What an evaluation actually looks like
Usually 60 to 90 minutes, and mostly it looks like playing. You fill in a history form, the clinician watches your child do ordinary things, and asks you a great many questions.
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You will not normally leave with a diagnosis in hand. Most clinicians share first impressions on the day and send the written report a week or two later, because scoring the standardised measures takes time. Bring anything you already have: daycare or school notes, the referral from your pediatrician, a list of words your child actually uses, and any earlier reports. If your child is having an unusually bad day, say so - it changes how the session should be read. And you are allowed to ask what the clinician is looking for while they are looking for it.
What waitlists are really like
Six to twelve weeks for an evaluation is common, and longer in some regions and specialties. It is normal, and it is not a reason to stop asking.
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Join more than one list. There is no penalty for it and the first opening is rarely where you expected. Ask three things on every call: how long is the wait today, do you keep a cancellation list, and is a shorter screening appointment available while we wait. Then ask again every few weeks, because lists move. If your child is under three, your state's early-intervention programme runs on its own timeline and is worth starting in parallel. From age three, the school district's evaluation route is separate again - and free.
What insurance usually covers
Speech, OT and PT are commonly covered with a referral. Most states require plans to cover medically necessary autism services, including ABA, once there is a diagnosis. The detail varies a lot by plan.
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Three things are worth confirming before the first appointment: whether the provider is in-network with your specific plan, not merely that they accept your insurer; whether prior authorisation is needed; and how many visits a year your plan allows. Ask the practice's billing contact, then ask your insurer, and write down the reference number for that call. School-based services are a separate system - if your child qualifies the district provides them free, and it does not touch your benefits. If you are paying out of pocket, ask directly whether a sliding scale exists. Many practices have one and few advertise it.
What to ask on the first call
Five minutes on the phone tells you more than an hour of reading. These are the questions worth spending it on.
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Do you take my plan, and are you in-network? What is the wait, today? Who exactly would see my child, and what are their credentials - the person doing the evaluation is often not the person doing the therapy. How do you measure progress, and how often will we sit down and talk about it? What is your cancellation policy? And if the call goes well: who else would you send me to, if you cannot take us? Practices refer to people they trust, and that is the one thing a directory cannot tell you.
