Dr. Ann’s Corner:
The Evaluation Process for an Autism Diagnosis
August 07, 2018
August 07, 2018
For families of individuals who are suspected of having an autism spectrum disorder (ASD), the evaluation process may seem mysterious, and maybe even intimidating for some. At Hopebridge, we are working hard to shed light on the assessment from start to finish, plus share how our team is here to make it as seamless as possible for you.
To do so, here is an outline of what diagnostic testing looks like from a parent’s perspective in six simple steps:
STEP 1: REFERRAL
The initial step of the evaluation process is the referral. Referrals come to Hopebridge by phone, fax or the contact form on the “Get Started” page of our website or Facebook questionnaire. Likewise, a referral may come directly from a parent or physician who suspects a child may be on the spectrum. Referrals are facilitated by our patient intake department, which records patient and guardian information, including insurance, primary care physician and any other medical information necessary to continue.
STEP 2: INTAKE
During the intake portion of the process, one of Hopebridge’s client advocates will obtain and verify the child’s insurance benefits. Once completed, the client advocate calls the family to ensure they understand the benefits that will be covered. At this time, he or she also walks them through the basics of the diagnostic testing and applied behavior analysis (ABA therapy). When the family confirms their desire to continue the evaluation process, the client advocate works to obtain a prior authorization for the appointment.
STEP 3: SCHEDULING THE DIAGNOSTIC APPOINTMENT
As soon as the pre-authorization for the evaluation is obtained from the insurance company, the appointment is scheduled based on availability of the parent and the psychologist who will complete the evaluation. Appointments can be accommodated within as early as two weeks, in some cases. Even at the later end, around 90 days, wait times are still often up to six months earlier than other local options. The assessment ordinarily occurs at the Hopebridge center that is located closest to the child’s home. Important paperwork – which includes questions regarding the child’s developmental milestones, behavior and medical history – is then sent to the caregiver to complete and bring with them to the appointment.
STEP 4: DIAGNOSTIC EVALUATION
It is helpful to arrive with the completed packet of paperwork 10 to 15 minutes before the scheduled appointment time, at which time guardians are asked to sign in at Hopebridge’s front desk. In order to make sure the evaluation room is set up properly, the psychologist will first need to determine the speech level of the child.
The assessment itself may vary from child to child, depending on a few different factors related to the individual being evaluated, such as speech level and age.
For example, for a younger child who does not speak, the evaluation involves just fewer than a dozen activities designed to bring out behaviors and social characteristics associated with autism spectrum disorder. To parents, this evaluation might appear as though their child was simply playing much of the time, however, the psychologist is closely observing the child’s behavior and behavioral responses.
In the case of a child who is fully verbal and approximately 10 years old, the assessment involves more than a dozen activities, all of which are designed to bring out speech, language patterns, behavior and social characteristics found in an individual with autism spectrum disorder. To parents, this would appear as though the evaluator was observing and interacting with the child while he or she is engaged in different types of activities, including play and problem-solving. Additionally, there are verbal exercises within the course of the evaluation.
The Autism Diagnostic Observation Scale, Second Edition (ADOS-2), which is what is used in Ohio, requires approximately one hour to administer.
STEP 5: SCORING
Following the administration portion of the evaluation, the psychologist requires approximately 15 minutes to score the ADOS-2. Upon tabulating the score, the psychologist will then share the results of the evaluation with the parents and answer any questions that might arise.
The psychologist then writes and submits a diagnostic report within the Hopebridge system. If the patient was diagnosed with ASD, the psychologist alerts Hopebridge’s patient intake team to the diagnosis.
STEP 6: ABA EVALUATION, AUTHORIZATION & THERAPY
Once the client advocate receives the completed diagnostic report (if the diagnosis is ASD), he or she begins the process of obtaining an authorization for therapy evaluations, including ABA, speech and occupational therapy, which is the next step to getting life-changing care. As with the diagnostic evaluation, once prior verification is obtained from the insurance company, the client advocate will contact the parents to schedule the appointment for a date and time that works well with the family and the Board Certified Behavior Analyst (BCBA), occupational therapist or speech language pathologist.
At the time of the evaluations, should the BCBA or therapist recommend services, pre-authorization for therapy is obtained as well. Once prior authorization is submitted and the center has the resources in place to accept a new kiddo to the program, the onboarding manager will coordinate a start date for therapy…it’s really as simple as that!
With this brief outline, we hope this clears up some questions (and answers!) for you. At Hopebridge, our mission is to help children with autism lead their best lives, and many times, that begins with the evaluation process. If you are interested in scheduling an appointment, please talk to your pediatrician or start the referral process on our website and we’ll contact you within 48 business hours.