Evaluation for High Funct. Autism in Girls

I'm looking for someone that can evaluate my 10-year-old daughter for Autism, ADHD, and processing problems. We have medi-cal, although we expect to pay out of pocket. She is 10 years old, highly intelligent (gifted), and socially motivated...exactly the kind of kid that can compensate so that these disabilities can fall under the radar. A few years back, she was diagnosed by a psychologist with Generalized Anxiety Disorder and Sensory Processing Disorder.  She also has a complicated genetic and in-utero history (she came to my family as a newborn). Despite treatment of a psychiatrist, OT, and psychotherapy, her symptoms continue to become more apparent and asynchronous with age. 

I've long felt that she also has ADHD and now we are starting to suspect that she is on the spectrum, particularly after learning about the Pathological Demand Avoidance profile. It was the first time we ever saw all of her symptoms together in one place. I've heard great things about the STAR center at UCSF for diagnosing girls on the spectrum, unfortunately, they do not take Medi-cal or out-of-pocket payments.

I'd love advice from folks whose kids fit (or come close to) this profile. I've received recs for Dr. Zoe Collins and Dr. Lisa Greenberg...do you have feedback about whether either of them might be a good fit for us? Do you know of someone that specializes in this area of hard-to-diagnose girls? 

Thank you!

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Very similar sounding to my 10-year-girl. I had never heard of PDA before - interesting and food for thought for my family. In the meantime, we have Kaiser and put her through their ADHD assessment.... which IMHO was very much geared to hyperactive boys, and she didn't meet their threshold but manifested enough anxiety through that assessment that she got the anxiety diagnosis. My partner and I are very much convinced she has ADHD but will never fit the clinical box due to gender bias. ANYWAY, I very much sympathize. Our solution for her was to change up her school situation, believing (for better or worse) that a normal large classroom setting would never get her adequate support for her needs. If we need to pursue a 504 or IEP later, we will, but for the moment we are scaffolding a lot at home. Good luck.

I can’t speak personally to how she’d handle a girl’s complicated diagnoses, but Dr. Renee Wachtel in San Leandro diagnosed my son with ASD around 5 years ago. The first clinician we took him to—and paid a small fortune out of pocket—was only willing to diagnose him with social communication disorder, a diagnosis which did not provide coverage for  many services he desperately needed.

Dr. Wachtel’s office wasn’t fancy, but the care was excellent. She listened well and was very observant. And at least then, she was a medi-cal provider. Her diagnostic report was top-notch, and multiple therapists over the years have mentioned how accurate they thought it was. Good luck to you.

I haven't heard of PDA, but I highly recommend Sumana Kaipa in Berkeley, who diagnosed our 8-year-old daughter this past summer with HFA and ADHD. Dr. Kaipa was able to get us in almost immediately, saw my daughter in person despite the pandemic, observed her through eight hours of testing over three days, worked with us as parents through an intensive interview and a follow-up discussion after diagnosis, and produced a wonderful fifteen-or-so page report that helped us understand her HFA/ADHD, identified her giftedness (twice-exceptional, as they call it), and was heavily relied on by our district in the early fall in getting our IEP in place given that they were unwilling/unable to do traditional testing themselves. The one-on-one work with her new speech and special ed teachers at school has been a game-changer for behavior, even remotely. Dr. Kaipa does not take insurance but we found that what we paid has paid tremendous dividends through the IEP process.

Dr. Sumana Kaipa, http://www.drkaipa.com/, in downtown Berkeley, did an evaluation of our 20-year-old daughter this fall focusing on ADHD.  Our daughter sounds similar in some ways to yours, and ADHD was not on our radar until recently.  Dr. Kaipa seemed very thorough: gathered records, talked to parents and did remote and in-person assessments of our daughter.  She also was very responsive to the kind of evaluation my daughter wanted.  My daughter liked her a lot, as did we parents, and her conclusions seemed spot-on.  Good luck!

Hello, 

With Medi-Cal, you can call Mental Health ACCESS for the county that you have Medi-Cal through.  You can request a full neuropsych eval to determine if your daughter is on the spectrum.  All this is free for Medi-Cal patients, although it may take a few months to happen once you request it.  

Our family has used Mental Health ACCESS to obtain comprehensive psych evals, a neuropsych eval, therapy, and EMDR, among other services.

+1 for Dr. Kaipa.  She assessed my 10 year old daughter (who sounds a lot like your daughter) last year and has helped us navigate the diagnosis and helped us advocate with her school.  I'm happy to chat if you want someone to talk through this with - it was a difficult diagnosis to accept but has helped us understand our daughter immensely and is helping her understand herself better as well.