When Parents Should Consider a Re-Evaluation for Autism

Autism spectrum disorder (ASD) is a neurodevelopmental disorder that children are born with. It’s also a disorder that affects an individual for their entire life, as there is no cure for it.

Getting an ASD diagnosis at a young age is very important, because it enables children with autism to receive the proper support and interventions that can help them build skills, modify behaviors and live as independently as possible.

Even if your child has already received an ASD diagnosis and is undergoing applied behavior analysis, or ABA therapy, there are still reasons why you should consider getting a re-evaluation for autism.

Below, we’ll explain some times when parents should consider a re-evaluation for autism for their child.

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What is an Autism Re-Evaluation?

Autism evaluations are typically done by clinical psychologists, developmental pediatricians or other professionals who are specifically trained in the field. In order to diagnose ASD in a child, they must follow the principles outlined in the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5.

The initial evaluation process is in-depth.

The professional conducting the evaluation will have conversations with parents and caregivers to get a better sense of the child and their abilities and challenges. They will then conduct observations of the child, and potentially even interact with them directly.

After collecting and analyzing data, the professional can give an accurate ASD diagnosis if appropriate.

Autism re-evaluations follow much of the same process, though they typically aren’t as comprehensive as initial evaluations. That’s because the focus of an autism re-evaluation is to confirm that ASD is still present, according to the clinical criteria.

Reason for Re-Evaluation	Who Requires It	Frequency or Trigger	Purpose
Insurance	Insurance companies	Often annually or biannually	To continue coverage for services like ABA therapy
Schools	School districts	As required by IEP/504 guidelines	To retain educational accommodations and support
Benefits	State or federal benefit agencies (e.g., Medicaid, SSI)	Per agency schedule	To qualify or maintain eligibility for support programs

When Should Parents Consider a Re-Evaluation for Autism?

Since autism is a lifelong disorder, it’s natural to wonder why a re-evaluation would be necessary. In most cases, an autism re-evaluation is done to ensure your child can receive the necessary support services and accommodations they require, or that they continue to receive such services.

Here are some of the main reasons why an autism re-evaluation might be necessary.

Insurance

Most insurance companies require an official ASD diagnosis before they’ll cover related services, such as ABA therapy. Once the diagnosis is given and ABA therapy is recommended, insurance companies will provide children and their families with the coverage they need for whatever support services are appropriate.

It’s also very common for insurance companies to require autism re-evaluations to be conducted on a regular basis for the behavioral services to continue. The re-evaluation will confirm that your child’s diagnosis is still appropriate, and is consistent with the current criteria outlined by the DSM-5.

Schools

If your child is diagnosed with ASD, they will be eligible for many additional support services and accommodations at school. Depending on your child’s specific needs, this could range from a dedicated Individual Education Plan (IEP), certain accommodations such as access to a therapist under a 504 plan and much more.

These accommodations and services are guaranteed to your child by state and federal law. In many cases, your child’s school will require an autism re-evaluation every so often, just to confirm the diagnosis so they can keep the access they need to these accommodations and/or resources.

Benefits

Many state governments have laws in place that ensure private insurance coverage for children who have ASD. Children on the autism spectrum also often qualify for public health benefits as well.

Families who need financial assistance to provide the proper support for their child with autism might qualify for a Medicaid plan or even Supplemental Security Income (SSI) through the Social Security Administration.

Just like the programs above, children must have an official ASD diagnosis before they, or their parents, qualify for these programs. In addition, they might also be required to have an autism re-evaluation done on an annual basis, or according to another schedule.

Again, these autism re-evaluations are done to confirm the diagnosis and the fact that the needs are still the same for the child and their parents.

Stage or Trigger	Recommended Action	Reason
Initial ASD Diagnosis	Full comprehensive evaluation	To establish official diagnosis and begin support
1–2 Years After Diagnosis	Re-evaluation (if required)	To meet insurance or school eligibility timelines
Before Starting New School Year	Schedule re-evaluation if needed	To ensure accommodations remain in place
When Applying for Benefits	Ensure diagnosis documentation is current	Required for Medicaid/SSI or similar services

Blue Gems ABA Conducts Autism Evaluations

If you believe your child may have autism, it’s important to get them evaluated for ASD as early as possible. That’s because studies have shown that the earlier treatment plans can be put into place, the more effective they are.

An official ASD diagnosis also activates certain insurance coverage, public benefits and accommodations for your child and family.

At Blue Gems ABA, we have a team of trained professionals that conducts in-depth autism evaluations and reevaluations, and can accurately diagnose ASD. If ASD is diagnosed, we also have a team of experienced BCBAs that administers ABA therapy on a one-to-one basis, helping children on the autism spectrum build the social, communication and daily life skills with which they commonly struggle.

To learn more, please contact us today.