Should A Parent Pursue An Autism Diagnosis?

A few weeks ago, I received a Facebook message from a mother who was filled with anxiety. Her son was diagnosed with a speech delay and she was absolutely positive that he also needed an official autism diagnosis. However, when she took him to the doctor, she was told that he didn’t meet enough of the criteria to warrant a diagnosis of autism spectrum disorder. Therefore, her question to me was whether she should she get a second opinion to get that autism diagnosis.

My first bit of advice to her was that she should absolutely get a second opinion. Some doctors are very skilled in certain areas such as childhood diagnosis but other doctors, not so much. Her doctor may simply not be as knowledgeable in that particular area. I, myself, have taken my own child to a doctor’s appointment, and remember being surprised when the doctor had to look something up in order to answer questions I was asking. However, it just goes to show that not all healthcare professionals know everything there is to know about child development. As much as I like to think that I myself know a lot about child development, I certainly don’t know everything, and therefore, it is not uncommon for me to refer a patient to someone who knows more about certain developmental milestones than I do. So yes, it never hurts to get a second opinion!

The other thing I encouraged this particular mother to think about was, “why does it matter whether he has autism or not?” I did not pose this question to make lite of the situation. Sometimes there is a good reason to have that diagnosis and we will talk about that reason in a minute. However, why is it so important that this child be labeled as “autistic?”

We know what the symptoms are. He’s 3 and not talking. He points or gestures for what he wants. He will guide his mother to what he wants, but he won’t ask for the item specifically. He can’t follow directions. He doesn’t respond to his name. He’s sensitive to sounds and textures. He isolates himself from others. He doesn’t engage with other kids. He doesn’t engage with other adults. There’s a lot that he can do, but he’s not following the typical developmental line.

My advice is that if we are aware of these developmental problems, then those are the things we will work on in therapy. Many of the children I work with at my clinic do not come with an official diagnosis. The referral form for many of these children simply says “delayed.” When I work with a child for the first time, I look at what they can do and what they can’t do and develop my treatment plan accordingly. I don’t really need a child to come to me with an official diagnosis in order to know how to work with them. In this case, if this child’s mother had brought her son to me for treatment, I wouldn’t have needed him to have a diagnosis of “autism” to help me create a plan of action. My own evaluation of the child’s abilities when he is in my treatment room, helps me develop an appropriate plan of action.

In this particular case, this child’s mother was waiting on a diagnosis in order to determine whether her child needed speech therapy, physical therapy or occupational therapy. What she didn’t understand was that she really didn’t need an official diagnosis. You can take your child to speech, occupational or physical therapist, and the therapists will examine your child’s abilities and determine a plan of action based on your child’s needs.

Now, that being said, there are certain instances where an official diagnosis may be necessary. One of those instances is when you are dealing with certain insurance plans. Some insurances will want that diagnosis in order to pay for the treatment. It’s not as common as it used to be, but some plans do require it. If that’s the case, then here is what I would do.

Go see another doctor who might be able to identify behaviors on the autism spectrum better. In this particular case, the doctor doesn’t appear to be as familiar with the signs of autism, otherwise he or she would have identified that the symptoms this mother was describing, were very much in line with autism spectrum disorder. The second thing I would do, is to get an appointment with a speech therapist or an occupational therapist. Therapists are typically very skilled in the insurance area and we often know how to approach insurance companies to get therapy treatments paid for. Therefore, even if you have to pay for that initial therapy appointment out of pocket, get it set up, so that your therapist can assist you in negotiations with your insurance provider. You’d be surprised at what we can do when it comes to insurance!

If you have any questions or concerns that you’d like me to address, please reach out to me. You can email me directly at

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Jason Spear Miller