Autism Assessment (number of sessions/cost)

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Lady Strange
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15 Jun 2022, 6:32 pm

Hello,
I did finally manage to find one psychologist that does do adult autism diagnosis. I however realized at least with this particular person that it will not be possible for me to do so due to the number of sessions she requires and the cost out of pocket to pay.

I added up the cost (she sent a sheet detailing cost) and I would be looking at about 2,500 dollars at least, if not more. Plus, the amount of sessions would be 7 or 8 one to two hour separate sessions. This is impossible to work with my current job.

I am mainly wondering for those who have been diagnosed, is this typical or does this seem like way too many sessions for an assessment? How many sessions did you have to attend separately, and how long was each sit down (number of hours)? I am in the USA so the cost is up there which that doesn't exactly surprise me.



IsabellaLinton
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15 Jun 2022, 6:45 pm

Mine was with an ASD Neuropsychologist.

I sent a 188 page developmental history ahead of time.
I'm sure she didn't expect anything that long.
I told her I'd pay her extra for her time reading, or she didn't need to read it all.

Then I had one marathon testing session, about 11 hours.
I think it was 8:00 am to 7:00 pm.
She had read most of my DH using the appendix.

Then I had to do a bunch of double-blind encrypted computer questionnaires from home.
They were sent to some group in America (forget the name).
This was to ensure consistency / no bias against the scores she had given me.

Then my daughter did similar encrypted questionnaires about me.
She wasn't allowed to show me or ask my input.

The questionnaires took maybe 2 hours in total for me.
Maybe 45 minutes for my daughter.

I got a draft version of the report online, about three weeks later.
It was 33 pages long.
The doctor asked me to correct any factual errors (e.g., my personal history / typos)
I emailed her a few edits but nothing significant.

You pay for their time to write the report even though you aren't with them.

Then I had the followup visit.
I got a formal paper copy, and a new email with the updated cyber copy.
I had to sign papers so she could send it to my other doctors (psych, GP etc.)
We talked through the report and recommendations.
I think that visit was an hour.

So, I guess the total for me was about 14 hours?
Then whatever amount of time it took her to write the report.

Total cost about $2800.00 plus tax was around $3000.00



DanielW
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15 Jun 2022, 7:07 pm

My assessment (in the US) was $2000. (including all of the various fees, for medical records and research etc.) done in 2 sessions (one nearly full day, and one half-day) on days I chose. (I'm paying, so you can be darn sure its going to me at MY terms) This was a few years ago, so the price seems to be what I would expect. As an Adult, particularly if you are in the US, I would advise against formal testing UNLESS you need workplace accommodations or are seeking possible disability benefits. Because aside from that its not going to do you a lot of good.

Honestly, I could afford it at the time and it was some validation, but it hasn't made a significant difference in my quality of life to this point.



IsabellaLinton
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15 Jun 2022, 7:15 pm

Mine was in 2018 so the price was a bit more current.

My word of advice is to get life insurance or any other medical clearance things that you might need, prior to diagnosis.

My daughter has been denied life insurance several times because of her ASD / ADHD diagnoses.
She also has a physical condition so maybe that's why?

She always says to remind people of this.

In my case it wasn't an issue because I already had life insurance.



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15 Jun 2022, 8:26 pm

On the other side of the world:

Incidental diagnosis and it wasn't all that much (health insurance and the government helping out). I guess I was too obvious or something, and I never heard of Asperger's or high functioning Autism before then. It was picked up quickly at a hospital.



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16 Jun 2022, 10:44 am

I was assessed in the U.S. in 2019 by a licensed psychologist.

When I contacted the psychologist's office I gave them a six page document explaining why I wanted an assessment.
<=>- What my father had done that caused me to read about Autism.
<=>- My score on the Autism Spectrum Quotient Test.
<=>- The score my bride get when she took the test on my behalf.
<=>- A one-page high-level chronology of my life.
<=>- A one-page list of records I could provide.
<=>- A note that my father and bride were potential sources of information.
<=>- A list of 18 Aspie "things" that seemed to sort of apply to me.

When they agreed to assess me I dropped off an unsolicited collection of records I thought might be useful, including:
<=>- A journal my mother had kept for my first year.
<=>- My Autism Spectrum Quotient test answers.
<=>- Personality tests I've taken and the results (for example, MBTI).
<=>- Report cards and transcripts.
<=>- Standardized school test results.
<=>- College admission test results.
<=>- A résumé.
The only thing I know the psychologist went over carefully was my mother's journal. (Though the psychologist apparently found the Table of Contents for the records noteworthy.)

Based upon the records I provided the psychologist offered to forego doing an IQ test as part of my assessment since it seemed unnecessary. Omitting that reduced the price a few hundred dollars, I think.

I had three appointments with the psychologist.
=>(1) My bride was with me for the first appointment. The three of us talked and the psychologist gave my bride a questionnaire to take at home and gave us some questions to ask my father.
=>(2) My bride was not invited. Most of this session was me taking questionnaires and doing some supervised thought exercises. The exercises were clearly designed for children and I found them amusing (I think the psychologist was slightly embarrassed by them) but I saw no reason to question their utility. This session was the longest of the three sessions but the psychologist was able to eat her lunch while I took the questionnaires.
=>(3) My bride and I were told the results: Autism Spectrum Disorder, Level 1 (Mild).
I don't recall exactly but I think the first and third appointments were about an hour each and the second appointment was a few hours.

The written assessment arrived in the mail some weeks later.

As I recall, if the assessment had included an IQ test it would've been a bit over one thousand dollars but without that it cost me a bit under one thousand.

Note the assessment cost was probably affected by several things:
<=>- What that specific practice charges.
<=>- I provided a lot of records, including information from before my first birthday.
<=>- My bride and father both cooperated.
<=>- We skipped the IQ test.
<=>- I was clearly not Level 2 or 3.
Medicare and my medical plan later reimbursed me for about half of the cost.

P.S. I thought the whole thing was kind of fun!


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shortfatbalduglyman
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16 Jun 2022, 11:16 am

year 2003

san diego, ca

about three sessions

about ten hours total (might be insufficient)

about five hundred bucks



Lady Strange
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16 Jun 2022, 6:53 pm

Thank you for the replies. I was just trying to get a feel for if that price range and number of sessions sounded about right. Sounds like the one I contacted, that the cost could be a little lower and number of sessions not as many. The other thing that made me real hesitant was she wanted me to sign a contract before even starting basically saying that once it began I had to see it fully through (cost and all those sessions), not just pay for them as I went. That is quite a chunk of change to just hand over without fully knowing what is going on, not to mention time commitment that I couldn't meet!

Thank you again, this helped.
I emailed and asked the lady's office if they can recommend any others around that do adult diagnosis, just hoping I could find one easier to work with maybe. That might be a shot in the dark so to speak.

Also, at this point I don't even know fully if it would be worth it. We've figured this out (me and husband and general doc knows about it too tho he cannot officially say), and there really isn't any good help for autism for me at this point. The only thing is the validation I admit is nice to have. I did keep her questionnaire that she had me fill out (and asked my mom a number of questions too and kept those answers), just incase at some future point things were more able to be worked out.



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16 Jun 2022, 8:07 pm

I suspect the number of sessions and the final cost varies somewhat from practice to practice. I think the assessment process has room for variation.

I can see why they might not want to do pay-per-visit, though. They probably block out the time on their calendar and then if, at the last minute, you are a no-show then they lose your payment and it is too late to schedule a paying replacement.


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IsabellaLinton
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16 Jun 2022, 8:31 pm

Lady Strange wrote:
I was just trying to get a feel for if that price range and number of sessions sounded about right.

The other thing that made me real hesitant was she wanted me to sign a contract before even starting basically saying that once it began I had to see it fully through (cost and all those sessions), not just pay for them as I went.


Price:

From what I've heard and read about other people doing assessments in USA, $2500-ish seems to be the going rate.
Most of these psychologists are about $250/hour.

I don't think the price is necessarily too high compared to others, but the inconvenience of having to go 7-8 times would be a PITA for me.

You'll have to miss work, pay gas prices and pay for parking. Plus I'm assuming the 7-8 sessions will be at least somewhat far apart so that the whole assessment will take quite a while. It's a burden on you to psych yourself up that many times.


Contract:

With mine, I had to pay half (about $1400) when I booked the appointment. That was five months before it took place. They wouldn't send me the Developmental History questions or confirm the date until I paid half like a deposit.

I can't remember if the payment was going to be refunded if I needed to cancel, but I'm pretty sure I was allowed to change (postpone) the date if something had come up. I got someone else's cancellation date or else I would have had to wait a lot longer than five months.

The other half was due on the day of my appointment, when I first walked in before it started. If I hadn't paid the second $1400 she wouldn't have done the assessment or written a report.

From what I've heard / read it's normal to be charged in lump sums so that they know these appointments will be met.


Insurance:

I'm not in USA and it seems like you don't have insurance for this. I wish I could make more suggestions about how you might be able to get insurance coverage, but I really don't know the American system.

Here we have coverage for psychiatry but they don't do the assessments. I have private insurance for psychologists which covers $1500 max per year, so I had to go without seeing my regular psychologist for the entire year to have that amount available on my claim. I had to pay the other half out of pocket (and go a year without trauma therapy). Also, I couldn't claim any of it on insurance until the appointment took place. That means I was out the deposit for five months before I could submit my claim.

It's hard to say what to do. I hope they write back to you with some ideas about other places that might be able to see you in fewer sessions. :( It's really sad that people are shut out of the diagnostic system so frequently.


Suggestion:

Have you tried contacting the nearby universities? I found my diagnostician through the Neuropsych Department of my university. In my case the cost was similar to other places, but the wait list was a LOT shorter. Perhaps you might find that it's cheaper through universities where you are.

Also, I remember Mona Pereth mentioned having graduate students do the assessment. I forget what she called the students in terms of a job title, but their work was overseen by the PhD doctor so it was considered "valid", but at a lower rate. She's in New York and this was an option for her.

I'm sorry I can't remember what their job titles were, or how to find them.

You might want to search through Mona's posts about assessment.



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17 Jun 2022, 6:28 am

the rate seems to be in keeping with what is available in the usa today. Most health insurance may pay around 20 percent of the cost of any psychological testing/evaluation. For the most part diagnosis does indeed come out of the pockets of the individuals. I am wondering about tele health options which are available today. That form of interaction with Doctors in psychology and psychiatry are generally covered today and might be easier to facilitate sessions for diagnosis or therapy or both than having to physically be in the office of the practicing professional. If you do not require official diagnosis to claim disability or other assistance (handicap accommodations etc) then you may find there are a few online practitioners from other countries willing to give assessments and which might not be quite as expensive. Do your diligent research on the experience and qualification of any professional you might choose, though. There are lots of "woo woo" scammers out there too. Best wishes.


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Lady Strange
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17 Jun 2022, 7:27 pm

IsabellaLinton
Thanks for the information. I didn't think about universities, I may look into that.

After finding out this information (especially cost) I am still trying to decide whether to further look into it or not. It would mainly be just validation and being official, which would be nice. I don't need disability or things like that for it so it wouldn't be for getting accommodations.

I wish that they could provide some real means of help for autism, not just "oh yep you have it, good luck in life!", I don't understand why there are therapies and things for people who have say bipolar disorder or depression, but as an autistic adult there really is nothing from what I can tell. It seems once you are over 18 you are on your own.