Why does a diagnosis matter?
I was recently asked by a potential client to complete an insurance form to help him obtain out of network benefits for an autism spectrum evaluation. The initial form was simple—mostly names and ID numbers; however, they came back with another question: why is this medically necessary? This got me thinking. I believe almost everyone finds value in understanding themselves and the group they find themselves aligned with. When we struggle, we want to understand why so we can learn from it—either to improve the next time or to help us understand certain situations may just not be our area of strength.
Many of my clients have sought therapy before, but just feel like something didn’t really click. Having the initial understanding of something (in these cases, autism) that affects every aspect of the person’s life can completely change how someone uses therapy—and also how they choose a therapist in the first place.
It can be very lonely and isolating to feel that you are different from others, and to feel like you don’t quite fit. Finding your tribe, or peers you can identify with and understand, is incredibly important. Having the correct diagnosis can help you understand where to find resources, how to explain what makes you unique to others, and help you achieve a sense of belonging in a community.
But back to the question: why is a psychological evaluation medically necessary? For children, it is easier; to justify expensive therapies, a diagnosis is required. In fact, insurance companies require frequent re-evaluations (typically every 3 years) after an initial autism diagnosis for children to continue to utilize insurance benefits for these therapies. But what about adults with fewer support needs?
One reason is that we don’t know what types of supports might be needed as situations change. Minimal supports needed during childhood and adolescence do not necessarily mean that supports won’t be needed in later years. Increased demands and requirements at different ages and in different settings can mean supports are now needed. Even more importantly, the toll that masking and pushing oneself to “pass” as non-autistic or less autistic can lead to a number of emotional problems including burnout, anxiety, depression, and even trauma. An autism evaluation will impact all aspects of life and is, therefore, a medical necessity.
Clients that seek me out for adult autism evaluations almost always believe that they have autism, which is why they are looking for this type of evaluation. Often, they have taken several online evaluations which have come up in the autistic range. Many of these individuals do have autism; however, often they do not—this is because, with the autism spectrum, we are looking not just at a snapshot of a person’s functioning at this particular moment, but also their pattern of strengths and weaknesses and their developmental history. Anxiety, ADHD, trauma, and other personality disorders can sometimes have overlapping symptoms and it can be incredibly important to figure out WHY these symptoms are presenting so we know how to proceed.
An evaluation may result in a diagnosis of Autism along with another condition, which further complicates things. Sometimes, a particular type of therapy can make a world of difference, but only if the treatment is targeting the correct issue.
Not knowing is hard. If you are worried about something, it can take an enormous toll—sleep difficulties, anxiety, and even depression. For many of my clients, just knowing one way or another is a relief. Many times, their intuition is correct with regards to a diagnosis. But quite often it is not—there is some other explanation for their symptoms—and it can still be helpful for a person to understand their own particular personality profile and what makes them them.
Dr. Jessica Myszak has over 10 years of experience evaluating children and adults for autism. She offers telehealth evaluations for individuals in Arizona, Colorado, Delaware, Georgia, Illinois, Missouri, Nebraska, New Hampshire, North Carolina, Nevada, Oklahoma, Tennessee, Texas, Utah, Pennsylvania, Virginia, Washington DC, and soon, Kentucky, Alabama, and Wisconsin. If you are interested in learning more about potentially working with her, you can visit her website here or email her here to get the process started.