How to get an autism diagnosis for your child in New Jersey

A diagnosis is usually the first thing insurance needs before it will cover ABA therapy. Getting one can feel confusing, and waiting lists can be long. These are the steps that move things along fastest.

Step 1: Talk to your pediatrician

Tell your child's doctor what you've noticed and ask for an autism screening. Pediatricians are advised to screen all children at 18 and 24 months, but you can ask at any age. The screening is a short questionnaire. If it shows concerns, ask for a referral for a full evaluation.

Step 2: If your child is under 3, call Early Intervention

The New Jersey Early Intervention System serves children from birth to age 3 with developmental delays. You can refer your child yourself at 888-653-4463. The evaluation is free, and children with an autism diagnosis are eligible for services. Early Intervention can start helping while you wait for a full autism evaluation.

Step 3: Book a full evaluation with a specialist

Autism is diagnosed by trained specialists, such as:

• Developmental-behavioral pediatricians
• Child psychologists or neuropsychologists
• Pediatric neurologists
• Child psychiatrists

Make sure the specialist is in your child's insurance network. If your child has NJ FamilyCare, call the member services number on the back of the card and ask for a list of in-network providers who do autism evaluations. With private insurance, use your plan's provider search or call member services.

Tips for long waiting lists

• Call several providers, not just one, and take the first good appointment.
• Ask to be put on the cancellation list.
• Ask whether a different clinician in the same practice has earlier openings.
• Keep the referral from your pediatrician handy; some offices need it before they will book.

What to bring to the evaluation

• Your notes about what you've noticed, with examples and ages
• Short videos of the behaviors that worry you
• Reports from Early Intervention, daycare or school, and any speech or occupational therapy
• Your child's insurance card

What the report should include

Insurance plans review the written report before approving ABA. Ask the evaluator to include:

• The diagnosis (autism spectrum disorder)
• A recommendation for ABA therapy
• The evaluator's name, credentials and signature

Ask for a copy of the full report for your records. You'll share it with your ABA provider.

You can talk to an ABA provider before the diagnosis

At Little Haven, you can apply even if you don't have the diagnosis yet. We'll check your insurance for free, explain what your plan requires, and be ready to start the moment the report comes in.

Sources: CDC, Screening and diagnosis; Autism New Jersey, Early Intervention; Autism New Jersey, NJ FamilyCare autism benefit.