Autism Evaluation Process: What to Expect

Are you a parent seeking an autism evaluation for your child? Or maybe you tried to enter into ABA therapy but ran into insurance issues. Whatever your situation, starting the journey to support your child’s development can be stressful, overwhelming, and confusing. But you are taking the right steps in seeking help. That is why we want to provide you with information on our autism evaluation process. Here is a detailed breakdown of how it works.

Where to Start

Maybe you are concerned about your child’s development, or your pediatrician is recommending an autism evaluation. Whatever the reason, it can be confusing to know where to start. In order to access autism therapies if they are on your insurance plan (such as ABA, speech therapy or occupational therapy), most insurance companies need an autism evaluation. Most insurance companies require an evaluation that includes a series of standardized assessments. Additionally, they need a report with the data of those assessments to support a concluding diagnosis of Autism Spectrum Disorder. These evaluations are typically performed by a qualified psychologist or neuropsychologist. It’s important to note that most insurance plans require something more than a simple neurologist diagnosis; neurologists do not use the standardized assessments insurance looks for.

What to Expect

The overall evaluation process at Healing Haven is not very long. It consists of three appointments which total roughly six hours altogether (depending on the child’s age and level of skill.) The turnaround time from the first appointment to receiving the final report averages about one to two months. However, that time depends on the facility performing the testing.

However, the wait to receive the assessment is generally the biggest issue. Most facilities that offer quality evaluations have waitlists of several months or more. But time is precious when it comes to a child’s development. Those several months can make a huge difference when it comes to receiving services.

One of the most impactful things you can do as a parent is obtain a clearer understanding of your child’s difficulties. At Healing Haven, we try to keep all evaluations–from the time parents contact us to when they receive results–within three months. This way, if intervention is necessary, it can be accessed as soon as possible.

The Autism Evaluation Process

Our autism evaluation process is typically divided into three appointments.

First Appointment

During the first appointment, a parent or guardian meets with the clinician. They will discuss background information, family history, and any concerns regarding their child’s development.

Second Appointment

The second appointment involves the direct assessment of the child. The clinician utilizes several standardized assessment tools to gather objective data on the child’s skills and their behaviors. The clinician will use this data to reflect the child’s developmental progression in comparison to other children of the same age.

Third Appointment

After these two first meetings, the clinician compiles all the information gathered into a report. In the third and final meeting, the clinician goes over the report with the parent(s)/guardian(s). Based on data and historical information, this meeting will specify whether a child may fall within the criteria of Autism Spectrum Disorder. If the child does not meet the criteria, parents and guardians may learn if something else is going on that better addresses their concerns (e.g. speech delay, learning impairment, anxiety, etc.)

Whether your child is on the spectrum or not, a developmental assessment provides a detailed evaluation of your child’s current level of skill and developmental status. A developmental assessment identifies factors contributing to your child’s difficulties, rules out diagnoses that may mislead treatment, and provides you with direction to address your child’s specific needs.

What to Look for in an Autism Evaluation Provider

The most important question to ask a facility offering evaluations is, “If my child is diagnosed, will this report unlock insurance covered ABA services?” You’re investing in a lengthy process. So you’re entitled to all the necessary information to access insurance covered services (if needed). Make sure you know which questions to ask to understand exactly what insurance requires for ABA services.

However, many facilities that offer autism evaluations are unaware of the specific insurance requirements for ABA services. So, many testing facilities may be honest saying that they can provide an autism evaluation but are unsure if insurance to cover ABA services will accept the type of evaluation provided.

At Healing Haven, we’ve had countless families who had their child previously evaluated. But they found their diagnostic report was missing components insurance requires in order to accept the diagnosis and access services. Thankfully, some insurance companies are lenient and allow us to fill in the missing components. Other times, too many components were missing, requiring an evaluation re-do. Obviously this is time consuming and costly. It is also a significant barrier to receiving services. So again, do your best to make sure that what the testing facility offers will be sufficient for your insurance.

An Important Note about BCBS/BCN of Michigan

Many families in our area have insurance through Blue Cross Blue Shield of Michigan or Blue Care Network of Michigan. For BCBS/BCN members it’s important to know that they have a list of centers for which they will accept an autism diagnosis. These specialized locations are called Approved Autism Evaluation Centers (AAEC).These AAECs are spread throughout the state, but unfortunately can have long waitlists – sometimes up to 12 months. As a result of these long waitlists, and because early intervention is so critical, BCBS and BCN will accept an autism evaluation from a qualified psychologist or neuropsychologist if it meets its standards. They call this type of evaluation a “Bridge Authorization”. This authorization serves as a place holder, allowing families to access services while they remain on a waitlist at an AAEC.

We understand how time-consuming and worrisome the autism evaluation process can be as you strive to get support for your child. But we are here for you and you are not alone in this journey. If you have questions or you’re interested in starting an evaluation, please reach out to us.

Toilet Training Tips for Kids With Autism

toilet training and autism

Toilet training is a fundamental skill to teach all kids. But it can be a tricky skill for children with autism to master. Some parents may find toilet training a smooth process, while others find it a huge battle. Many parents try to start the process and feel discouraged, then decide to take a break. Wherever you are in your child’s journey to using the toilet independently, know that success is definitely possible.

Is Your Child Ready for Toilet Training?

The first step in helping your child with autism use the toilet? Determine if they’re ready. Our Director of Clinical Standards, Dr. Jennifer Thomas, Ph.D., BCBA-D, LBA, suggests a list of pre-requisites to consider before starting the toilet training process.

Can your child…

  • sit on the toilet or potty chair for a few minutes?
  • pull pants up or down?
  • hold urine for at least 30 minutes?
  • imitate skills such as sitting and wiping?
  • find the bathroom or potty chair in the house?

Your child doesn’t need to be proficient in each of these steps all at once to start toilet training. However, keep in mind that the process will be easier and more successful if your child can complete most steps first. If your child struggles with fine motor strength and control, consider occupational therapy (OT). OT can help with skills such as pulling pants up and down, wiping, etc. Additionally, there should be minimal behaviors occurring with bathroom use. If behaviors arise often, be sure to address them prior to starting the toilet training process.

Reinforcement and Encouragement

It’s important to utilize reinforcement and encouragement when working on toilet training your child with autism. You can reinforce their success in using the toilet in a variety of ways, including:

  • Food, such as candy or a small treat
  • A sticker chart
  • A highly preferred activity such as tablet time, a game or favorite toy
Child sitting with teddy bear

Along with reinforcers, use lots of verbal encouragement. Make sure it’s specific and descriptive: “I love how you asked to go to the potty.” Or “You did an amazing job sitting on the toilet for x amount of time!” etc.

Barriers to Toilet Training

Toilet training kids with autism can definitely have its setbacks. You might encounter challenging behaviors from your child, such as fear of using the toilet, refusing to use it, misusing toilet paper or other materials, or tantrums when encouraged to use the toilet.

Some children with autism might be hesitant to use the toilet due to sensory issues. If this is the case for your child, identify the sensory issue. It could be that the toilet seat is uncomfortable, they may feel cold, or feel afraid of the loud flushing sound. Perhaps utilize a toilet seat and let your child hold a stuffed animal or toy while sitting to help them feel safe and comforted.

Another barrier to toilet training is constipation. Kids with autism can be prone to constipation due to selective eating. If you notice your child struggling to void with bowel movements, consult your pediatrician.

General Tips for Toilet Training Kids with Autism

  1. Take toilet training one step at a time! While many parents are eager for their child to gain independence in the bathroom, try not to rush through the process.
  2. Have your child use pull ups or underwear as they transition from diapers.
  3. Use visuals in the bathroom such as a step-by-step laminated sheet with photos to help your child remember the toilet use process.
  4. When starting toilet training, plan a time to be at home with your child (Ideally, a week).
  5. Take data. You could create a chart, take notes in a notebook, or find a data sheet that works for you through an online search. For each toilet session, list the date, time, accident, success, location, and any independent request.
  6. Make the experience fun and rewarding! Ensure your child is comfortable on the toilet by having them pick out a preferred toilet seat. Keep toys and books in the bathroom and even play music. The more enjoyable the experience is for your child, the more likely they will pick up skills and move towards independence.
Parent hugging child

If your child receives ABA therapy, check in with your child’s BCBA. They can give suggestions specific to your child as well as general support throughout toilet training.

Toilet training, though necessary, is a huge task to undertake as a parent. While it can be discouraging at times, remember to celebrate the successes. And with encouragement and consistent reinforcement, your child will learn in his or her own time.

Back to School Tips for Parents of Different Learners

A few years ago we created a pretty extensive list of back to school tips for kids with autism. At first it seemed there wasn’t much more we could add to it. But upon further thought and research, we want to share more in-depth back to school tips and resources. Many of these ideas can benefit typical kids in addition to those with special needs or a learning disability. In this post we also connect you with some great resources to help you as you get ready for the new school year.

So why is preparing for the transition back to school so important, especially for different learners? By doing some preplanning, you can help reduce anxiety in your child about a new school year. You can also make sure your child has the proper support they need in their new classroom or new school. And with some advance preparation, you can create some important routines that we know many children rely on. Read on for helpful back to school tips that you can start on now.

Use a Back to School Countdown

Let’s face it, there is so much going on in the rush before school starts. You want to squeeze in the last free days of summer, while shopping for school supplies, new clothes and scheduling any needed doctor appointments. How can you cram anything else in? This Back to School Countdown from Understood.org offers some great ideas to get your child ready to go back to school. Not all of the tips may apply, but there are sure to be some that will help you, as well as your child, prepare for that first day back in the classroom.

In addition to the practical back to school tips for you, an actual countdown calendar can be helpful for your child. Create a calendar of the few weeks before school. With your child, cross off each day leading up to the first day of school. Doing so provides a visual for them to see when school starts and may help reduce some anxiety they may have.  

Use Social Stories

Social stories are a great way communicate to your child what they can expect in a new situation, teach appropriate behavior, and much more. And thankfully there are a ton of free resources out there to help you so you don’t have to start from scratch. By creating a print social story, or using a topical video social story, you can help reduce anxiety your child may have about the new school year, new teacher, new classmates, new routine, etc.

Dyan from “And Next Comes L” has an extensive list of free back to school social stories you can download and print. She also includes some topical stories for times that may cause more stress and anxiety, like changing classes for gym, art or music. Additionally, she has a few video social stories about High School, riding the bus, listening to the teacher, how to greet people at school, and more!

Communicate With Their Teacher

Create a “get to know me” document or write a letter to your child’s teacher. By sharing your child’s diagnoses, strengths and weaknesses, dietary restrictions, sensory needs, things that interest them, and strategies that work for them, you are empowering your child’s teacher with important information for their success at school. There are a few templates available for introduction letters and “get to know me” documents.

  • This Card to Help Teachers Get to Know Your Child is from Understood.org. Older kids who are able to write and communicate could complete it on their own, which will help them develop self-advocacy skills.
  • Understood.org also has two different Back-to-School Introduction Letters for elementary and middle school students. They are fairly basic, but may be just what you need to communicate important information with your child’s teacher.
  • For younger students, or those starting at a new school, a more robust document may be warranted. The Autism Alliance of Michigan has a free download called “The Big Book All About Me”. You can print it out and fill in a variety of important pieces of information like your contact info, family member details, photos, your dreams for your child, their learning style and so much more!
  • You can always just type up a letter detailing the above things for the teacher and email it to them before school starts – if you know who your child’s teacher is.

And don’t forget to make or send copies of whichever version you choose to your child’s aides, the school therapists, principal, “specials” teachers, basically anyone who will be working with your child.

Using Technology

If your child uses an AAC to communicate – an Alternative and Augmentative Communication device, ask if your child’s teacher(s) and aides are familiar with using them. There are several different programs available, so some training may be needed. Work with your child’s speech therapist to help ensure those working with your child day in and day out know how to utilize this tool to facilitate communication with your child.

In addition to communication, there are apps that can help students with a variety of learning and back to school challenges. Here’s a list of different apps to look through from supporting academics, executive functioning skills, managing anxiety and more. One of the apps that stood out to us is Tiny Tap. “TinyTap helps grade-schoolers and middle-schoolers work on specific academic or social skills. Families and kids can create lessons, games, or quizzes on any topic. Kids can also access dozens of lessons and games created by other people. There are a bunch of popular ones made by teachers to help kids learn to make inferences and understand social situations. It has reading and math lessons, too.

A few more reminders….

If your child has gotten used to sleeping in, be sure to start easing them back into the earlier wake up schedule a few weeks before school starts. Getting them to bed a little earlier each day and waking up a bit earlier each day will help them get the rest they need, and hopefully help reduce the stress that comes with rushing out the door because they slept too late.

If your child seeks sensory input or is upset by loud sounds, prepare a sensory kit for school with their favorite fidgets, chewy necklaces, noise-reducing headphones, etc.

Do you have some other back to school tips or routines that have helped you prepare? If so, share them in the comments. We wish you a smooth and successful new school year!

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