RisingMiddleSchoolMama wrote:Thank you for your reply. I would appreciate knowing the psychiatrist and psychologist that you used. If you have experience with any Kaiser ones to avoid, that would be helpful, too.

We are not in a position to pay much out of pocket right now. That is part of the conundrum for our family. I am very appreciative of everyone's read and any help/suggestions.

The practice we use is in Columbia. There are several recommended on this board frequently though.

Anonymous wrote:

RisingMiddleSchoolMama wrote:Yes, we know the tests that should have been done and weren't (even the evaluator pscyhologist gave us the list of additional tests he would recommend but as I mentioned he said no insurance co would pay for them) The 2 dx given were “Social Functioning Disorder of Childhood" and the report said "her difficulties do not rise to the level of Autism Spectrum Disorder but are real and do require attention."

Other dx given is "Persistent Depressive Disorder”.

The tests done were BASC 3rd edition (daughter and I both filled out), Autism Spectrum Scale (both mom and dad completed), WISC 5th edition, WRAML2 and story making subtest and Rorschach Inkblot.

There is no diagnosis called "social functioning disorder of childhood" and your psychologist is incorrect about insurance. Most will pay for autism testing. I don't see how Kaiser can get away with not paying for it.

That is a diagnosis. F94.9

Thank you. So far places mentioned here are:

Children's (for full evaluation)
CAAT - Dr. Black for full evaluation and Christy Donly for therapy

We sure would appreciate additional input on therapists. That is our first concern. Christy Donly looks very qualified. She is a bit far for us (we are in Alexandria/Old Town). Hoping there is someone closer and would like to see someone at Kaiser, first. Surely they provide services for ASD? Believe they are legally required to and want to see one of those Kaiser therapists (who treat Autism level 1 through therapy) even if we don't have the ASD diagnosis.

Thank you, again.

Please, please consider just going to the out-of-network people listed so you can get the testing. Put it on a credit card and figure out the payment another time. Kaiser definitely won't pay, even if you bring them the results that differ from the initial assessment. We did a full educational neuropsych evaluation for our daughter (two days of testing) for a different diagnosis, and it was enormously helpful just to have the assessment, all the testing norms, and the provider included a list of ways her teachers could help during the school day. The cost then (6 years ago) was close to $2,000 but worth it for assessing next steps. You need to think of the cost as something that you just have to do - like replacing the transmission on your car or fixing the heat on a frigid day. If you have a choice of insurance companies, the next time you have open enrollment, switch to one that has a PPO and out-of-network coverage. It sucks that health plans for which you are paying premiums are so restrictive, but that is how they cover the most people at the lowest cost. We pay more for a PPO plan, and then still pay an absurd amount to go out of network. It's just part of the new reality of health coverage and costs.

Thank you for everyone's read and responses. It is hard not to be overwhelmed as we need services right now, not a legal fight with Kaiser for a proper evaluation. I sure would appreciate any input as to therapists, but within and outside Kaiser. I need to get a therapist ASAP who can help my dd and I'll start the appeal with Kaiser (which I expect will drag on for months). This is from her eval: "Re: Autism Spectrum Disorder: while there are indications of Autism Spectrum Disorder, on both the BASC3 and the ASRS, the data were not conclusive of that diagnosis. The diagnosis of Social Functioning Disorder covers the difficulties she presents." Thank you, again.

RisingMiddleSchoolMama wrote:Yes, we know the tests that should have been done and weren't (even the evaluator pscyhologist gave us the list of additional tests he would recommend but as I mentioned he said no insurance co would pay for them) The 2 dx given were “Social Functioning Disorder of Childhood" and the report said "her difficulties do not rise to the level of Autism Spectrum Disorder but are real and do require attention."

Other dx given is "Persistent Depressive Disorder”.

The tests done were BASC 3rd edition (daughter and I both filled out), Autism Spectrum Scale (both mom and dad completed), WISC 5th edition, WRAML2 and story making subtest and Rorschach Inkblot.

There is no diagnosis called "social functioning disorder of childhood" and your psychologist is incorrect about insurance. Most will pay for autism testing. I don't see how Kaiser can get away with not paying for it.

You need to get a autism assessment that includes an ADOS test. If no one at Kaiser can give this test can you appeal to go out of network? David Black's group at caatonline.com is experienced with ASD girls. We see Christy Donley there. I don't know if she does testing, but they do have others who definitely can.

Our insurance does not cover out of network. We are limited to the list of child therapists and psychiatrists that are out Kaiser centers.
Here is the full list of therapists with Kaiser (I believe but may be missing someone, hard to get a complete list I'm finding). I don't see any of them with ASD in their profile and was told they all do CBT but that psychiatrist will only prescribe meds.

Child Therapists out of Burke, VA (closest to us):
1) Ann Freeman, LCSW
2) Lori Miller, LCSW
3) Harumi Sanchez-Yosa
4) Lynn Lynes, LCSW
5) Jessica Hansen, LCSW
6) Ann Cuebas, LCSW
7) Megan Fullen, LCSW
8) Dr. Sulaih Masten, PhD (psychologist)

Other Kaiser child therapists:
Evans Chenere Psychotherapy Child Largo
Felder Linda Psychotherapy Child Shady Grove
Heflin Khristine Psychotherapy Child Largo
Henderson Lisa Psychotherapy Child Largo
Lyte Nicole Psychotherapy Child Ashburn
McKinney Jacqueline Psychotherapy Child Shady Grove
Meader Briana Psychotherapy Child Columbia
Plater Lori Psychotherapy Child Largo

Kaiser Child Psychiatrists:
Chiao Christine Burke
Goraya Kamalinder Shady Grove
Hatten Katina Northwest Dc Mob
Kaur Balbinder Shady Grove
Miller Ashley Burke
Patton-Smith Asha Burke
Stokes Rene Largo
Tripuraneni Bhaskara Shady Grove
Tweedie Allison Burke

Thank you for your reply. I would appreciate knowing the psychiatrist and psychologist that you used. If you have experience with any Kaiser ones to avoid, that would be helpful, too.

We are not in a position to pay much out of pocket right now. That is part of the conundrum for our family. I am very appreciative of everyone's read and any help/suggestions.

I am not very familiar with Kaiser, but are you able to pay for out of network providers? I worked with several in network (different insurance) psychologists and had no positive results, so now we see a psychiatrist and psychologist who are out of network. We do get a very limited amount back by filing out of network claims, but it's negligible. The most important thing is that my DD is getting the help she needs. (And fortunately we can afford to pay out of pocket even though it is a huge hit to our budget.)

My DD's neuropsych at Childrens was covered by insurance including the educational component (because she has a medical diagnosis that necessitated the testing). Because your daughter has medical diagnoses now as well, it may be covered. Again, I'm not familiar with how Kaiser would handle this. The neuropsych intake process is a bit convoluted at Childrens and you need to call frequently and make sure you are progressing through the line, but they were able to tell me exactly what the out of pocket expenses would be ahead of time.

Yes, we know the tests that should have been done and weren't (even the evaluator pscyhologist gave us the list of additional tests he would recommend but as I mentioned he said no insurance co would pay for them) The 2 dx given were “Social Functioning Disorder of Childhood" and the report said "her difficulties do not rise to the level of Autism Spectrum Disorder but are real and do require attention."

Other dx given is "Persistent Depressive Disorder”.

The tests done were BASC 3rd edition (daughter and I both filled out), Autism Spectrum Scale (both mom and dad completed), WISC 5th edition, WRAML2 and story making subtest and Rorschach Inkblot.

Thank you. We know Dr. Conlon as he evaluated my son several years ago. Unfortunately, he went to Krieger last summer (at John Hopkins) and Kaiser does not have a developmental pediatrician on staff right now. I initially requested to see Dr. Conlon at Krieger or a specialist at Children's for my daughter's evaluation due to Kaiser's gap (as they aren't fully staffed). They denied my request. We went to Dr. Syd Brown at Shady Grove thinking we were getting a full neuropsych evaluation. Only after the testing did I find out according to his words, he did "cognitive and personality testing". He said no insurance company would pay for more testing, including what he said was "education testing". Just to note, I didn't request education testing. I was looking for a correct dx specific to whether our daughter has Aspergers and to receive the needed services. My expressed concern with our pediatrician was that our daughter would not be dx accurately.

I'm really struggling as I can't find a therapist (Kaiser or otherwise) who is skilled at working with Girl Aspergers Tweens/Teens and I am overwhelmed at how best to deal with Kaiser. We started this process in Oct (at my daughter's 12th birthday) approaching Kaiser for an evaluation due to our concerns and middle school is only months away now. Our daughter needs a therapist so that is my first priority.

Thank you so much.

I do know a good developmental pediatrician through Kaiser who could diagnose Aspergers if you don't have the official dx yet. He may know of good therapists too- Dr. Conlon.

RisingMiddleSchoolMama wrote:Help. We can't find a qualified CBT therapist for our 12 year old daughter who seems to be Aspergers (know it isn't called that anymore but it Autism Level 1).

Our insurance is Kaiser. Does anyone have a Kaiser therapist to recommend? Or someone that has helped their daughter?

We live in Alexandria.

We also weren't given a full neuropsych. eval from Kaiser. We requested one suspecting she has Aspergers. She was just given 2 mental health dx. The psychologist who did the evaluation said no insurance will pay for the full evaluation. Now Kaiser is only referring us to their mental health therapists and I can't find one who has experience with autism.

Thank you in advance. This has been quite complex as she is very high functioning, under the radar which I'm learning is typical for girls.

So sorry you are dealing with this. What were the 2 diagnoses that the psychologist gave (you say they were "mental health" diagnoses)?

Did the psychologist do any testing to rule in/out autism? Do you know what tests should have been done and weren't? Do you know what testing the psychologist DID do? Do you have a clear idea on what basis the 2 "mental health diagnoses" were given? (i.e. if anxiety was diagnosed was it just based on self-reporting of symptoms or was some kind of symptom checklist or questionnaire administered. For example, with ADHD, either the Vanderbilt or Connors questionnaires are usually given. With mood disorders, there are standardized mood reporting questionnaires which validate self-reported depression and helps to distinguish it from other problems like anxiety.

Help. We can't find a qualified CBT therapist for our 12 year old daughter who seems to be Aspergers (know it isn't called that anymore but it Autism Level 1).

Our insurance is Kaiser. Does anyone have a Kaiser therapist to recommend? Or someone that has helped their daughter?

We live in Alexandria.

We also weren't given a full neuropsych. eval from Kaiser. We requested one suspecting she has Aspergers. She was just given 2 mental health dx. The psychologist who did the evaluation said no insurance will pay for the full evaluation. Now Kaiser is only referring us to their mental health therapists and I can't find one who has experience with autism.

Thank you in advance. This has been quite complex as she is very high functioning, under the radar which I'm learning is typical for girls.