Steps for getting evaluated for 4 year old for potential autism

[Anonymous]

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 But a warning that many schools are using outdated concepts of autistic behavior that misses autism in many girls.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?

It’s entirely possible that, as a special ed lawyer, you’re only involved in cases where things don’t work out as they’re supposed to. We were offered an ADOS from PGCPS when our child was 4. We paid for a private neuropsych for other reasons, but the school psychologist was able to offer the ADOS.

[Anonymous]

OP here - thank you so much to everyone for your thoughts, opinions and suggestions. My daughter has been in childcare and recently switched to pre-k. The behaviors that seemed okay when she was younger, now seem more obviously different from her classmates.

I had previously set up an appointment with a child psychologist for the anxiety and will look into OT while putting her on the waitlists for Children’s and Kennedy Krieger for evaluation. Thank you for sharing your advice and experience.

[Anonymous]

Anonymous wrote:OP here - thank you so much to everyone for your thoughts, opinions and suggestions. My daughter has been in childcare and recently switched to pre-k. The behaviors that seemed okay when she was younger, now seem more obviously different from her classmates.

I had previously set up an appointment with a child psychologist for the anxiety and will look into OT while putting her on the waitlists for Children’s and Kennedy Krieger for evaluation. Thank you for sharing your advice and experience.

Sounds like a great plan!

[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.

OP indicated social difficulties and anxiety. I don't know if her child is similar to mine, but my child who also has anxiety and social difficulties has benefited greatly from OT and a social skills class. Getting an OT evaluation (ideally with a practice with therapists experienced in autism) would be a good first step as has been previously mentioned.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here - thank you so much to everyone for your thoughts, opinions and suggestions. My daughter has been in childcare and recently switched to pre-k. The behaviors that seemed okay when she was younger, now seem more obviously different from her classmates.

I had previously set up an appointment with a child psychologist for the anxiety and will look into OT while putting her on the waitlists for Children’s and Kennedy Krieger for evaluation. Thank you for sharing your advice and experience.

Sounds like a great plan!

+1

[Anonymous]

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?

In addition to the poster who said PG, I've seen school psychs administer the ADOS in LCPS and MCPS. You're a special ed lawyer and you don't know that some school psychologists have PhDs? Most are certified with a specialist degree, but there are school psychologists in every local district with PhDs in school psychology. Some are practicing with only their school psych certification and some are also licensed psychologists. Also, the publisher of the ADOS classifies it as needing level C qualifications to administer (which includes certified school psychs at the specialist level) rather than a level N (needs to have a PHD).

[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?

In addition to the poster who said PG, I've seen school psychs administer the ADOS in LCPS and MCPS. You're a special ed lawyer and you don't know that some school psychologists have PhDs? Most are certified with a specialist degree, but there are school psychologists in every local district with PhDs in school psychology. Some are practicing with only their school psych certification and some are also licensed psychologists. Also, the publisher of the ADOS classifies it as needing level C qualifications to administer (which includes certified school psychs at the specialist level) rather than a level N (needs to have a PHD).

What’s with the attitude?

[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?

In addition to the poster who said PG, I've seen school psychs administer the ADOS in LCPS and MCPS. You're a special ed lawyer and you don't know that some school psychologists have PhDs? Most are certified with a specialist degree, but there are school psychologists in every local district with PhDs in school psychology. Some are practicing with only their school psych certification and some are also licensed psychologists. Also, the publisher of the ADOS classifies it as needing level C qualifications to administer (which includes certified school psychs at the specialist level) rather than a level N (needs to have a PHD).

What’s with the attitude?

Probably from how frustrating it is to deal with special ed lawyers who make incorrect claims and waste families thousands of dollars!

[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?

In addition to the poster who said PG, I've seen school psychs administer the ADOS in LCPS and MCPS. You're a special ed lawyer and you don't know that some school psychologists have PhDs? Most are certified with a specialist degree, but there are school psychologists in every local district with PhDs in school psychology. Some are practicing with only their school psych certification and some are also licensed psychologists. Also, the publisher of the ADOS classifies it as needing level C qualifications to administer (which includes certified school psychs at the specialist level) rather than a level N (needs to have a PHD).

What’s with the attitude?

Probably from how frustrating it is to deal with special ed lawyers who make incorrect claims and waste families thousands of dollars!

I'm not the special ed attorney but I feel like the truth is somewhere in between. I don't doubt many school districts can administer the ADOS, the question is will they and if so how long until they will actually do it? Autistic girls (on average) often do better than autistic boys at younger ages and then struggle more at older ages as social demands increase. Unless there is a significant educational impact right now Child Find will wave you off. And even if they don't wave you off their goal will never be to diagnose your child ASAP. They will do what they are legally required to do. It is not their job to provide the top level gold standard of services to treat neurodevelopmental conditions.

[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?

In addition to the poster who said PG, I've seen school psychs administer the ADOS in LCPS and MCPS. You're a special ed lawyer and you don't know that some school psychologists have PhDs? Most are certified with a specialist degree, but there are school psychologists in every local district with PhDs in school psychology. Some are practicing with only their school psych certification and some are also licensed psychologists. Also, the publisher of the ADOS classifies it as needing level C qualifications to administer (which includes certified school psychs at the specialist level) rather than a level N (needs to have a PHD).

What’s with the attitude?

Probably from how frustrating it is to deal with special ed lawyers who make incorrect claims and waste families thousands of dollars!

+1. My kid didn’t have the ADOS from early stages but did get other evaluations that were the same as private ones (OT, PT and hearing.)

[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?

In addition to the poster who said PG, I've seen school psychs administer the ADOS in LCPS and MCPS. You're a special ed lawyer and you don't know that some school psychologists have PhDs? Most are certified with a specialist degree, but there are school psychologists in every local district with PhDs in school psychology. Some are practicing with only their school psych certification and some are also licensed psychologists. Also, the publisher of the ADOS classifies it as needing level C qualifications to administer (which includes certified school psychs at the specialist level) rather than a level N (needs to have a PHD).

What’s with the attitude?

Probably from how frustrating it is to deal with special ed lawyers who make incorrect claims and waste families thousands of dollars!

I'm not the special ed attorney but I feel like the truth is somewhere in between. I don't doubt many school districts can administer the ADOS, the question is will they and if so how long until they will actually do it? Autistic girls (on average) often do better than autistic boys at younger ages and then struggle more at older ages as social demands increase. Unless there is a significant educational impact right now Child Find will wave you off. And even if they don't wave you off their goal will never be to diagnose your child ASAP. They will do what they are legally required to do. It is not their job to provide the top level gold standard of services to treat neurodevelopmental conditions.

The point I am trying to make is that families are ill served by the common notion that you need to panic and pay $$ to get all the services ASAP. if it is autism there is no cure. It’s ok to take some time and consideration. The only thing I would probably fast track is a language delay but even then you can just go straight to an SLP.

[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?

In addition to the poster who said PG, I've seen school psychs administer the ADOS in LCPS and MCPS. You're a special ed lawyer and you don't know that some school psychologists have PhDs? Most are certified with a specialist degree, but there are school psychologists in every local district with PhDs in school psychology. Some are practicing with only their school psych certification and some are also licensed psychologists. Also, the publisher of the ADOS classifies it as needing level C qualifications to administer (which includes certified school psychs at the specialist level) rather than a level N (needs to have a PHD).

What’s with the attitude?

Probably from how frustrating it is to deal with special ed lawyers who make incorrect claims and waste families thousands of dollars!

I'm not the special ed attorney but I feel like the truth is somewhere in between. I don't doubt many school districts can administer the ADOS, the question is will they and if so how long until they will actually do it? Autistic girls (on average) often do better than autistic boys at younger ages and then struggle more at older ages as social demands increase. Unless there is a significant educational impact right now Child Find will wave you off. And even if they don't wave you off their goal will never be to diagnose your child ASAP. They will do what they are legally required to do. It is not their job to provide the top level gold standard of services to treat neurodevelopmental conditions.

You are acting like the ADOS is a magic, fail-proof tool. It's not! It is culturally biased and less likely to identify level 1 girls. It is a great tool, sure, but it is just a tool.

[Anonymous]

Anonymous wrote:

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?

In addition to the poster who said PG, I've seen school psychs administer the ADOS in LCPS and MCPS. You're a special ed lawyer and you don't know that some school psychologists have PhDs? Most are certified with a specialist degree, but there are school psychologists in every local district with PhDs in school psychology. Some are practicing with only their school psych certification and some are also licensed psychologists. Also, the publisher of the ADOS classifies it as needing level C qualifications to administer (which includes certified school psychs at the specialist level) rather than a level N (needs to have a PHD).

What’s with the attitude?

Probably from how frustrating it is to deal with special ed lawyers who make incorrect claims and waste families thousands of dollars!

I'm not the special ed attorney but I feel like the truth is somewhere in between. I don't doubt many school districts can administer the ADOS, the question is will they and if so how long until they will actually do it? Autistic girls (on average) often do better than autistic boys at younger ages and then struggle more at older ages as social demands increase. Unless there is a significant educational impact right now Child Find will wave you off. And even if they don't wave you off their goal will never be to diagnose your child ASAP. They will do what they are legally required to do. It is not their job to provide the top level gold standard of services to treat neurodevelopmental conditions.

The point I am trying to make is that families are ill served by the common notion that you need to panic and pay $$ to get all the services ASAP. if it is autism there is no cure. It’s ok to take some time and consideration. The only thing I would probably fast track is a language delay but even then you can just go straight to an SLP.

Early identification of autism is associated with better outcomes. For us it has been really helpful. My goal is not to save as much money as possible.

[Anonymous]

Anonymous wrote:

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?

In addition to the poster who said PG, I've seen school psychs administer the ADOS in LCPS and MCPS. You're a special ed lawyer and you don't know that some school psychologists have PhDs? Most are certified with a specialist degree, but there are school psychologists in every local district with PhDs in school psychology. Some are practicing with only their school psych certification and some are also licensed psychologists. Also, the publisher of the ADOS classifies it as needing level C qualifications to administer (which includes certified school psychs at the specialist level) rather than a level N (needs to have a PHD).

What’s with the attitude?

Probably from how frustrating it is to deal with special ed lawyers who make incorrect claims and waste families thousands of dollars!

I'm not the special ed attorney but I feel like the truth is somewhere in between. I don't doubt many school districts can administer the ADOS, the question is will they and if so how long until they will actually do it? Autistic girls (on average) often do better than autistic boys at younger ages and then struggle more at older ages as social demands increase. Unless there is a significant educational impact right now Child Find will wave you off. And even if they don't wave you off their goal will never be to diagnose your child ASAP. They will do what they are legally required to do. It is not their job to provide the top level gold standard of services to treat neurodevelopmental conditions.

You are acting like the ADOS is a magic, fail-proof tool. It's not! It is culturally biased and less likely to identify level 1 girls. It is a great tool, sure, but it is just a tool.

I definitely didn't say that. Why do you need to ascribe to me something I didn't say or imply.? ADOS is the gold standard for diagnosing autism and certainly better than not doing it at all.

[Anonymous]

Anonymous wrote:

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?

In addition to the poster who said PG, I've seen school psychs administer the ADOS in LCPS and MCPS. You're a special ed lawyer and you don't know that some school psychologists have PhDs? Most are certified with a specialist degree, but there are school psychologists in every local district with PhDs in school psychology. Some are practicing with only their school psych certification and some are also licensed psychologists. Also, the publisher of the ADOS classifies it as needing level C qualifications to administer (which includes certified school psychs at the specialist level) rather than a level N (needs to have a PHD).

What’s with the attitude?

Probably from how frustrating it is to deal with special ed lawyers who make incorrect claims and waste families thousands of dollars!

I'm not the special ed attorney but I feel like the truth is somewhere in between. I don't doubt many school districts can administer the ADOS, the question is will they and if so how long until they will actually do it? Autistic girls (on average) often do better than autistic boys at younger ages and then struggle more at older ages as social demands increase. Unless there is a significant educational impact right now Child Find will wave you off. And even if they don't wave you off their goal will never be to diagnose your child ASAP. They will do what they are legally required to do. It is not their job to provide the top level gold standard of services to treat neurodevelopmental conditions.

The point I am trying to make is that families are ill served by the common notion that you need to panic and pay $$ to get all the services ASAP. if it is autism there is no cure. It’s ok to take some time and consideration. The only thing I would probably fast track is a language delay but even then you can just go straight to an SLP.

Very poor information.