TEEN AUTISM EVALUATION

TEEN AUTISM EVALUATIONS

We love working with teenagers to help them better understand themselves and help the people in their life recognize how to best support them. If your teen is neurodivergent, it is a true gift for them to understand how their brain works and recognize supports and strategies that can aid them as they complete school and take the steps toward independence. Many of the families we work with have experienced significant challenges prior to seeking an evaluation. Difficulties with peers, school refusal, self-harming behaviors, and emotional outbursts are some of the common concerns we hear from parents and teens. Some clients have been evaluated multiple times in the past but had negative experiences with the process and felt invalidated and misunderstood, and other clients have never been seen by a mental health provider. For some, therapists or teachers may have brought up the idea of autism, but for others, parents or the teen themselves may have come across information that resonates.

If you’ve researched the subject, you know the importance of finding an autism evaluator who is up-to-date in their knowledge and familiar with the literature on masking, the female presentation of autism, and recognizing nuance. There are significant differences between child evaluations and adult evaluations but what about evaluations for teenagers? It can be challenging to find a provider who can combine information from both the teen client in an affirming way but also incorporate information from parents, teachers, and other sources. We strive to do this well. As we have refined our process for adult assessments, we have realized how many of these same concepts and processes apply to older teens, and we incorporate a structured interview and questions about masking in an age-appropriate way for all of our clients. Our goal is to meet the client where they are, and we have had many parents share how surprised or pleased they were that their teen has opened up or shared as much as they did when asked in an affirming, kind way.

Because the teen years are a time of tremendous grown and change, evaluation measures which are most appropriate for one teenager are not necessarily the best method for another. For some older teens, especially those who are comfortable sharing information in a structured interview alongside a parent, the process (and cost) may be very similar to that of an adult evaluation. For others, it might be important to interview teens and parents separately or to assess for other mental health conditions to rule out or further examine possible areas of difficulty. Some teens may have significant mental health records which are important to review and have therapists or teachers who can share information about their background or current functioning.

A Teen Autism Evaluation Typically Consists of:

One or more appointments—An evaluation typically starts with a 2-hour parent interview, where parents can share concerns, information about their teen’s developmental history, and what they are looking for in an evaluation. Depending on the teenager and their needs, we will schedule one to three additional office or video-appointments. (In some situations, it can be best for parent and teen to be initially interviewed together—let us know if you think this is the case, and we can discuss and schedule accordingly!)
Rating scales for parent and teen to complete online to provide more information about your teen’s typical behaviors.
An individualized evaluation based on the needs of the client
A written report of results
Other Communication Disorders
An explanation of results, with recommendations and next steps for suggested follow-up. The goal is that by the end of this process, you have a clear understanding of your teen’s strengths and needs and a vision of what supports the teen might need moving forward. (You are welcome to attend this appointment with your child, or we are able to meet with parents and teens separately to address their individual questions—this varies by family!)

Dr. Myszak’s and Dr. Long’s experience allows them to meet the needs of different types of clients, rather than using a “cookie-cutter” approach. They are aware of the different ways that autism can present in girls and women, and some of the testing and interviews with females focuses on their experience of “camouflaging” their symptoms and their internal experiences involving socialization. They are familiar with the concepts of Pathological Demand Avoidance (PDA), which many families have found and identify with. Teens with PDA experience significant anxiety, which often results in meltdowns, tantrums, and other behaviors. While PDA is not currently a separate diagnosis, when described along with an Autism Spectrum Disorder diagnosis, it can open the door to understanding and strategies for families and educators.

Autism Evalution May Inclue (But are not limited to):

MIGDAS-2, a structured interview to assess for symptoms of autism
CARS-2, a checklist of symptoms associated with autism
Vineland-3, an interview about adaptive functioning
CAT-Q, a rating scale about camouflaging symptoms
Cognitive measures
Achievement/Academic Measures
Measures of Sensory processing
Measures of Auditory processing
Measures of Executive Functioning
Social Language and Social Pragmatic Assessments
Projective Measures
Personality Measures
Other Qualitative Measures of Possible Autism Traits
ADOS-2, a structured observation for symptoms of autism—while we do not commonly use this for teenagers, there are some times when it may be appropriate depending on the goals of the assessment or needs of the client. Even when we use this measure, we NEVER use this one particular score to diagnose or gatekeep a particular diagnosis!

Some teenagers may need a diagnosis to justify an IEP or 504 plan in school, receive private support services, or access other programs that require medical documentation of autism. We offer a balanced approach to evaluation, to identify both the teen’s strengths and weaknesses and provide recommendations and referrals.

Do You Know?

Dr. Myszak and Dr. Long do not use students or techs to complete any testing, and they personally complete all of the work that goes into each psychological evaluation. They take pride in being able to help families learn about their teen and learn what they can do to help them moving forward. They want you to walk away from an evaluation with a clear understanding of your teen’s strengths and needs and knowledge of what to do next to support your teenager. If you are looking to schedule sooner, you should consider working with Dr. Rovane—Dr. Rovane is a post-doc with availability for many types of evaluations, and she works under supervision of Dr. Myszak. Reach out to learn more about scheduling with her!

Many teen evaluations can be completed over telehealth. With others, some portions (especially parent interviews and informing appointments) can be completed over telehealth with some in-person testing. If you wondering what is possible for your situation, please reach out for more information.

Because of the variety of needs in teen evaluations, pricing varies depending on the complexity of the case and the time needed to complete all interviews, testing, report writing, and communicate information with the family. Some clients may be able to complete assessment in one session, while others may need multiple appointments. Because it is not always obvious from the beginning how much time will need to be spent on these, a deposit of $2000 is due on the day of the first appointment, and the balance for everything is due on at the final appointment, where results are communicated to the family. We quote the maximum possible cost to you ($6200), but very rarely reach this amount for an evaluation. The total cost for many evaluations ends up being between $2800 and $3800.

As a psychology practice, we are deeply committed to neurodiversity affirmation and strive to create a safe and inclusive space for individuals seeking support, particularly within the autistic community. Understanding the unique challenges faced by females, LGBTQIA folks, and other high-masking individuals who identify with autism is at the core of our practice. When conducting evaluations, we take great care to ensure that these personality traits are adequately addressed and accounted for. Your experience and perspective matter to us, and our aim is to provide you with an evaluation that truly reflects your teen’s individual strengths, challenges, and needs. We look forward to supporting you and your family on their journey of self-discovery and empowerment.