ASD evaluation without selling a kidney

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew DS had autism since he was little (no one believed me, initially). We paid a reasonable sum, in the hundreds, when he was diagnosed with ADHD by a developmental pediatrician at 6. His MCPS elementary school gave him an IEP due to extremely inattentive behaviors, inability to complete assignments on time, and write: he had group speech, a scribe/aide for writing, pull-outs to finish his work, preferential seating, repeated directions, etc. The works.

We paid Stixrud prices (thousands) for a full neuro when he was 10, because he needed updated data to qualify for MCPS' gifted and learning disabled program. ADHD was confirmed but we were told it would cost extra to explore autism. We chose not to, because he was getting everything he needed with the IEP, predicated on the ADHD. He got into the special program, which turned out great for him.

Only when he was 17 did we return to Stixrud to specifically ask for autism testing (and a reconfirmation of the ADHD), so we could request services and accommodations from colleges. His chosen college's Disability Office assigned him a single room with private bath on the strength of the autism diagnosis.

All this to say, OP, that:

A. You will need to budget money and time for repeated evaluations over the course of his childhood, because most institutions/programs require paperwork that is 4 years old or less. There are waitlists everywhere for testing and some of them can be very long. Make sure to schedule in advance.

B. You can be strategic in your diagnosis targeting, depending how you plan on using that label.

This is not necessary. You can schedule repeated testing at places like Children’s. I was encouraged to schedule serial testing years in advance. You don’t need to pay that much for it. Although I’m sure Stixrud loves your viewpoint!

PP you replied to. You're right, but we have ADHD ourselves and scheduling years in advance is not our strong suit Also, and this is important, not all neuropsych reports are created equal and we REALLY appreciated the doctor we worked with at Stixrud. The reports were extremely detailed, explained so much, and included a page in MCPS-speak of recommended accommodations that no elementary, middle or high school denied us. We had the same success for college accommodations, with the same doctor. It's not the label that opens doors; it's the way the doctor argues for accommodations that often clinches matters for institutions who need to be persuaded to provide those accommodations.

Of course I'm sure Children's and other hospital centers also have psychologists with good writing skills on staff, but they might be more pressed for time. We continued wth Stixrud because you don't change a winning team.

If you have $20k to waste or are set on justifying an accomodation to keep up with the Jonses (eg extended time on the SAT) ok fine. But for those of us who have limited budgets and have to invest in services that our kids need (OT, therapy, tutoring) then no, we cannot pay uneccesary money.

DP - what is the matter with you? Why do you think it's okay to speak to people like this?

what’s wrong with YOU? or better asked, what’s wrong with “providers” who charge SN families $5000 for an incomplete evaluation (like the PP whose kid didn’t even get autism included) or that they could get for an insurance copay elsewhere.

Are you trying to imply I'm a provider falsely representing myself as a parent? I'm not.

Please stop bashing other parents. You are literally achieving nothing.

Obviously not. I’m not bashing parents. I’m bashing the bad advice that you have to spend $1000ss on testing. And I am also bashing the numerous providers happy to take our money, yes.

LOL you implied parents are getting diagnoses to "keep up with the Jones". Stop being a toxic POS.

it happens. I literally just heard about a friend of a friend who was instructed by their kid’s private school to obtain a dx asap. it would be helpful for people advocating lining the pockets of Drs Stixrud and Black to give more information about their financial status, diagnosis, and why they did not rely on school testing, IEE, and/or insurance covered services.

All people on this board have SN kids. You need to do better to be kinder, this tone is out of line and unacceptable.

If you had a child with SN, you would know that 1) school testing cannot give medical diagnosis 2) w/o medical diagnosis a child with disability cannot get insurance coverage for any services 3) places that take insurance have 1-2 year waiting list for both ASD evaluations and full neuropsych. In fact, families that go via private pay route to private providers to get a faster diagnosis don't crowd further the KKI and Childrens waitlists. So it's a good thing.

Schools and Infants and Toddlers have much lower standard for identifying issues too - in speech, OT and physical development. Their evaluations are low quality and services are scarce and frankly also not great quality. People who can afford do private services.

And not that it's any of your business, but HHI is $280K, 5 yo ASD child diagnosed at 2.5 years in private practice.

I think this is wrong about needing a “medical diagnosis” for insurance coverage. We got OT covered without any diagnosis - the OT did their own testing to show the motor skills delays. Also got an amazing course of behavioral therapy covered with no diagnosis. Possibly ABA would require a “medical diagnosis” but I’m not sure that it does.

NP - almost all private payors require a diagnosis for covered services. That can be done in different ways, and a therapist doesn't necessarily need to render a formal diagnosis of ASD or anxiety or whatever, but the vast majority of insurance companies are going to require that.

PP is right that school testing can't render a diagnosis that can be used for healthcare insurance reimbursement. My DS was "diagnosed" with specific learning disability/dyslexia through school testing, but no insurance company is going to pay for the private dyslexia remediation services we're getting for him.

No that’s just not true that you have to do a pricey private diagnostic evaluation to get any insurance covered services. For most services the provider enters a diagnostic code. I’ve gotten a ton of covered services for my kid prior to the DSM dx. For some services (such as ABA) more would be required. And obviously insurance companies vary.

More specifically, insurance plans vary.

PP is correct that private payors require a diagnosis but they are confusing the issue because the "diagnosis" can just be the specific motor issue the OT is seeing. It can be very vague. The question is will the plan cover a given service without a diagnosis of ASD or ADHD or other medical condition and the answer is it varies a lot and yes, some people do benefit from an insurance coverage standpoint from a comprehensive diagnostic evaluation. Many others benefit from clarity on their child's issues and pointing the way towards services that will actually help them.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew DS had autism since he was little (no one believed me, initially). We paid a reasonable sum, in the hundreds, when he was diagnosed with ADHD by a developmental pediatrician at 6. His MCPS elementary school gave him an IEP due to extremely inattentive behaviors, inability to complete assignments on time, and write: he had group speech, a scribe/aide for writing, pull-outs to finish his work, preferential seating, repeated directions, etc. The works.

We paid Stixrud prices (thousands) for a full neuro when he was 10, because he needed updated data to qualify for MCPS' gifted and learning disabled program. ADHD was confirmed but we were told it would cost extra to explore autism. We chose not to, because he was getting everything he needed with the IEP, predicated on the ADHD. He got into the special program, which turned out great for him.

Only when he was 17 did we return to Stixrud to specifically ask for autism testing (and a reconfirmation of the ADHD), so we could request services and accommodations from colleges. His chosen college's Disability Office assigned him a single room with private bath on the strength of the autism diagnosis.

All this to say, OP, that:

A. You will need to budget money and time for repeated evaluations over the course of his childhood, because most institutions/programs require paperwork that is 4 years old or less. There are waitlists everywhere for testing and some of them can be very long. Make sure to schedule in advance.

B. You can be strategic in your diagnosis targeting, depending how you plan on using that label.

This is not necessary. You can schedule repeated testing at places like Children’s. I was encouraged to schedule serial testing years in advance. You don’t need to pay that much for it. Although I’m sure Stixrud loves your viewpoint!

PP you replied to. You're right, but we have ADHD ourselves and scheduling years in advance is not our strong suit Also, and this is important, not all neuropsych reports are created equal and we REALLY appreciated the doctor we worked with at Stixrud. The reports were extremely detailed, explained so much, and included a page in MCPS-speak of recommended accommodations that no elementary, middle or high school denied us. We had the same success for college accommodations, with the same doctor. It's not the label that opens doors; it's the way the doctor argues for accommodations that often clinches matters for institutions who need to be persuaded to provide those accommodations.

Of course I'm sure Children's and other hospital centers also have psychologists with good writing skills on staff, but they might be more pressed for time. We continued wth Stixrud because you don't change a winning team.

If you have $20k to waste or are set on justifying an accomodation to keep up with the Jonses (eg extended time on the SAT) ok fine. But for those of us who have limited budgets and have to invest in services that our kids need (OT, therapy, tutoring) then no, we cannot pay uneccesary money.

DP - what is the matter with you? Why do you think it's okay to speak to people like this?

what’s wrong with YOU? or better asked, what’s wrong with “providers” who charge SN families $5000 for an incomplete evaluation (like the PP whose kid didn’t even get autism included) or that they could get for an insurance copay elsewhere.

Are you trying to imply I'm a provider falsely representing myself as a parent? I'm not.

Please stop bashing other parents. You are literally achieving nothing.

Obviously not. I’m not bashing parents. I’m bashing the bad advice that you have to spend $1000ss on testing. And I am also bashing the numerous providers happy to take our money, yes.

LOL you implied parents are getting diagnoses to "keep up with the Jones". Stop being a toxic POS.

it happens. I literally just heard about a friend of a friend who was instructed by their kid’s private school to obtain a dx asap. it would be helpful for people advocating lining the pockets of Drs Stixrud and Black to give more information about their financial status, diagnosis, and why they did not rely on school testing, IEE, and/or insurance covered services.

All people on this board have SN kids. You need to do better to be kinder, this tone is out of line and unacceptable.

If you had a child with SN, you would know that 1) school testing cannot give medical diagnosis 2) w/o medical diagnosis a child with disability cannot get insurance coverage for any services 3) places that take insurance have 1-2 year waiting list for both ASD evaluations and full neuropsych. In fact, families that go via private pay route to private providers to get a faster diagnosis don't crowd further the KKI and Childrens waitlists. So it's a good thing.

Schools and Infants and Toddlers have much lower standard for identifying issues too - in speech, OT and physical development. Their evaluations are low quality and services are scarce and frankly also not great quality. People who can afford do private services.

And not that it's any of your business, but HHI is $280K, 5 yo ASD child diagnosed at 2.5 years in private practice.

I think this is wrong about needing a “medical diagnosis” for insurance coverage. We got OT covered without any diagnosis - the OT did their own testing to show the motor skills delays. Also got an amazing course of behavioral therapy covered with no diagnosis. Possibly ABA would require a “medical diagnosis” but I’m not sure that it does.

NP - almost all private payors require a diagnosis for covered services. That can be done in different ways, and a therapist doesn't necessarily need to render a formal diagnosis of ASD or anxiety or whatever, but the vast majority of insurance companies are going to require that.

PP is right that school testing can't render a diagnosis that can be used for healthcare insurance reimbursement. My DS was "diagnosed" with specific learning disability/dyslexia through school testing, but no insurance company is going to pay for the private dyslexia remediation services we're getting for him.

No that’s just not true that you have to do a pricey private diagnostic evaluation to get any insurance covered services. For most services the provider enters a diagnostic code. I’ve gotten a ton of covered services for my kid prior to the DSM dx. For some services (such as ABA) more would be required. And obviously insurance companies vary.

This is very nuanced. Provider (even OT or PT) will need to do an evaluation with established testing that's appropriate for child's age and suspected deficits. No, they don't just punch in a diagnosis code. They need to conduct and document an evaluation that supports that diagnosis code. It's not free. Yes, it's cheaper than full neurophych but is also very limited to their area of expertise.

Then on insurance side, it's also not so clear cut as you try to paint it (not sure to what purpose?). For example some plans have separate categories for habilitative and Autism services. With different appointment limits.

Our OT was able to just take the OT testing done for the IEP. It really wasn’t tough. Obviously all insurance companies are different. The therapist definitely did just punch in a code based on the intake with her.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thank you for asking this question, and for all the responses. We paid thousands for a diagnosis from someone recommended by our private school this spring, and ended up asking for our money back (eval report was not timely delivered). I am now trying to find ways forward to see how to help our child without feeling like we are being scammed. In our case it seemed that all the person did was administer tests, and was not actually working as a counselor to help children, and it was clear our child has a high IQ and likely (?) dyslexia and possibly (?) borderline ADHD but maybe not (never got the report) and the sense we received from the tester was it was all geared towards getting our extra time and accommodations in school. This was the third person we’ve tried to seek help from, we tried recommended nutritionist and independently a psychiatrist before the school made a suggestion. So even assuming we can find affordable testing, what are good indicators that the results are trustworthy and the administrators are looking out primarily for the child’s welfare? Do you get second opinions? See,s hard to do when it is so expensive. But the responses here have been incredibly helpful and validating the feeling that this should not be so expensive and alternatives exist…even if we have to wait.

I'm sorry you have had bad experiences. I think you might have misaligned expectations, though, as well. Generally the psychologists who administer tests only administer tests. That's their specialty and often their whole practice is administering tests and writing reports. Their reports give the test results and generally offer a list of accommodations (such as extra time) that seem appropriate based on the test results. The psychologist has always met with us after writing the report to discuss and go over the findings. They aren't also the people who will counsel your child.

After having this done, we have taken the report to our child's regular psychiatrist and therapist and school to implement steps from there and decide which accommodations and recommendations make sense. It is that team (and us of course) who are "looking out for the child's welfare."

A nutritionist wouldn't be the right person for this, and probably not a psychiatrist either. You want a psychologist who does testing (a "neuropsych').

Except this provider didn’t actually complete a report. But yes, I do think it’s important for parents to understand that the “neuropsych” is done one a one-off basis by a practitioner with no relationship with your child and who will not generally provide ongoing therapy. As well, many of their recommendations for therapy will be impossible to access, nonexistant, or impossible for the school to implement. It’s a LOT of money to pay just on the faith that recommendations made by someone who doesn’t actually know your kid will be executable. But if all you’re looking for is a piece of paper to get extended time on the SATs, that is likely doable.

This wasn't our experience at all. Recommendations were definitely actionable and very helpful (extra time is not one of the recommendations). And the evaluator did a school observation, had teachers fill out rating scales, spoke extensively with us and her OT, and reviewed documents in addition to the testing so she wasn't just relying on the testing. If anything your comment highlights the importance of working with someone who will do a thorough evaluation, which takes time, and unfortunately working with insurance limits the time they can spend with your child.

Yeah I had people try to sell me on that approach as well. There’s no magic bullet and I prefer to spend my money on actual therapies.

Sell you on the approach of clearly identifying your child's strengths and challenges and what services can help them? That's horrible, I'm sorry you had to go through that. Good for your for being smarter than all us other parents who are clearly idiots.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thank you for asking this question, and for all the responses. We paid thousands for a diagnosis from someone recommended by our private school this spring, and ended up asking for our money back (eval report was not timely delivered). I am now trying to find ways forward to see how to help our child without feeling like we are being scammed. In our case it seemed that all the person did was administer tests, and was not actually working as a counselor to help children, and it was clear our child has a high IQ and likely (?) dyslexia and possibly (?) borderline ADHD but maybe not (never got the report) and the sense we received from the tester was it was all geared towards getting our extra time and accommodations in school. This was the third person we’ve tried to seek help from, we tried recommended nutritionist and independently a psychiatrist before the school made a suggestion. So even assuming we can find affordable testing, what are good indicators that the results are trustworthy and the administrators are looking out primarily for the child’s welfare? Do you get second opinions? See,s hard to do when it is so expensive. But the responses here have been incredibly helpful and validating the feeling that this should not be so expensive and alternatives exist…even if we have to wait.

I'm sorry you have had bad experiences. I think you might have misaligned expectations, though, as well. Generally the psychologists who administer tests only administer tests. That's their specialty and often their whole practice is administering tests and writing reports. Their reports give the test results and generally offer a list of accommodations (such as extra time) that seem appropriate based on the test results. The psychologist has always met with us after writing the report to discuss and go over the findings. They aren't also the people who will counsel your child.

After having this done, we have taken the report to our child's regular psychiatrist and therapist and school to implement steps from there and decide which accommodations and recommendations make sense. It is that team (and us of course) who are "looking out for the child's welfare."

A nutritionist wouldn't be the right person for this, and probably not a psychiatrist either. You want a psychologist who does testing (a "neuropsych').

Except this provider didn’t actually complete a report. But yes, I do think it’s important for parents to understand that the “neuropsych” is done one a one-off basis by a practitioner with no relationship with your child and who will not generally provide ongoing therapy. As well, many of their recommendations for therapy will be impossible to access, nonexistant, or impossible for the school to implement . It’s a LOT of money to pay just on the faith that recommendations made by someone who doesn’t actually know your kid will be executable. But if all you’re looking for is a piece of paper to get extended time on the SATs, that is likely doable.

You are just making up stuff to support your point. What was a nonexistent therapy that was recommended and you couldn't find in the DMV metro area?

There are tools, tests and protocols that are in place and certain level of credentials required for all evaluations including neuropsych. If only someone who knows your child could evaluate them, then why don't we all do it ourselves or go to granmas to get screened for complex developmental issues. You're fighting with windmills on this thread. I truly feel for people who cannot afford access to quality healthcare in this country. I also get that you might need to find a way to explain it to yourself, but this board has a lot of educated people and whatever you're selling, they are not buying. Best of luck.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew DS had autism since he was little (no one believed me, initially). We paid a reasonable sum, in the hundreds, when he was diagnosed with ADHD by a developmental pediatrician at 6. His MCPS elementary school gave him an IEP due to extremely inattentive behaviors, inability to complete assignments on time, and write: he had group speech, a scribe/aide for writing, pull-outs to finish his work, preferential seating, repeated directions, etc. The works.

We paid Stixrud prices (thousands) for a full neuro when he was 10, because he needed updated data to qualify for MCPS' gifted and learning disabled program. ADHD was confirmed but we were told it would cost extra to explore autism. We chose not to, because he was getting everything he needed with the IEP, predicated on the ADHD. He got into the special program, which turned out great for him.

Only when he was 17 did we return to Stixrud to specifically ask for autism testing (and a reconfirmation of the ADHD), so we could request services and accommodations from colleges. His chosen college's Disability Office assigned him a single room with private bath on the strength of the autism diagnosis.

All this to say, OP, that:

A. You will need to budget money and time for repeated evaluations over the course of his childhood, because most institutions/programs require paperwork that is 4 years old or less. There are waitlists everywhere for testing and some of them can be very long. Make sure to schedule in advance.

B. You can be strategic in your diagnosis targeting, depending how you plan on using that label.

This is not necessary. You can schedule repeated testing at places like Children’s. I was encouraged to schedule serial testing years in advance. You don’t need to pay that much for it. Although I’m sure Stixrud loves your viewpoint!

PP you replied to. You're right, but we have ADHD ourselves and scheduling years in advance is not our strong suit Also, and this is important, not all neuropsych reports are created equal and we REALLY appreciated the doctor we worked with at Stixrud. The reports were extremely detailed, explained so much, and included a page in MCPS-speak of recommended accommodations that no elementary, middle or high school denied us. We had the same success for college accommodations, with the same doctor. It's not the label that opens doors; it's the way the doctor argues for accommodations that often clinches matters for institutions who need to be persuaded to provide those accommodations.

Of course I'm sure Children's and other hospital centers also have psychologists with good writing skills on staff, but they might be more pressed for time. We continued wth Stixrud because you don't change a winning team.

If you have $20k to waste or are set on justifying an accomodation to keep up with the Jonses (eg extended time on the SAT) ok fine. But for those of us who have limited budgets and have to invest in services that our kids need (OT, therapy, tutoring) then no, we cannot pay uneccesary money.

DP - what is the matter with you? Why do you think it's okay to speak to people like this?

what’s wrong with YOU? or better asked, what’s wrong with “providers” who charge SN families $5000 for an incomplete evaluation (like the PP whose kid didn’t even get autism included) or that they could get for an insurance copay elsewhere.

Are you trying to imply I'm a provider falsely representing myself as a parent? I'm not.

Please stop bashing other parents. You are literally achieving nothing.

Obviously not. I’m not bashing parents. I’m bashing the bad advice that you have to spend $1000ss on testing. And I am also bashing the numerous providers happy to take our money, yes.

LOL you implied parents are getting diagnoses to "keep up with the Jones". Stop being a toxic POS.

it happens. I literally just heard about a friend of a friend who was instructed by their kid’s private school to obtain a dx asap. it would be helpful for people advocating lining the pockets of Drs Stixrud and Black to give more information about their financial status, diagnosis, and why they did not rely on school testing, IEE, and/or insurance covered services.

All people on this board have SN kids. You need to do better to be kinder, this tone is out of line and unacceptable.

If you had a child with SN, you would know that 1) school testing cannot give medical diagnosis 2) w/o medical diagnosis a child with disability cannot get insurance coverage for any services 3) places that take insurance have 1-2 year waiting list for both ASD evaluations and full neuropsych. In fact, families that go via private pay route to private providers to get a faster diagnosis don't crowd further the KKI and Childrens waitlists. So it's a good thing.

Schools and Infants and Toddlers have much lower standard for identifying issues too - in speech, OT and physical development. Their evaluations are low quality and services are scarce and frankly also not great quality. People who can afford do private services.

And not that it's any of your business, but HHI is $280K, 5 yo ASD child diagnosed at 2.5 years in private practice.

I think this is wrong about needing a “medical diagnosis” for insurance coverage. We got OT covered without any diagnosis - the OT did their own testing to show the motor skills delays. Also got an amazing course of behavioral therapy covered with no diagnosis. Possibly ABA would require a “medical diagnosis” but I’m not sure that it does.

NP - almost all private payors require a diagnosis for covered services. That can be done in different ways, and a therapist doesn't necessarily need to render a formal diagnosis of ASD or anxiety or whatever, but the vast majority of insurance companies are going to require that.

PP is right that school testing can't render a diagnosis that can be used for healthcare insurance reimbursement. My DS was "diagnosed" with specific learning disability/dyslexia through school testing, but no insurance company is going to pay for the private dyslexia remediation services we're getting for him.

No that’s just not true that you have to do a pricey private diagnostic evaluation to get any insurance covered services. For most services the provider enters a diagnostic code. I’ve gotten a ton of covered services for my kid prior to the DSM dx. For some services (such as ABA) more would be required. And obviously insurance companies vary.

More specifically, insurance plans vary.

PP is correct that private payors require a diagnosis but they are confusing the issue because the "diagnosis" can just be the specific motor issue the OT is seeing. It can be very vague. The question is will the plan cover a given service without a diagnosis of ASD or ADHD or other medical condition and the answer is it varies a lot and yes, some people do benefit from an insurance coverage standpoint from a comprehensive diagnostic evaluation. Many others benefit from clarity on their child's issues and pointing the way towards services that will actually help them.

Sure except my child’s OT issues were quite obviously fine motor skills apparent to everyone. The whole point is to address the “specific motor issue.” That’s where I think parents can get really off track and confused: failing to focus on treating the challenges that are self-evident.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thank you for asking this question, and for all the responses. We paid thousands for a diagnosis from someone recommended by our private school this spring, and ended up asking for our money back (eval report was not timely delivered). I am now trying to find ways forward to see how to help our child without feeling like we are being scammed. In our case it seemed that all the person did was administer tests, and was not actually working as a counselor to help children, and it was clear our child has a high IQ and likely (?) dyslexia and possibly (?) borderline ADHD but maybe not (never got the report) and the sense we received from the tester was it was all geared towards getting our extra time and accommodations in school. This was the third person we’ve tried to seek help from, we tried recommended nutritionist and independently a psychiatrist before the school made a suggestion. So even assuming we can find affordable testing, what are good indicators that the results are trustworthy and the administrators are looking out primarily for the child’s welfare? Do you get second opinions? See,s hard to do when it is so expensive. But the responses here have been incredibly helpful and validating the feeling that this should not be so expensive and alternatives exist…even if we have to wait.

I'm sorry you have had bad experiences. I think you might have misaligned expectations, though, as well. Generally the psychologists who administer tests only administer tests. That's their specialty and often their whole practice is administering tests and writing reports. Their reports give the test results and generally offer a list of accommodations (such as extra time) that seem appropriate based on the test results. The psychologist has always met with us after writing the report to discuss and go over the findings. They aren't also the people who will counsel your child.

After having this done, we have taken the report to our child's regular psychiatrist and therapist and school to implement steps from there and decide which accommodations and recommendations make sense. It is that team (and us of course) who are "looking out for the child's welfare."

A nutritionist wouldn't be the right person for this, and probably not a psychiatrist either. You want a psychologist who does testing (a "neuropsych').

Except this provider didn’t actually complete a report. But yes, I do think it’s important for parents to understand that the “neuropsych” is done one a one-off basis by a practitioner with no relationship with your child and who will not generally provide ongoing therapy. As well, many of their recommendations for therapy will be impossible to access, nonexistant, or impossible for the school to implement . It’s a LOT of money to pay just on the faith that recommendations made by someone who doesn’t actually know your kid will be executable. But if all you’re looking for is a piece of paper to get extended time on the SATs, that is likely doable.

You are just making up stuff to support your point. What was a nonexistent therapy that was recommended and you couldn't find in the DMV metro area?

There are tools, tests and protocols that are in place and certain level of credentials required for all evaluations including neuropsych. If only someone who knows your child could evaluate them, then why don't we all do it ourselves or go to granmas to get screened for complex developmental issues. You're fighting with windmills on this thread. I truly feel for people who cannot afford access to quality healthcare in this country. I also get that you might need to find a way to explain it to yourself, but this board has a lot of educated people and whatever you're selling, they are not buying. Best of luck.

Oh boy. How many people get “social skills group” listed on their reports? They don’t exist many places (and have very little evidence anyway).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thank you for asking this question, and for all the responses. We paid thousands for a diagnosis from someone recommended by our private school this spring, and ended up asking for our money back (eval report was not timely delivered). I am now trying to find ways forward to see how to help our child without feeling like we are being scammed. In our case it seemed that all the person did was administer tests, and was not actually working as a counselor to help children, and it was clear our child has a high IQ and likely (?) dyslexia and possibly (?) borderline ADHD but maybe not (never got the report) and the sense we received from the tester was it was all geared towards getting our extra time and accommodations in school. This was the third person we’ve tried to seek help from, we tried recommended nutritionist and independently a psychiatrist before the school made a suggestion. So even assuming we can find affordable testing, what are good indicators that the results are trustworthy and the administrators are looking out primarily for the child’s welfare? Do you get second opinions? See,s hard to do when it is so expensive. But the responses here have been incredibly helpful and validating the feeling that this should not be so expensive and alternatives exist…even if we have to wait.

I'm sorry you have had bad experiences. I think you might have misaligned expectations, though, as well. Generally the psychologists who administer tests only administer tests. That's their specialty and often their whole practice is administering tests and writing reports. Their reports give the test results and generally offer a list of accommodations (such as extra time) that seem appropriate based on the test results. The psychologist has always met with us after writing the report to discuss and go over the findings. They aren't also the people who will counsel your child.

After having this done, we have taken the report to our child's regular psychiatrist and therapist and school to implement steps from there and decide which accommodations and recommendations make sense. It is that team (and us of course) who are "looking out for the child's welfare."

A nutritionist wouldn't be the right person for this, and probably not a psychiatrist either. You want a psychologist who does testing (a "neuropsych').

Except this provider didn’t actually complete a report. But yes, I do think it’s important for parents to understand that the “neuropsych” is done one a one-off basis by a practitioner with no relationship with your child and who will not generally provide ongoing therapy. As well, many of their recommendations for therapy will be impossible to access, nonexistant, or impossible for the school to implement . It’s a LOT of money to pay just on the faith that recommendations made by someone who doesn’t actually know your kid will be executable. But if all you’re looking for is a piece of paper to get extended time on the SATs, that is likely doable.

You are just making up stuff to support your point. What was a nonexistent therapy that was recommended and you couldn't find in the DMV metro area?

There are tools, tests and protocols that are in place and certain level of credentials required for all evaluations including neuropsych. If only someone who knows your child could evaluate them, then why don't we all do it ourselves or go to granmas to get screened for complex developmental issues. You're fighting with windmills on this thread. I truly feel for people who cannot afford access to quality healthcare in this country. I also get that you might need to find a way to explain it to yourself, but this board has a lot of educated people and whatever you're selling, they are not buying. Best of luck.

Oh boy. How many people get “social skills group” listed on their reports? They don’t exist many places (and have very little evidence anyway).

Yes they do. Stop spreading misinformation.

[Anonymous]

Anonymous wrote:

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Anonymous wrote:

Anonymous wrote:I knew DS had autism since he was little (no one believed me, initially). We paid a reasonable sum, in the hundreds, when he was diagnosed with ADHD by a developmental pediatrician at 6. His MCPS elementary school gave him an IEP due to extremely inattentive behaviors, inability to complete assignments on time, and write: he had group speech, a scribe/aide for writing, pull-outs to finish his work, preferential seating, repeated directions, etc. The works.

We paid Stixrud prices (thousands) for a full neuro when he was 10, because he needed updated data to qualify for MCPS' gifted and learning disabled program. ADHD was confirmed but we were told it would cost extra to explore autism. We chose not to, because he was getting everything he needed with the IEP, predicated on the ADHD. He got into the special program, which turned out great for him.

Only when he was 17 did we return to Stixrud to specifically ask for autism testing (and a reconfirmation of the ADHD), so we could request services and accommodations from colleges. His chosen college's Disability Office assigned him a single room with private bath on the strength of the autism diagnosis.

All this to say, OP, that:

A. You will need to budget money and time for repeated evaluations over the course of his childhood, because most institutions/programs require paperwork that is 4 years old or less. There are waitlists everywhere for testing and some of them can be very long. Make sure to schedule in advance.

B. You can be strategic in your diagnosis targeting, depending how you plan on using that label.

This is not necessary. You can schedule repeated testing at places like Children’s. I was encouraged to schedule serial testing years in advance. You don’t need to pay that much for it. Although I’m sure Stixrud loves your viewpoint!

PP you replied to. You're right, but we have ADHD ourselves and scheduling years in advance is not our strong suit Also, and this is important, not all neuropsych reports are created equal and we REALLY appreciated the doctor we worked with at Stixrud. The reports were extremely detailed, explained so much, and included a page in MCPS-speak of recommended accommodations that no elementary, middle or high school denied us. We had the same success for college accommodations, with the same doctor. It's not the label that opens doors; it's the way the doctor argues for accommodations that often clinches matters for institutions who need to be persuaded to provide those accommodations.

Of course I'm sure Children's and other hospital centers also have psychologists with good writing skills on staff, but they might be more pressed for time. We continued wth Stixrud because you don't change a winning team.

If you have $20k to waste or are set on justifying an accomodation to keep up with the Jonses (eg extended time on the SAT) ok fine. But for those of us who have limited budgets and have to invest in services that our kids need (OT, therapy, tutoring) then no, we cannot pay uneccesary money.

DP - what is the matter with you? Why do you think it's okay to speak to people like this?

what’s wrong with YOU? or better asked, what’s wrong with “providers” who charge SN families $5000 for an incomplete evaluation (like the PP whose kid didn’t even get autism included) or that they could get for an insurance copay elsewhere.

Are you trying to imply I'm a provider falsely representing myself as a parent? I'm not.

Please stop bashing other parents. You are literally achieving nothing.

Obviously not. I’m not bashing parents. I’m bashing the bad advice that you have to spend $1000ss on testing. And I am also bashing the numerous providers happy to take our money, yes.

LOL you implied parents are getting diagnoses to "keep up with the Jones". Stop being a toxic POS.

it happens. I literally just heard about a friend of a friend who was instructed by their kid’s private school to obtain a dx asap. it would be helpful for people advocating lining the pockets of Drs Stixrud and Black to give more information about their financial status, diagnosis, and why they did not rely on school testing, IEE, and/or insurance covered services.

All people on this board have SN kids. You need to do better to be kinder, this tone is out of line and unacceptable.

If you had a child with SN, you would know that 1) school testing cannot give medical diagnosis 2) w/o medical diagnosis a child with disability cannot get insurance coverage for any services 3) places that take insurance have 1-2 year waiting list for both ASD evaluations and full neuropsych. In fact, families that go via private pay route to private providers to get a faster diagnosis don't crowd further the KKI and Childrens waitlists. So it's a good thing.

Schools and Infants and Toddlers have much lower standard for identifying issues too - in speech, OT and physical development. Their evaluations are low quality and services are scarce and frankly also not great quality. People who can afford do private services.

And not that it's any of your business, but HHI is $280K, 5 yo ASD child diagnosed at 2.5 years in private practice.

I think this is wrong about needing a “medical diagnosis” for insurance coverage. We got OT covered without any diagnosis - the OT did their own testing to show the motor skills delays. Also got an amazing course of behavioral therapy covered with no diagnosis. Possibly ABA would require a “medical diagnosis” but I’m not sure that it does.

NP - almost all private payors require a diagnosis for covered services. That can be done in different ways, and a therapist doesn't necessarily need to render a formal diagnosis of ASD or anxiety or whatever, but the vast majority of insurance companies are going to require that.

PP is right that school testing can't render a diagnosis that can be used for healthcare insurance reimbursement. My DS was "diagnosed" with specific learning disability/dyslexia through school testing, but no insurance company is going to pay for the private dyslexia remediation services we're getting for him.

No that’s just not true that you have to do a pricey private diagnostic evaluation to get any insurance covered services. For most services the provider enters a diagnostic code. I’ve gotten a ton of covered services for my kid prior to the DSM dx. For some services (such as ABA) more would be required. And obviously insurance companies vary.

More specifically, insurance plans vary.

PP is correct that private payors require a diagnosis but they are confusing the issue because the "diagnosis" can just be the specific motor issue the OT is seeing. It can be very vague. The question is will the plan cover a given service without a diagnosis of ASD or ADHD or other medical condition and the answer is it varies a lot and yes, some people do benefit from an insurance coverage standpoint from a comprehensive diagnostic evaluation. Many others benefit from clarity on their child's issues and pointing the way towards services that will actually help them.

Sure except my child’s OT issues were quite obviously fine motor skills apparent to everyone. The whole point is to address the “specific motor issue.” That’s where I think parents can get really off track and confused: failing to focus on treating the challenges that are self-evident.

Well it's a good thing you are here to set us straight ::

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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Anonymous wrote:

Anonymous wrote:Thank you for asking this question, and for all the responses. We paid thousands for a diagnosis from someone recommended by our private school this spring, and ended up asking for our money back (eval report was not timely delivered). I am now trying to find ways forward to see how to help our child without feeling like we are being scammed. In our case it seemed that all the person did was administer tests, and was not actually working as a counselor to help children, and it was clear our child has a high IQ and likely (?) dyslexia and possibly (?) borderline ADHD but maybe not (never got the report) and the sense we received from the tester was it was all geared towards getting our extra time and accommodations in school. This was the third person we’ve tried to seek help from, we tried recommended nutritionist and independently a psychiatrist before the school made a suggestion. So even assuming we can find affordable testing, what are good indicators that the results are trustworthy and the administrators are looking out primarily for the child’s welfare? Do you get second opinions? See,s hard to do when it is so expensive. But the responses here have been incredibly helpful and validating the feeling that this should not be so expensive and alternatives exist…even if we have to wait.

I'm sorry you have had bad experiences. I think you might have misaligned expectations, though, as well. Generally the psychologists who administer tests only administer tests. That's their specialty and often their whole practice is administering tests and writing reports. Their reports give the test results and generally offer a list of accommodations (such as extra time) that seem appropriate based on the test results. The psychologist has always met with us after writing the report to discuss and go over the findings. They aren't also the people who will counsel your child.

After having this done, we have taken the report to our child's regular psychiatrist and therapist and school to implement steps from there and decide which accommodations and recommendations make sense. It is that team (and us of course) who are "looking out for the child's welfare."

A nutritionist wouldn't be the right person for this, and probably not a psychiatrist either. You want a psychologist who does testing (a "neuropsych').

Except this provider didn’t actually complete a report. But yes, I do think it’s important for parents to understand that the “neuropsych” is done one a one-off basis by a practitioner with no relationship with your child and who will not generally provide ongoing therapy. As well, many of their recommendations for therapy will be impossible to access, nonexistant, or impossible for the school to implement. It’s a LOT of money to pay just on the faith that recommendations made by someone who doesn’t actually know your kid will be executable. But if all you’re looking for is a piece of paper to get extended time on the SATs, that is likely doable.

This wasn't our experience at all. Recommendations were definitely actionable and very helpful (extra time is not one of the recommendations). And the evaluator did a school observation, had teachers fill out rating scales, spoke extensively with us and her OT, and reviewed documents in addition to the testing so she wasn't just relying on the testing. If anything your comment highlights the importance of working with someone who will do a thorough evaluation, which takes time, and unfortunately working with insurance limits the time they can spend with your child.

Yeah I had people try to sell me on that approach as well. There’s no magic bullet and I prefer to spend my money on actual therapies.

Sell you on the approach of clearly identifying your child's strengths and challenges and what services can help them? That's horrible, I'm sorry you had to go through that. Good for your for being smarter than all us other parents who are clearly idiots.

Sell me on the approach that I need yet another layer of expensive expertise instead of finding schools, teachers and therapies that work.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I knew DS had autism since he was little (no one believed me, initially). We paid a reasonable sum, in the hundreds, when he was diagnosed with ADHD by a developmental pediatrician at 6. His MCPS elementary school gave him an IEP due to extremely inattentive behaviors, inability to complete assignments on time, and write: he had group speech, a scribe/aide for writing, pull-outs to finish his work, preferential seating, repeated directions, etc. The works.

We paid Stixrud prices (thousands) for a full neuro when he was 10, because he needed updated data to qualify for MCPS' gifted and learning disabled program. ADHD was confirmed but we were told it would cost extra to explore autism. We chose not to, because he was getting everything he needed with the IEP, predicated on the ADHD. He got into the special program, which turned out great for him.

Only when he was 17 did we return to Stixrud to specifically ask for autism testing (and a reconfirmation of the ADHD), so we could request services and accommodations from colleges. His chosen college's Disability Office assigned him a single room with private bath on the strength of the autism diagnosis.

All this to say, OP, that:

A. You will need to budget money and time for repeated evaluations over the course of his childhood, because most institutions/programs require paperwork that is 4 years old or less. There are waitlists everywhere for testing and some of them can be very long. Make sure to schedule in advance.

B. You can be strategic in your diagnosis targeting, depending how you plan on using that label.

This is not necessary. You can schedule repeated testing at places like Children’s. I was encouraged to schedule serial testing years in advance. You don’t need to pay that much for it. Although I’m sure Stixrud loves your viewpoint!

PP you replied to. You're right, but we have ADHD ourselves and scheduling years in advance is not our strong suit Also, and this is important, not all neuropsych reports are created equal and we REALLY appreciated the doctor we worked with at Stixrud. The reports were extremely detailed, explained so much, and included a page in MCPS-speak of recommended accommodations that no elementary, middle or high school denied us. We had the same success for college accommodations, with the same doctor. It's not the label that opens doors; it's the way the doctor argues for accommodations that often clinches matters for institutions who need to be persuaded to provide those accommodations.

Of course I'm sure Children's and other hospital centers also have psychologists with good writing skills on staff, but they might be more pressed for time. We continued wth Stixrud because you don't change a winning team.

If you have $20k to waste or are set on justifying an accomodation to keep up with the Jonses (eg extended time on the SAT) ok fine. But for those of us who have limited budgets and have to invest in services that our kids need (OT, therapy, tutoring) then no, we cannot pay uneccesary money.

DP - what is the matter with you? Why do you think it's okay to speak to people like this?

what’s wrong with YOU? or better asked, what’s wrong with “providers” who charge SN families $5000 for an incomplete evaluation (like the PP whose kid didn’t even get autism included) or that they could get for an insurance copay elsewhere.

Are you trying to imply I'm a provider falsely representing myself as a parent? I'm not.

Please stop bashing other parents. You are literally achieving nothing.

Obviously not. I’m not bashing parents. I’m bashing the bad advice that you have to spend $1000ss on testing. And I am also bashing the numerous providers happy to take our money, yes.

LOL you implied parents are getting diagnoses to "keep up with the Jones". Stop being a toxic POS.

it happens. I literally just heard about a friend of a friend who was instructed by their kid’s private school to obtain a dx asap. it would be helpful for people advocating lining the pockets of Drs Stixrud and Black to give more information about their financial status, diagnosis, and why they did not rely on school testing, IEE, and/or insurance covered services.

All people on this board have SN kids. You need to do better to be kinder, this tone is out of line and unacceptable.

If you had a child with SN, you would know that 1) school testing cannot give medical diagnosis 2) w/o medical diagnosis a child with disability cannot get insurance coverage for any services 3) places that take insurance have 1-2 year waiting list for both ASD evaluations and full neuropsych. In fact, families that go via private pay route to private providers to get a faster diagnosis don't crowd further the KKI and Childrens waitlists. So it's a good thing.

Schools and Infants and Toddlers have much lower standard for identifying issues too - in speech, OT and physical development. Their evaluations are low quality and services are scarce and frankly also not great quality. People who can afford do private services.

And not that it's any of your business, but HHI is $280K, 5 yo ASD child diagnosed at 2.5 years in private practice.

I think this is wrong about needing a “medical diagnosis” for insurance coverage. We got OT covered without any diagnosis - the OT did their own testing to show the motor skills delays. Also got an amazing course of behavioral therapy covered with no diagnosis. Possibly ABA would require a “medical diagnosis” but I’m not sure that it does.

NP - almost all private payors require a diagnosis for covered services. That can be done in different ways, and a therapist doesn't necessarily need to render a formal diagnosis of ASD or anxiety or whatever, but the vast majority of insurance companies are going to require that.

PP is right that school testing can't render a diagnosis that can be used for healthcare insurance reimbursement. My DS was "diagnosed" with specific learning disability/dyslexia through school testing, but no insurance company is going to pay for the private dyslexia remediation services we're getting for him.

No that’s just not true that you have to do a pricey private diagnostic evaluation to get any insurance covered services. For most services the provider enters a diagnostic code. I’ve gotten a ton of covered services for my kid prior to the DSM dx. For some services (such as ABA) more would be required. And obviously insurance companies vary.

This is very nuanced. Provider (even OT or PT) will need to do an evaluation with established testing that's appropriate for child's age and suspected deficits. No, they don't just punch in a diagnosis code. They need to conduct and document an evaluation that supports that diagnosis code. It's not free. Yes, it's cheaper than full neuropsych but is also very limited to their area of expertise.

Then on insurance side, it's also not so clear cut as you try to paint it (not sure to what purpose?). For example some plans have separate categories for habilitative and Autism services. With different appointment limits.

Our OT was able to just take the OT testing done for the IEP. It really wasn’t tough. Obviously all insurance companies are different. The therapist definitely did just punch in a code based on the intake with her.

Not for the PP who will clearly remain on their soapbox, but anyone else who is in IEP OT boat:
- OT testing in public education does not aim to identify ALL exitsting OT issues. The ONLY issues they look at are those that can plausibly affect access to the curriculum. And even for that, it would have to be a significant issue in order to qualify for services. In my experience with MCPS, the school ignores issues and gives crappy quality evaluations for one and one purpose only: to ration services, which is a subject for a different thread. My point is: never take school SLP or OT at face value, if you suspect issues and they deny it - get your child screened outside of school system or do a school observation to document whether your child has an issue or not.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Thank you for asking this question, and for all the responses. We paid thousands for a diagnosis from someone recommended by our private school this spring, and ended up asking for our money back (eval report was not timely delivered). I am now trying to find ways forward to see how to help our child without feeling like we are being scammed. In our case it seemed that all the person did was administer tests, and was not actually working as a counselor to help children, and it was clear our child has a high IQ and likely (?) dyslexia and possibly (?) borderline ADHD but maybe not (never got the report) and the sense we received from the tester was it was all geared towards getting our extra time and accommodations in school. This was the third person we’ve tried to seek help from, we tried recommended nutritionist and independently a psychiatrist before the school made a suggestion. So even assuming we can find affordable testing, what are good indicators that the results are trustworthy and the administrators are looking out primarily for the child’s welfare? Do you get second opinions? See,s hard to do when it is so expensive. But the responses here have been incredibly helpful and validating the feeling that this should not be so expensive and alternatives exist…even if we have to wait.

I'm sorry you have had bad experiences. I think you might have misaligned expectations, though, as well. Generally the psychologists who administer tests only administer tests. That's their specialty and often their whole practice is administering tests and writing reports. Their reports give the test results and generally offer a list of accommodations (such as extra time) that seem appropriate based on the test results. The psychologist has always met with us after writing the report to discuss and go over the findings. They aren't also the people who will counsel your child.

After having this done, we have taken the report to our child's regular psychiatrist and therapist and school to implement steps from there and decide which accommodations and recommendations make sense. It is that team (and us of course) who are "looking out for the child's welfare."

A nutritionist wouldn't be the right person for this, and probably not a psychiatrist either. You want a psychologist who does testing (a "neuropsych').

Except this provider didn’t actually complete a report. But yes, I do think it’s important for parents to understand that the “neuropsych” is done one a one-off basis by a practitioner with no relationship with your child and who will not generally provide ongoing therapy. As well, many of their recommendations for therapy will be impossible to access, nonexistant, or impossible for the school to implement. It’s a LOT of money to pay just on the faith that recommendations made by someone who doesn’t actually know your kid will be executable. But if all you’re looking for is a piece of paper to get extended time on the SATs, that is likely doable.

This wasn't our experience at all. Recommendations were definitely actionable and very helpful (extra time is not one of the recommendations). And the evaluator did a school observation, had teachers fill out rating scales, spoke extensively with us and her OT, and reviewed documents in addition to the testing so she wasn't just relying on the testing. If anything your comment highlights the importance of working with someone who will do a thorough evaluation, which takes time, and unfortunately working with insurance limits the time they can spend with your child.

Yeah I had people try to sell me on that approach as well. There’s no magic bullet and I prefer to spend my money on actual therapies.

Sell you on the approach of clearly identifying your child's strengths and challenges and what services can help them? That's horrible, I'm sorry you had to go through that. Good for your for being smarter than all us other parents who are clearly idiots.

Sell me on the approach that I need yet another layer of expensive expertise instead of finding schools, teachers and therapies that work.

Nobody selling nothing here. If you're so sure of what you're doing, why all the arguing here?

[Anonymous]

Ours was free at school from the school psychologist...

[Anonymous]

Many insurance companies will authorize, at minimum, an ABA initial assessment by a BCBA with just a Rx assessment from a pediatrician or a pre-diagnosis that fits one of their pre-determined categories. Also if you’ve been utilizing ABA and change insurance providers usually they continue it, at least for several months, until you meet their additional requirements.

Often insurance, at least initially, will only authorize the initial assessment and wait for the ABA provider to send copies of assessments, assessment report, goals and objectives, and recommendation for service hours. Some companies then require the pediatrician to write another Rx for hours based upon the findings of the initial ABA assessment others will approve X hours for Y weeks based solely on BCBA recommendations.

The reason they’re pretty lenient initially, especially with EI, is many young children aren’t testable by standard means. You might have an 18 month old with pediatrician flagging possible developmental disabilities, but they are unable to attend to standard testing. In that instance the presence of barriers to learning/testing is enough to warrant a need for ABA without a formal diagnosis of X.

When you go for reevaluation they’ll want to see that child has made progress so you ideally repeat the same assessments, write another report, and make new recommendations. Usually at that point they’ll renew services again without much question as long as progress is being made and parents still want services. Some require another Rx from pediatrician following the reassessment. It’s very company/provider/plan/state dependent, some are very particular and some are more lenient.

After about another year of ABA though, this child should have enough skills to be testable or at least diagnosable and insurance might then start asking about an ADOS and/or more formal diagnosis from pediatrician. They usually give time for this, like ok we’ll approve hours for another 9 months but you need to get x, y,z before their next birthday. At some point they want diagnostic evals to justify continued services. Especially after about 2-3 consecutive years of ABA.

[Anonymous]

I just saw a thing from Virginia Tech that as part of a research study they are doing no cost evaluations. Look on FB for “Virginia tech autism clinic and center for autism research”

[Anonymous]

Children no longer accepts new patients under 4 years old

Anonymous wrote:Children’s Hospital and Inova take insurance but have a very long wait list. Look for hospital clinics, they usually take insurance.

We waited over a year to be seen at Children and we paid about $1K out of pocket.