Recs for diagnosis/treatment for anxious young adult daughter

Seeking guidance and recommendations for diagnosis and treatment for my daughter, who just turned 18. She suffers from generalized anxiety, social anxiety, some periods of selective mutism and overall emotional dysregulation (very strong emotions, some obsessive thoughts, lots of difficulty with decisions, among other things). I’ve suspected she might be on the spectrum, although her pediatrician had dismissed it, but after learning how it presents differently in females, it's been in the back of my mind. Because of her anxiety, she had refused diagnosis or treatment, but she is finally ready, but now we`re in the  challenging process of figuring out where to go next, and having a hard time exploring our options. I would love advice or guidance with: 

  • What kind of assessment/evaluation and type of specialist should I look for (psychiatrist, neuropsychologist, developmental pediatrician, although she’s an adult now?)
  • Do you have recommendations of a great provider who can do a comprehensive assessment? Any that take insurance (Blue Shield/Magellan)?  The long list of providers on their website is not very helpful. Since it’s open enrollment season for health insurance, I’ve considered switching to Kaiser just for this purpose, but I'm not really sure if it makes a difference. Have you had a good experience with Kaiser in terms of evaluation/assessment? Is it worth exploring this option? 
  • Do you know any providers who are knowledgeable in the female autism spectrum? Should that even be my priority when searching? 

Any advice is welcome and much appreciated. 

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Havinvg a slightly younger, AFAB autistic teen that had similar anxieties but was only diagnosed autistic when they entered middle school:

For spectrum evaluation, a neuropsych that has experience with AFAB autistics is best. We literally called everyone with availability, and went with those that we felt best about when we called. I don’t think we, as non-professionals, have any other way to evaluate medical staff. I lack the the knowledge for an objective evaluation, so all I have is subjective one. 

As for Kaiser: after many years with them, and being very satisfied with their service (as much as one can be satisfied with such a provider…), we moved to PPO after we found Kaiser’s support for autistic and ND children severely lacking. I hate everything with the current insurer we have, but at least they provide and cover some services our autistic child needs. 

Our child's anxiety was exacerbated, it seems, at the Summit Center, so I would not recommend them at all. CBT/DBT/family systems therapy--all these things might help more than going to Summit.  (I thought they were anxiety/worry experts but for our kid it was harmful, we didn't even know not to try to reason with him when he went into a spin ruminating...we'd patiently discuss with him at all hours, for hours, and we later learned that was not helpful to him!) There is so much disagreement in these fields, it seems, it would be good to keep a close eye on whatever people suggest as some will try to just throw drugs at your kid--they have a hammer and every kid is a nail.


I look forward to reading the responses to your question. What I have seen helpful with kids, young adults, with selective mutism is horseback riding. Something about it helps with staying connected to the body and Im sure many more things. Kaisers mental health treatment is mainly medication. It's tough getting an appointment and when you do it may or may not be helpful.  When it was requested in our family we tried our Kaiser insurance first and then went private.   I believe that Kaiser has a treatment center in Fremont for the evaluation/treatment  of Autism, a parent sued Kaiser ages ago for treatment for Autism.

 Id also check if she has any sleep issues. People who dont get deep sleep end up with anxiety, depression...

I wish I could be more helpful. We are also big fans of the find out what they can do and support that.