child is 4 so in most cases it will be the country/city doing the evaluation not the school. IMO there are a broader range of professionals than just a single school psychologist at eg DC Early Stages. if the child is not having difficulty at preschool then it’s probably OK to wait and see, maybe put your name on a list at the children’s hospital near you.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Unless you are made of money, start with your county or state free evaluation which will also set you up for an IEP. If you want something more specialized most large hospitals and all childrens hospitals have autism clinics likely covered by insurance.

Yes, this is the most cost effective way. But a warning that many schools are using outdated concepts of autistic behavior that misses autism in many girls.

Sigh. No, they will perform the ADOS which is the gold standard assessment (and gender neutral). If they don’t do the ADOS then insist on it or to get an independent examination after.

I'm a special ed lawyer. I have never seen a school psychologist perform an ADOS or be certified to do so. They don't even have PhDs. What school district are you in that does the ADOS?

Child Find for 4 year olds certainly does. How do you think they assess 4 year olds?

PP can you say which county you are in where Child Find administered an ADOS that you were aware of?

Reddit typically has much better info than DCUM on actual practices:

https://www.reddit.com/r/schoolpsychology/comments/qx3nhy/do_school_psychologists_use_the_ados/

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Unless you are made of money, start with your county or state free evaluation which will also set you up for an IEP. If you want something more specialized most large hospitals and all childrens hospitals have autism clinics likely covered by insurance.

Yes, this is the most cost effective way. But a warning that many schools are using outdated concepts of autistic behavior that misses autism in many girls.

Sigh. No, they will perform the ADOS which is the gold standard assessment (and gender neutral). If they don’t do the ADOS then insist on it or to get an independent examination after.

I'm a special ed lawyer. I have never seen a school psychologist perform an ADOS or be certified to do so. They don't even have PhDs. What school district are you in that does the ADOS?

Child Find for 4 year olds certainly does. How do you think they assess 4 year olds?

PP can you say which county you are in where Child Find administered an ADOS that you were aware of?

Reddit typically has much better info than DCUM on actual practices:

https://www.reddit.com/r/schoolpsychology/comments/qx3nhy/do_school_psychologists_use_the_ados/

We live in a country with a devolved education system. There are vast differences between school systems. The Reddit you linked to doesn't answer my question. Which DMV county or school system are you aware of, where the ADOS is currently being administered?

[Anonymous]

Anonymous wrote:

Anonymous wrote:There is a lot of variability in school evals (by district and psych), so I'm not sure why these posters are insisting that something always or never happens.

Some school psychologists use the ADOS; many do not. Some rely on rating scales, some on interviews. Some are more thorough than private evals, and some are not. A school eval is free and the pathway to school services, so it is a great place to start. However, if your daughter's challenges do not seem to be impacting her at preschool, then it may not be worthwhile as they focus on educational impact.

The child is 4 so in most cases it will be the country/city doing the evaluation not the school. IMO there are a broader range of professionals than just a single school psychologist at eg DC Early Stages. if the child is not having difficulty at preschool then it’s probably OK to wait and see, maybe put your name on a list at the children’s hospital near you.

"Wait and see" is fine if you start private services in the meantime and are willing to stick with them

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Unless you are made of money, start with your county or state free evaluation which will also set you up for an IEP. If you want something more specialized most large hospitals and all childrens hospitals have autism clinics likely covered by insurance.

Yes, this is the most cost effective way. But a warning that many schools are using outdated concepts of autistic behavior that misses autism in many girls.

Sigh. No, they will perform the ADOS which is the gold standard assessment (and gender neutral). If they don’t do the ADOS then insist on it or to get an independent examination after.

I'm a special ed lawyer. I have never seen a school psychologist perform an ADOS or be certified to do so. They don't even have PhDs. What school district are you in that does the ADOS?

Child Find for 4 year olds certainly does. How do you think they assess 4 year olds?

PP can you say which county you are in where Child Find administered an ADOS that you were aware of?

Reddit typically has much better info than DCUM on actual practices:

https://www.reddit.com/r/schoolpsychology/comments/qx3nhy/do_school_psychologists_use_the_ados/

We live in a country with a devolved education system. There are vast differences between school systems. The Reddit you linked to doesn't answer my question. Which DMV county or school system are you aware of, where the ADOS is currently being administered?

You get the ADOS in the IEE if they don’t do it in the initial evaluation.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There is a lot of variability in school evals (by district and psych), so I'm not sure why these posters are insisting that something always or never happens.

Some school psychologists use the ADOS; many do not. Some rely on rating scales, some on interviews. Some are more thorough than private evals, and some are not. A school eval is free and the pathway to school services, so it is a great place to start. However, if your daughter's challenges do not seem to be impacting her at preschool, then it may not be worthwhile as they focus on educational impact.

The child is 4 so in most cases it will be the country/city doing the evaluation not the school. IMO there are a broader range of professionals than just a single school psychologist at eg DC Early Stages. if the child is not having difficulty at preschool then it’s probably OK to wait and see, maybe put your name on a list at the children’s hospital near you.

"Wait and see" is fine if you start private services in the meantime and are willing to stick with them

OP has only described the most vague issues so it is not clear what services are even indicated.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:There is a lot of variability in school evals (by district and psych), so I'm not sure why these posters are insisting that something always or never happens.

Some school psychologists use the ADOS; many do not. Some rely on rating scales, some on interviews. Some are more thorough than private evals, and some are not. A school eval is free and the pathway to school services, so it is a great place to start. However, if your daughter's challenges do not seem to be impacting her at preschool, then it may not be worthwhile as they focus on educational impact.

The child is 4 so in most cases it will be the country/city doing the evaluation not the school. IMO there are a broader range of professionals than just a single school psychologist at eg DC Early Stages. if the child is not having difficulty at preschool then it’s probably OK to wait and see, maybe put your name on a list at the children’s hospital near you.

"Wait and see" is fine if you start private services in the meantime and are willing to stick with them

OP has only described the most vague issues so it is not clear what services are even indicated.

That's the point of an evaluation, which is what the first responders suggested.