A potential client recently asked me to complete an insurance form to help him obtain out-of-network benefits for an autism spectrum evaluation. The initial form was straightforward—mostly names and ID numbers—but then came the follow-up question: Why is this medically necessary? This question got me thinking about the importance of a diagnosis and how it impacts individuals seeking answers.

Understanding oneself and the group with which one identifies can be incredibly valuable. When we struggle, we want to understand why—whether to improve our approach to challenges or simply accept that certain situations may not align with our strengths. For many individuals, obtaining an accurate diagnosis is the key to unlocking the right support and resources.

How a Diagnosis Impacts Therapy and Self-Understanding

Many of my clients have sought therapy before, but they often feel that something didn’t quite click. Understanding that autism (or another condition) affects every aspect of life can completely change how someone approaches therapy. This includes:

How a Diagnosis Impacts Therapy and Self-Understanding

Choosing a therapist who specializes in autism.
Utilizing therapy in a way that aligns with their unique neurodivergence.
Finding strategies that are effective for their specific needs.

Additionally, many individuals feel isolated and disconnected from others. Receiving a diagnosis can provide clarity and help them find their community, allowing them to connect with peers who share similar experiences.

Why is a Psychological Evaluation Medically Necessary?

For children, justifying expensive therapies often requires a formal diagnosis. Insurance companies typically require re-evaluations every three years to continue covering services like ABA therapy, occupational therapy, and speech therapy.

But what about adults with fewer immediate support needs? The necessity of a diagnosis remains just as important. Here’s why:

1. Changing Support Needs Over Time

Just because someone doesn’t require significant support in childhood doesn’t mean they won’t need it later in life. Increased demands in adulthood—work, relationships, and daily responsibilities—can lead to challenges that require new forms of support.

2. The Toll of Masking and Burnout

Many autistic individuals engage in masking, trying to blend in or appear neurotypical. Over time, this can lead to:

Burnout (mental, emotional, and physical exhaustion)
Anxiety and depression
Trauma from prolonged masking

A proper diagnosis can validate these experiences and help individuals navigate their needs more effectively.

3. Understanding Overlapping Conditions

Many clients seek an autism evaluation because they strongly suspect they are autistic. Often, they have taken online tests that suggest they fall within the autistic range. However, not everyone who suspects autism has it.

Understanding Overlapping Conditions

This is because autism shares overlapping symptoms with other conditions, including:

Anxiety disorders
ADHD
Trauma-related disorders
Personality disorders

A comprehensive psychological evaluation helps determine why symptoms are occurring and ensures that the correct diagnosis leads to the right treatment plan.

4. Co-existing diagnoses and Proper Treatment

Many individuals receive a dual diagnosis, meaning they have autism along with another condition. This distinction is critical because different conditions require different types of therapy. If a person is receiving the wrong treatment, they may not see the improvements they need.

The Relief of Knowing

The uncertainty surrounding one’s symptoms can be incredibly stressful. Not knowing can take an emotional toll, leading to:

Sleep difficulties
Heightened anxiety
Depressive symptoms

For many of my clients, simply having an answer provides relief—even if their intuition about their diagnosis wasn’t entirely accurate. Understanding one’s unique personality profile helps individuals make sense of their experiences and plan for the future.

FAQs

1. Why is an autism diagnosis important for adults?

An autism diagnosis helps adults understand their experiences, access necessary support, and receive appropriate treatment for overlapping conditions. It also validates feelings of difference and helps individuals connect with the autistic community.

2. What conditions can mimic autism symptoms?

Autism shares similarities with ADHD, anxiety disorders, trauma-related disorders, and certain personality disorders. A professional evaluation ensures that individuals receive an accurate diagnosis and the right type of support.

3. How does masking affect autistic individuals?

Masking refers to suppressing autistic traits to appear more neurotypical. Over time, masking can lead to burnout, anxiety, depression, and emotional exhaustion.

4. What if I suspect I have autism but I’m unsure?

Seeking an autism evaluation can provide clarity and guidance. Whether the result confirms autism or points to another condition, understanding yourself better can be empowering and helpful for long-term well-being.

5. How do I schedule an autism evaluation with Dr. Myszak?

Dr. Myszak offers both in-person and telehealth evaluations across multiple states. To learn more or schedule an evaluation, visit her website.

Conclusion

A diagnosis matters because it helps individuals understand themselves, access appropriate support, and receive the right treatment. Whether for insurance coverage, therapy, or personal understanding, an autism evaluation can provide the clarity needed to navigate life’s challenges.

Need an Autism Evaluation?

Dr. Jessica Myszak has over 10 years of experience performing psychological evaluations with children and adults. She offers both in-person and telehealth evaluations. In addition to seeing clients on the Chicago North Shore, she can work with families who reside in Alabama, Arizona, Arkansas, Colorado, Delaware, Florida, Georgia, Illinois, Kansas, Kentucky, Maine, Maryland, Missouri, Nebraska, New Hampshire, New Jersey, Nevada, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, West Virginia, and Wisconsin! If you want to learn more about potentially working with her, you can contact her to start the process.