What happens at a toddler assessment?

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My son is 14 months old, and we're in the process of scheduling his autism assessment. I'm trying to mentally prepare myself a bit for this, so I was wondering what's going to go on during it?

Oh, I was also wondering....if he is diagnosed, what kind of services will be available to us (generally speaking), and would these be covered by our insurance, or are they free, how does the funding work? We're in the US - state of NY to be exact.

Thank you.

I'd be surprised if they could diagnose autism that early, BUT I did have my son assessed in the state of NY through the local school district at age three. Before the age of three, you can get assessments/services done through your local health department Early Intervention. Even if they can't diagnose autism, they may pick up on sensory/cognitive/speech issues. Early therapy is good in all these cases as far as I can tell.

You can also access private assessments/therapies so long as your insurance covers it.

I would personally go the early intervention route initially, because they will cover a lot of services you might need. Or, I suppose you can schedule both the private assessments and public assessments at the same time. It often takes a while to get through it all.

I have heard of autism diagnosis as young as 9 months, but I think around 18-24 is more common.

My son was evaluated by Early Intervention in California at 33 months. I called them because my neighbor's child qualified for free speech therapy, and my son was still only speaking 2-3 word phrases.

First they sent a woman out to do an intake, basically a half-hour interview where she asked me about milestones and my concerns. She scheduled a screening team, 2 women who asked me more questions and performed some simple observations -- they observed DS climb stairs, stack blocks, get a cheerio out of a jar, etc. I don't remember how they evaluated his speech, but they concluded it was only a 25% delay and didn't qualify for further testing.

During the observation, the screeners noted some repetitive behavior. He kept trying to open the front door to go see a gardener with a leaf blower, and kept rocking on my glider footstool. They arranged for testing with the EI psychologist. The screening took about an hour.

The psychologist first did some sort of intelligence test -- showed pictures to see what items he could name, asked him to pick which picture comes next in a sequence, and had him try to put together some 3 piece puzzles (which he had trouble with). Next she started asking me questions from a form, while he was allowed to go play with toys at another table. She covertly observed how he played with them. Then she asked him to a pretend birthday party. He didn't sing, but did blow out a pretend candle. Years later I was reading about ADOS module 1 and realized she had performed that test.

During the testing, DS kept insistently trying to leave the room. It got so bad we had to finish the parent questionaire over the phone later. Before we left, the psychologist told me, "He doesn't have autism, he's just strong willed." Three years later, he was diagnosed with Aspergers using the ADOS module 2.

So we didn't get any services from EI, but our neighbor's child got an hour a week of in-home speech and OT. Other children I know have gotten 10-20 hours of ABA, plus speech, OT, and respite care. In CA, if you get an autism diagnosis, your insurance has to cover speech, OT, and now ABA. What you get will vary from state to state.

Thanks so much for the info! We are going through the county health department. At first we tried to go the private route because that's what his pediatrician recommended, however the waiting list was over 6 months long and we didn't think that it would be wise to wait. Would it be a good idea to start video taping some of his "red flag" behaviors in case he doesn't exhibit them while being observed? (such as not responding to his name or gestures, generally ignoring us, lack of stranger/separation anxiety, soothing with objects, arm flapping, hand flapping, strange body movements, repetitive vocalizations, repetitive door slamming)

Also, if he isn't diagnosed, I'm assuming that I can get a second opinion, right? I've known that something was going on since he was born and refused to be held. At this point, I don't feel like I can accept no for an answer.

Thanks again.

Just wanted to post an update...

My son had his assessment today with the county, and he qualified for speech and occupational therapy, and a special ed. teacher. They said that they're seeing a lot of sensory issues, and him generally wanting to just do his own thing. They are not qualified to diagnose him, but they are switching his diagnostic evaluation waiting list placement to a different list, which may mean a shorter waiting period on that. They said that whether he's diagnosed or not right now, he would still be receiving the same services. So, I'm very pleased with the outcome of the assessment, and so happy to find that I do not have to try to fight for services.

I am in NY and know of several little ones who got diagnosed autistic at a young age, of course they were more on the severe end of the spectrum. One boy got services early, and was in a special autism program and is doing AWESOME today!! he got diagnosed before he turned 2, and he is 4 and doing so well! I am so glad they agreed to services and I hope that you get the answers you are looking for!