Autism Assessment for Teens & Preteens

Parent Q&A

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  • Testing for autism?

    Feb 28, 2022

    After filling out a basic questionnaire for my child’s psychiatrist, we think our 15 year old is on the autism spectrum. We went to our pediatrician to get a referral and they basically said that our child, if they had autism, would be on the upper end of the spectrum so there’s not much point in testing as there’s not much that can be practically done. Is this true, am I just attaching a label to my child with no practical benefit? My child doesn’t seem to care either. We do have an ADHD dx but the accommodations offered by the school aren’t helpful or applicable. Local resources are welcome, especially if they take insurance. Thank you.


     

    That’s an utterly ridiculous and dismissive response from your psychiatrist (I would get a new one). Psychiatrists are in no way qualified to Dx autism or ADHD. Their understanding is limited to the DSM which is wholly inaccurate. I recommend joining Facebook groups of actually autistic families (not autism parents, who are generally ableist) to learn some of the ways we are different and the things that help us. I fought for my daughters accommodations for 10 years before they were anywhere near accurate. I was diagnosed at 36 and have lived a life of agony because I didn’t know. Go to your regional center. That would be RCEB if you’re in Berkeley. Familiarize yourself with the DSM-5 diagnosis because even though it’s wrong, that’s what they use. Make a list of ways that your child fits into the criteria. They’ll do an intake, then a psych evaluation, then hopefully you’ll get in and be eligible for services - which can be extensive depending on how much you ask for. I’m looking forward to when they help my teen live independently and I can start caring for myself again. Happy to answer questions. 

    When we did a reassessment this past summer for my 13 year old, he was given the additional high functioning ASD diagnosis. Your pediatrician is sort of right in that there are no specific additional services or medication directly linked with HFASD, BUT it was extremely helpful for us to better understand my son's nuero-differences. He, too, was diagnosed with ADHD at a younger age and has accomodations and medication.  We also started Social Thinking group therapy, even before we got the HFASD dx, because of the pragmatic social challenges he was already having.  The neuropsychologist that did his evaluation was able to give us a list of resources and additional recommendations, but they pretty much lined up with things that were needed for his ADHD. What was added on the report, was the recommendation to get him a learning coach for overall executive function delays and struggle in school with overall organizing, keeping to deadlines and planning strategies. That was a bit harder to find, but I found SOS4Students on this forum and (although not cheap) he's had a lot of great success and improvement with his sessions and workshops. 

    What I also have learned through joining groups like AANE (which has a great Intro to ASD Diagnosis workshop for parents), is that understanding your brain and then being able to advocate or disclose when necessary is part of living as an autistic person. There is also something to finding a community and finding support through those communities.  Just my experience.

    My teen was diagnosed with ASD at 18 and it has been extremely helpful! We were also on the fence about whether it mattered to get the diagnosis but my son really wanted to know. It turns out that having the diagnosis has been very helpful in college with accommodations, housing, and even financial support from the Department of Rehabilitation. All the reading I've done about ASD has helped me understand my son much better and I think, helped him understand himself as well as informed his therapy. I have no regrets whatsoever and would highly recommend getting the diagnosis. We ended up paying to have a private neuropsych exam (not cheap) but if you are not in a hurry you should be able to get it through your insurance at UCSF or through your school district. 

    Absolutely you can/should get your son tested.  And find a new pediatrician.  You can contact your insurance first, or also the regional center (RCEB for Alameda/Contra Costa county) if you have difficulty with your insurance covering.  There generally is a long wait where you go to get testing, but good for you for advocating for your son. At least with ASD testing you can r/o possibilities if he isn't or services if he is found to be on the spectrum.

  • Hi. My daughter is 15.5 years old and in 10th grade. She used to be a great student but is failing most of her 10th grade classes with Fs due to anxiety and depression (which started during distance learning because of the COVID-19 pandemic, our public schools are still closed as of June 2nd 2021). My son is a bit younger and is also having anxiety and anger issues. His therapist recommended that we get him tested for autism/asperger's. This got me thinking that my daughter might also be affected by autism/asperger's as she has always been shy, and is now unable to keep up with Zoom classes when she has to work on small groups (she disconnects without warning and says she cannot avoid it). Also, she has always assumed rules that do not exist about what is allowed behavior and what is not, just because she is afraid of doing things differently from others or and doesn't like to stand out. I have been reading quite a bit about asperger's and autism lately and it seems a lot of girls are not diagnosed because they hide their symptoms much better than boys. So, I am looking for recommendations about providers who can do an assessment and have experience diagnosing teenage or older girls with not-so-obvious symptoms. Any recommendations? We live in the southern part of Alameda County but are willing to drive where needed..

    I would NOT recommend Sumana Kaipa, she completely misdiagnosed our child, and caused us much distress. She moved way too quickly in making a diagnosis that was completely wrong.

    Hello there -
    We have an ADHD kiddo, so not quite the same, but maybe comparable in terms of thorough assessment needs. We are currently with https://www.taliakurlandpsyd.com/ for an assessment. She came highly recommended by https://www.clearwaterclinic.com/ , our therapists. She is very professional, clear in communication but also warm with my son, who even enjoyed the first session.  Clearwater also does assessments, but the wait list was longer with them. Hope that helps and that you will get the info you need to help your kiddo. It's a tough road for all of us, and I believe that gathering as much information as possible helps us identify the best way forward. 

    I recommend Sumana Kaipa in Berkeley. She diagnosed my 8-year old last summer, also high-functioning but with similar issues. She has lots of recommendations on this site so I think people have universally appreciated her excellent work.

    The Mind Institute at UC Davis is an excellent resource:

    https://health.ucdavis.edu/mindinstitute/

    We took our nonbinary neuro atypical 17 year old to Diana Trichilo: https://www.drtrichilo.com/ up in Sebastopol. I highly recommend her. She was fantastic; kind, thoughtful, and thorough, very aware of the differences between the boys and girls autistic expression, and understood the system and how to get access to services. Working with her was totally worth the travel and expense. Even though it was long way to go for appointments, we explored the area and made day trips out of them.

  • 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!

    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.