Wondering how to get an autism evaluation in Virginia for a child, teen, or adult? This guide breaks down who can diagnose autism, how the process works across ages, what paperwork to gather, how insurance and Medicaid fit in, and where to find trusted help statewide. We also show how Norfolk Autism Center supports families at each step.
What An Autism Diagnosis Means
A diagnosis confirms that communication, social interaction, and behavior patterns meet criteria for autism spectrum disorder using standardized criteria. Clinicians rely on caregiver history, developmental records, and direct observation, often with validated tools. For a plain-language overview of diagnostic steps, review the CDC page on clinical testing and diagnosis for autism.
Who Can Diagnose Autism In Virginia
For medical diagnosis, evaluation is typically completed by a licensed clinical psychologist, developmental pediatrician, child and adolescent psychiatrist, or neurologist. Qualified speech-language pathologists and occupational therapists often contribute standardized assessments that inform the diagnostic decision. Primary care clinicians screen and then refer to diagnostic specialists.
Schools can determine special education eligibility under the category of autism for services. This is not the same as a medical diagnosis, but it can unlock individualized education program supports. See the Virginia Department of Education overview of Autism Spectrum Disorder eligibility.
Screening vs. Diagnosis
Screening flags developmental differences that may warrant a full evaluation. The American Academy of Pediatrics recommends autism-specific screening at 18 and 24 months, with ongoing developmental screening at regular well-child visits. Learn more from the CDC’s guidance on autism screening in primary care and the AAP’s autism recommendations.
How Diagnosis Works For Babies And Toddlers
If your child is under 3, start with Virginia’s Part C Early Intervention system. The Infant & Toddler Connection of Virginia coordinates developmental evaluations, service planning, and referrals. Families can self-refer, and services are available statewide. Visit the Infant & Toddler Connection of Virginia to find your local program. Virginia Medicaid also describes how EI works on its Early Intervention member page.
During early intervention, teams may recommend a medical diagnostic evaluation with a developmental pediatrician or psychologist. Continue regular pediatric visits and use milestone tools like the CDC’s developmental milestones and the 18-month checklist.
How Diagnosis Works For Preschool- And School-Age Children
Families have two tracks that can run in parallel. One is a medical diagnosis through a clinician. The other is a school evaluation for special education eligibility. You may request a school evaluation in writing at any time. VDOE explains the steps and timelines at Evaluation and Eligibility for Special Education. For a parent-friendly walk-through, see the state’s Virginia Family Guide to Special Education and the VDOE Video Guide to the Special Education Evaluation Process.
Tip: A school eligibility decision does not automatically equal a medical diagnosis, and insurers often require a medical diagnosis for treatment coverage. Keep both processes moving when possible.
How Autism Diagnosis Works For Teens And Adults
Adults can ask a primary care clinician for a referral to a psychologist or psychiatrist who evaluates autism in adults. Nonprofit directories can help you identify evaluators statewide. See the Autism Society of Central Virginia’s Adult Evaluation Providers and the broader ASCV Resource Directory. Virginia’s vocational rehabilitation agency also supports job readiness for autistic adults. Learn about DARS Autism Services. NAC specifically treats children, not adults, after diagnosis.
What To Expect During A Diagnostic Evaluation
Clinicians review medical and developmental history, school or therapy records, and caregiver questionnaires. They observe communication, social reciprocity, play, repetitive behaviors, and sensory responses. Teams may use gold-standard tools such as structured caregiver interviews and play-based observations, alongside cognitive and language testing. The CDC summarizes typical clinical elements on its diagnosis page.
Bring copies of prior reports, individualized education plans, therapy notes, and any milestone logs. If you need help organizing records, our team can share a simple prep checklist during your first call.
Insurance, Medicaid & Costs
Private plans usually require a formal diagnosis for treatment coverage. For children and teens enrolled in Virginia Medicaid or FAMIS Plus, the EPSDT benefit covers medically necessary screening, diagnostic services, and treatment up to age 21. See the DMAS page on EPSDT. Applied behavior analysis coverage details are outlined in the DMAS ABA services FAQs.
Families who need long-term home and community support may explore Developmental Disability Medicaid waivers. There is a state waiting list, and screening starts with your local Community Services Board. Read DMAS’s overview of DD Waivers and DBHDS guidance on Waiver Services. For quick help connecting with local services, dial 2-1-1 Virginia.
How Long The Process Takes
Timelines vary by provider availability, insurance authorization, and whether you pursue school evaluation, medical diagnosis, or both. Early intervention can start before a formal medical diagnosis when developmental delays are present. Schools follow state timelines for eligibility once you consent to evaluation. If you encounter waitlists, ask to be placed on a cancellation list and request interim support from your pediatrician and school team.
Step-By-Step: Starting Today
1) If your child is under 3: Call your local Infant & Toddler Connection program and your pediatrician. Keep pediatric well-visits and complete recommended screenings. Start a binder for paperwork. Use the CDC milestone checklists to track observations.
2) If your child is 3 to 21: Submit a written school evaluation request to the special education administrator and contact a diagnostic clinician for a medical evaluation. You can do both. Share teacher observations, report cards, and prior assessments.
3) If you are an adult: Ask your primary care clinician for referrals, review nonprofit directories, and call your local CSB for information on supports. If work goals are a priority, contact DARS Autism Services.
4) If you need help now: Call 2-1-1 Virginia for statewide information and referrals. For local help getting started with therapy services and family training, contact Norfolk Autism Center.
Documents To Gather Before Your Appointment
Collect birth and medical history, vaccination records, past evaluations, therapy notes, IEP or 504 plans, behavior logs, milestone checklists, and any videos that show communication or behavior concerns. If you do not have copies, sign releases so your new evaluator can request them from prior providers and the school.
School Evaluation Tips For Families
Make your evaluation request in writing and keep a copy with the date submitted. Schools review referrals, seek consent, and evaluate using multiple sources of data. Eligibility requires evidence of an adverse educational impact and the need for specially designed instruction. Learn the steps on VDOE’s Evaluation and Eligibility page and bookmark the Virginia Family Special Education Connection FAQs.
Finding Evaluators And Local Support
Nonprofit directories can shorten your search. The Autism Society of Central Virginia maintains a statewide resource directory that includes adult evaluation providers. Virginia’s university partners curate training and links; see the VCU Autism Center’s Virginia Autism Resource Center. If you need help navigating waivers or local providers, DBHDS points families to “My Life, My Community” and your local CSB. Use the VACSB CSB/BHA Directory to locate the board that serves your area.
How Norfolk Autism Center Can Help
We can share referral lists for diagnostic specialists, help you prepare for evaluation, and coordinate with your pediatrician and school. After diagnosis, we provide center-based ABA therapy, home-based services, and structured family training. Learn more about Early Intervention, our Parent Resources, and common questions in our FAQ. When you are ready, contact us for a no-obligation consultation.
Frequently Asked Questions
Do I need a diagnosis before the school will help? No. Schools evaluate for special education eligibility under state rules. A medical diagnosis can help, but it is not required for school services.
Do I need a diagnosis before therapy starts? Private insurance and Medicaid usually require a medical diagnosis for ABA coverage. Early intervention services for children under 3 can begin based on developmental delay.
How much does an evaluation cost? Costs vary by clinician and insurance. EPSDT covers medically necessary screening, diagnostic services, and treatment for Medicaid members under 21. Always request a cost estimate from the evaluating provider and confirm benefits with your plan.
How do I speed things up? Ask to join cancellation lists, complete intake paperwork quickly, and gather records in advance. For school, submit your request in writing and respond to consent forms promptly.
Key Takeaways
Start screening early, run school and medical paths in parallel, keep records organized, and use statewide resources to reduce delays. If you need a starting point, reach out to Norfolk Autism Center, and we will help you map next steps.
