The Parent’s Guide to Autism Evaluation

The Parent’s Guide to Autism Evaluation
PARENT GUIDE

What to expect every step of the way

Medically reviewed by Nicole Garber, MD, Chief Medical Officer

By Bethany Barney, MSS, LCSW

You're curious about an autism evaluation for your child. Maybe your pediatrician recommended it, maybe the school did, or maybe you've been watching and wondering long enough that you're ready for answers. Whatever brought you here, you probably have questions about what this process actually looks like. Here's what to expect.
If you’re concerned that your child may have Autism Spectrum Disorder (ASD) due to differences in how they interact with others, communicate, or behave (such as difficulties with social interactions, repetitive actions, or very specific interests), this guide will walk you through an example of a quality evaluation process, help you know what to expect, and explain what makes Blackbird Health’s evaluation process special. 
What you'll find in this guide

What is an autism evaluation?
An autism evaluation is a multi-step process where specialists use interviews, observations, and standardized tools to identify whether your child meets the diagnostic criteria for Autism Spectrum Disorder (ASD), as defined by the DSM-5. There is no single test for autism—it typically takes several appointments to build a complete picture of how your child develops, communicates, and interacts with others.

Why is an autism evaluation important?
An autism evaluation helps you understand how your child experiences the world. With a diagnosis, you can access therapies, school accommodations, and support services that fit your child’s needs.

Can you get evaluated too late? No. While earlier diagnosis means earlier intervention (which research shows improves outcomes), autism evaluation at any age provides value. Late-diagnosed teens and adults often say the diagnosis finally helped them understand themselves.
 

What happens during an autism evaluation?
While the specific tools used, how long the evaluation takes, and how it’s structured will vary based on your child’s age, developmental level, and where they’re being evaluated, a quality autism evaluations should include:

Clinical interviewsMomBoy.Autism.BlackbirdHealth
In-depth conversations with parents and caregivers gather information about your child's developmental history, behavior patterns, and daily functioning from infancy to the present. During this time, clinicians often utilize the ADI-R (Autism Diagnostic Interview-Revised), a structured parent interview that explores your child’s developmental milestones, early social behaviors, communication development, repetitive behaviors or restricted interests, sensory sensitivities, and family history. This comprehensive interview can take 90 minutes to three hours.

Direct observation and interaction
Your child will engage in structured and semi-structured activities designed to assess communication, social, and behavioral skills. Clinicians often use the ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition)—considered the gold standard for observational assessment—to watch how your child initiates and responds to social bids, engages in imaginative play, handles transitions, responds to their name, makes eye contact, and navigates unexpected changes. The ADOS-2 typically takes 40–60 minutes. While widely regarded as the most comprehensive tool of its kind, clinicians may also use other observational measures and play-based assessments to gain a complete understanding of your child’s abilities.

Multiple perspectives
Input is gathered from parents, teachers, childcare providers, and other adults who interact with your child regularly to understand behavior across different environments. This multi-informant approach is crucial because autism can present differently at home versus school, or with familiar versus unfamiliar people. Clinicians use science-backed tools—most commonly the ASRS (Autism Spectrum Rating Scale)—to analyze these perspectives, along with additional behavior assessments and other standardized measures that help provide a full picture of your child’s strengths and challenges.

Comprehensive reporting
After completing all assessments, the specialist will provide a detailed written report with findings, diagnosis (if appropriate), and specific recommendations for interventions and support. Reports typically include the background information collected, the various assessment results with scores and interpretations, clinical observations, diagnostic conclusions based on DSM-5 criteria, your child's unique strengths and challenges, and concrete recommendations for therapies, educational support, and next steps.

How do I prepare my child for autism testing?

Good preparation can help the clinicians you are working with get a fuller picture of your child’s development and daily life. Before the appointment, gather relevant documents you may need and take a moment to prepare some notes on areas the clinician will want to discuss such as milestones, your own observations, triggers for your child, and any family histories of autism, ADHD, anxiety, or other relevant conditions you’re aware of. 

Documents to pack for your appointments:

  • Completed intake forms

  • Insurance card and photo ID

  • Any previous psychological or developmental evaluations

  • School reports, report cards, IEP/504 documentation if applicable

  • List of current medications

  • Medical records related to developmental concerns

  • Your notes on milestones, observations, and history

Prepare your childMomSon.Autism.BlackbirdHealth

While you don’t want to coach your child on specific activities or behaviors, the goal after all is to see what your child does spontaneously, you can and should provide your child with information about the appointment that matches their developmental level:

For very young children (ages 2-4): Explain that they'll meet someone who will play with them and learn more about who they are. 

For school-aged children (ages 5-12): Share that they'll do specific play-based and conversational activities. Let them know the appointment will last about an hour and reassure them there won't be any shots or medical procedures.

For teens (ages 13+): Be direct about the purpose. Explain that the evaluation helps understand how they learn and communicate so they can get the right support. Emphasize this is about understanding strengths and challenges, not judging them.

Important: Depending on age and development level, your child may need to be observed without you present during certain portions of the evaluation. Prepare them for this separation in advance.

How is Blackbird Health's evaluation different?

While the process described above represents the sort of high quality autism evaluation you should look for, Blackbird Health goes a bit further in order to examine all factors affecting your child’s development. We call our approach, the whole-child model. 

While a standard evaluation typically examines:

  • Autism-specific behaviors and symptoms
  • Developmental history related to autism criteria
  • Current functioning in social and behavioral domains

Blackbird Health’s whole-child model examines:

  • Physical health factors (sleep, nutrition, medical conditions)
  • Co-occurring mental health conditions (anxiety, ADHD, and depression)
  • Sensory and developmental considerations
  • Family dynamics and environmental factors
  • Speech and language needs
  • Family history

We don’t believe in one-size-fits-all assessments. Our neuro-science based process starts broad, then quickly pinpoints where to go deeper—so we can uncover what’s really going on and what each child truly needs.

Integrated care: When we identify a need for an occupational therapy (OT) or speech language pathology (SLP) evaluations, these are available within Blackbird Health. For patients requiring these therapies ongoing, we have curated a network of high quality therapists and will support patients throughout the referral and treatment process as part of our integrated treatment model.

Experienced team: Our diagnosticians specialize in autism and neurodevelopmental conditions, with extensive training in autism assessment across all ages and developmental levels.

Ongoing support: Our relationship doesn't end with diagnosis. We provide continued care through therapy, medication management when appropriate, educational advocacy support, and consultation as you implement recommendations. 

Timely access to autism evaluations: Unlike hospital systems with months-long waitlists, Blackbird Health serves southeastern Pennsylvania and Northern Virginia families without delays. After completing our New Patient Visit, your child’s evaluation can begin as early as 4-6 weeks in Pennsylvania and 2-4 weeks in Virginia (vs. 12-18 month hospital waitlists elsewhere).

Educational advocacy support: Blackbird Health’s services go beyond diagnosis. Our educational consultation services include IEP meeting support, school advocacy services, and guidance on securing appropriate accommodations for your child's unique needs.


Standard Autism Evaluation


Blackbird's Whole-Child Model

Focuses on autism-specific behaviors Examines autism + co-occurring conditions
12-18 month waitlists 2-6 week access
Single diagnosis focus Whole-child focus
Ends with diagnosis Ongoing support + advocacy

Blackbird Health’s virtual and in-person options for autism evaluations?

Our patients access care both in person and virtually. Our clinicians recommend the method of care that will best support each child.

Most of our providers are hybrid, so they see patients both virtually and in our clinics. Our virtual intake allows us to observe children and adolescents in their natural environment, often providing meaningful insight into how they function in daily life.

If in-person care is clinically necessary, our team will recommend in-person appointments moving forward. If a family prefers in-person care, we will do our best to accommodate that request.

Virtual visits give clinicians the ability to:

  • Observe the child in familiar surroundings, which often leads to more relaxed, genuine behavior
  • See sibling and caregiver interactions in real time
  • Pick up on environmental factors—overcrowded spaces, noise levels, sleep setup—that influence behavior and wellbeing
  • Gain clues about emotional regulation, attention, and executive function through at-home routines
These insights help clinicians build rapport early in the therapeutic relationship and develop more informed, personalized diagnoses and care plans.

 

What's the step-by-step process??

1. Virtual registration
Your first step is to contact Blackbird Health and register as a new patient. A Care Navigator will guide you through submitting insurance information and completing intake forms. We accept most major insurance plans and offer competitive rates for those paying out of pocket.

2. Intake, aka the New Patient Evaluation DadandDaughter.Autism.BlackbirdHealth
At Blackbird, we combine the typical consultation and screening appointments into one comprehensive 90-minute virtual intake session with a psychiatric mental health nurse practitioner (PMHNP) which we call the New Patient Evaluation. This appointment includes conversations with both you and your child and covers background information, medical history, family history, and social history. It also determines whether specialized evidence-based assessments are needed such as the BASC-3 (Behavior Assessment System for Children), the Vanderbilt Assessment Scale, or PHQ-9 (Patient Health Questionnaire). Sometimes this appointment takes less time, but reserving 90 minutes ensures we have time to go over everything thoroughly. 

The New Patient Evaluation is conducted virtually, which allows us to observe children in their natural environment, providing meaningful insight into daily functioning. Virtual intakes are as clinically effective as in-person assessments, while offering faster access and convenience for families. 

We use NPs for the New Patient Evaluation because their clinical training allows them to assess patients from both a therapeutic and medical perspective, evaluating psychological, behavioral, and physical health factors to form a more holistic picture of your child from the start.

3. The autism evaluation
The Blackbird Health autism evaluation involves the administration of “gold standard” diagnostic measures and the gathering of information from multiple sources:

Diagnostic interview appointment
This interview allows the clinician to gather detailed information about your child. This appointment is conducted in person or virtually, depending on the parent’s preference.

  • Who attends: Parents and caregivers. Children aged 14+ are often involved in this meeting as well.
  • What happens: We gather crucial background information, including developmental, educational, social, service, and medical histories, along with your family's concerns, including any challenging behaviors.
  • Duration: 60-120 minutes

The ADOS administration appointment
The diagnostician meets with your child to administer the ADOS-2 (Autism Diagnostic Observation Schedule).

  • Who attends: Your child will attend alone. If your child is very young, you may also be included in the evaluation room.
  • What happens: The ADOS is typically conducted in person but can be done virtually, depending on your child’s needs and developmental level.
  • Duration: Typically a 40 to 60-minute administration

Completing the ASRS 
Following the ADOS, the clinician collects crucial information from various sources using the ASRS (Autism Spectrum Rating Scale). The ASRS is based on reports filled out by your child’s parents, teachers, childcare providers, and any specialists they may regularly see (such as therapists), ensuring a complete picture of your child's functioning across all environments.

4. Diagnosis and feedback
You can expect a 30-60 minute diagnostic feedback session where the clinician reviews the findings from additional testing and behavioral assessment tools—such as the BASC-3, the Vanderbilt Assessment Scale, or PHQ-9—explains whether your child meets ASD criteria, and provides treatment recommendations. We offer flexibility in scheduling additional sessions if needed, and these sessions can be conducted virtually.

 

Frequently asked questions about autism testing

At what age can autism be diagnosed?

Autism can be reliably diagnosed as early as age 2, though some children show signs earlier. The CDC recommends autism screening at 18 and 24 months during well-child visits. While autism can be diagnosed at any age (including adulthood), earlier diagnosis allows children to access intervention services during critical developmental periods.

How is autism diagnosed?

Autism is diagnosed through a comprehensive evaluation that includes clinical interviews with parents, standardized assessments (particularly the ADOS), rating scales completed by multiple caregivers, and direct observation of the child. There is no single medical test for autism—diagnosis is based on meeting specific behavioral criteria outlined in the DSM-5.

Does insurance cover autism testing?

Most commercial insurance plans cover autism evaluations when medically necessary. Coverage typically includes diagnostic evaluation, ADOS administration, clinical interviews, and report writing. Some plans require pre-authorization before the evaluation. Check with your insurance company about your specific benefits for autism assessment and whether pre-authorization is required.

How much does an autism evaluation cost?

The cost of an autism evaluation varies based on your insurance coverage. Most commercial insurance plans cover autism evaluations when medically necessary, typically including the diagnostic evaluation, ADOS administration, clinical interviews, and report writing. At Blackbird Health, we accept most major insurance plans. Contact our Care Navigators at (484) 202-0751 for specific cost information for your situation.

Do I need a referral for an autism evaluation?

Requirements vary by practice and insurance plan. Some autism specialty centers accept direct contact from families without physician referral, while others require referral from a pediatrician or other provider. Check with your insurance company about referral requirements for your specific plan. At Blackbird Health, families can contact us directly without a referral.

What is the difference between an autism screening and an autism evaluation?

Autism screening is a brief questionnaire (like the M-CHAT) used during routine pediatric visits to identify children who may need further evaluation. It takes 5-10 minutes and flags potential concerns. The evaluation is a comprehensive, multi-hour assessment conducted by specialists that can definitively diagnose autism spectrum disorder. All children receive screening; only those with concerns proceed to full evaluation.

Can my child's pediatrician diagnose autism?

Some pediatricians diagnose autism, particularly for children with clear presentations. However, many refer to specialists for comprehensive evaluation, especially when the presentation is complex, co-occurring conditions need assessment, or detailed testing is needed for school accommodations. Specialists with autism assessment training typically provide more comprehensive evaluation.

What should I bring to an autism evaluation?

Bring completed intake forms, insurance card and photo ID, any previous evaluations or school reports, list of current medications, medical records related to developmental concerns, and notes on your child's developmental milestones and current behaviors. Also bring items that comfort your child (favorite toy, snack, comfort object) if allowed by the evaluator.

What if I disagree with the autism evaluation results?

If you disagree with the evaluation results, first discuss your concerns with the evaluator during the feedback session. Ask for clarification about which DSM-5 criteria weren't met and why. You have the right to seek a second opinion from another qualified evaluator. If your child is very young (under age 3), consider re-evaluation in 6-12 months as autism symptoms become clearer with development.

What happens if autism is not diagnosed early?

While early diagnosis and intervention provide advantages, autism diagnosis at any age is valuable. Late-diagnosed individuals (teens and adults) often report that diagnosis helps them understand themselves, access appropriate support, connect with the autism community, and develop self-advocacy skills. It's never too late for autism evaluation if you have concerns.

 

Contact Blackbird Health for an autism evaluation? 

Blackbird Health provides comprehensive autism evaluations for children ages 2+ throughout Pennsylvania and Virginia. Our whole-child approach examines all factors affecting development, ensuring you receive accurate diagnosis and actionable recommendations.

Locations serving Pennsylvania and Virginia families

Pennsylvania offices:

Virginia offices:

Get started with at Blackbird Health: Call (484) 202-0751 or email: info@blackbirdhealth.com.

Click here to begin registration and to request an appointment. Our Care Navigators will guide you through the process and schedule your evaluation appointments. We're here to answer your questions and support your family through every step of the evaluation journey.
 


This article is for educational purposes only and does not replace professional medical advice. Consult with your child's healthcare provider or a mental health professional for personalized guidance.

Bethany Barney, MSS, LCSW

Bethany Barney, MSS, LCSW

Bethany Barney, MSS, LCSW is a Diagnostician and Director of Clinical Evaluation at Blackbird Health. With her specialization in neurodevelopmental disorders and child and adolescent mental health, she brings extensive expertise to comprehensive clinical assessments that help children and families access the support they need to thrive.

Need an autism evaluation? We can help without the wait.

Contact us today to learn more about our services. To speak to a Blackbird

Health Care Navigator, call (484) 202-0751, or email Blackbird Health at info@blackbirdhealth.com. If you're ready to schedule and autism evaluation, click here to started.Get started

 

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