As a registered psychologist in Vancouver, BC, specializing in autism and neurodevelopmental disorders, I’m often asked by families what they should consider when deciding to pursue a private autism assessment for their child. In this post, I’ll share some key points to consider when you begin your search for an autism evaluation. While I’m based in Vancouver, the considerations I outline are relevant to families across many regions.

1. Find a professional: In British Columbia, several clinical experts (i.e., psychologist, pediatrician, psychiatrist) can make a diagnosis of autism spectrum disorder.
   • Licensing: The first step once you have identified a potential professional is to check if they are licensed by their college:
     • Registered psychologist: https://chcpbc.org/public/licence-verification/ (if you look up 2804, that’s me!)
     • Pediatrician/Psychiatrist: https://www.cpsbc.ca/public/registrant-directory
   • Clinical Experience: If the clinical expert is licensed in the profession, the next step is to take a look at their biography and what their clinical training is in. Although a professional may be licensed, they may not have the specialized training, experience, or the relevant degree to complete an autism assessment. A psychology license in British Columbia does not grant specialties- it is up to the psychologist themselves to say whether they have the training and experience to provide specific services. For instance, I have a psychology license and my area is in child clinical psychology. A psychologist who specializes in adult substance use will also have a psychology license, but will have a very different skillset and training.
     • For autism and/or child psychology assessments, psychologist colleagues of mine generally have a Ph.D/Psy.D in clinical psychology, school psychology, or counseling psychology. Please note that within psychology, there are a variety of other streams that sound similar to but do not have the same coursework or clinical specialization to complete any psychology assessments (e.g., completing a Ph.D in developmental psychology, social psychology, or disability studies is not an equivalent degree). In addition to having a doctorate in one of the above streams, it is important to look at what their training pathway looks like (e.g., where did they complete their residency? where did they list their clinical placements?). This information should be easily found and should be consistent (e.g., a person who emphasizes child psychology assessments in their practice should have completed several rotations and a residency in child psychology assessments).
   • Clinician-family fit: Once you have identified whether your professional of choice is licensed and has the appropriate experience, it is important that you, your family and your child feel comfortable with the professional. They should be able to answer your questions.
2. Components of an Autism Assessment:
   • Detailed Developmental History: This can be completed via an intake form or an interview. At the very least, the clinician should have information regarding your child’s birth history, developmental milestones, social history, family history and educational history. In my practice, I have families complete an intake form first and I follow-up with additional questions.
   • Autism Diagnostic Interview-Revised (ADIR): This is required in British Columbia and usually takes 1.5 hours to complete. In other geographical regions, a similar semi-structured interview regarding your child’s early years and their behaviours should be completed. Regardless of the tool used, this information is imperative in an autism assessment as behaviours must be present at an early developmental period and be persistent. Your clinician should be asking lots of questions about the types of behaviours, the frequency of behaviours and the quality of the behaviours.
   • Autism Diagnostic Observation Schedule (ADOS): This is mandatory in British Columbia and usually takes 40+minutes to complete depending on the child’s age. In other geographical regions, a similar observation tool should be used where the clinician is observing your child. Depending on your child’s age, sometimes the parent/caregiver needs to be in the room and other times, the child is seen alone.
   • Cognitive Assessment: Completing a cognitive assessment as part of an autism evaluation is considered to be “gold standard”. The purpose of this is to rule out other explanations for differences in behaviours. This is not a requirement in British Columbia; however, I complete a cognitive assessment with all autism assessment (unless this was previously completed) in order to align with best practice.
   • Adaptive Assessment: An adaptive assessment is also a key part of an autism evaluation. This is not mandatory in British Columbia but aligns with best practice guidelines. I also complete an adaptive functioning assessment as part of my autism assessments.
   • Review of School Report Cards and other Collateral Information (e.g., home videos, interview with school team): This is not mandatory but is often part of my autism evaluations in order to understand the child’s behaviour at different timepoints and in different settings.
3. Key points to consider/ask your clinician:
   • Feedback: How quickly can your clinician provide feedback? Generally, feedback should be given as soon as possible following the collection of all information. In my private practice, I reserve an hour to go over all the assessment findings, discuss any diagnostic outcomes, and discuss intervention options with the family and child.
   • Report Writing: How quickly are reports completed and sent to parents? Reports are important for funding and for support services. I generally provide reports within 2 weeks.