Individuals may go through several different types of autism evaluations in order to gain eligibility into treatment.  These may involve different types of professionals and various testing tools.  Compliance with these assessment types is needed in order to get the ‘ticket in the door’ to services.

In Michigan, many private insurance providers require Autism Evaluations to be completed through an AAEC in order for autism therapies, primarily Applied Behavioral Analysis, to be reimbursed.  In general, these centers meet criteria developed in partnership with the Michigan behavioral health care community and use a comprehensive, team approach to diagnosing autism.  A list of approved AAECs can be found here:

 

https://www.bcbsm.com/index/find-a-doctor/other-directories.html

This evaluation is done through the public school district or intermediate school district (ISD) to determine eligibility for special education services, appropriate classroom placement, and support services within the school district. The school psychologist, social worker, speech therapist, occupational therapist and teacher generally work together as a team to complete the evaluation. This assessment is usually referred to as an Educational Certification rather than a medical diagnosis.

This evaluation is completed by a physician or medical doctor such as a developmental pediatrician, a pediatric neurologist, or psychiatrist who usually obtains a patient history and physical examination and makes general behavioral observations during the clinic visit. This assessment does not usually include any standardized testing.

CMH eligibility screenings completed by an approved diagnostician. This could include a social worker, psychologist, or medical professional. These assessors use a combination of standardized testing materials specifically for diagnosing Autism, such as the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R).  A psychological evaluation for Autism is generally more comprehensive than a medical evaluation and may also include assessment of IQ, developmental level, language, behavior, daily living skills, and social abilities.  It will often take several hours to complete and includes a parent interview as well as direct observation of the individual being tested.