Why Early Diagnosis Matters: A Guide to Neurodivergent Assessments for Families
Key Takeaways
“Neurodivergent” is just atypical neurological functioning.
Whoever makes the diagnosis determines the information you receive about your child.
Medical providers and educational institutions have different criteria for evaluation. Pediatricians may provide an initial diagnosis, but comprehensive evaluations by psychologists or neuropsychologists offer deeper insight into a child’s strengths, challenges, and support needs.
Diagnosis drives intervention, thus determining efficacy of those interventions.
Imagine taking your car into the automotive shop and saying, “It’s just not running well. Something’s off.” The mechanic responds with, “Well, sometimes it helps to replace the battery. Let’s try that first and see if it works.” When that doesn’t help, he says, “Well, it could be the brakes. Let’s try that out and see if it helps.” By the time the problem is found and correctly fixed, it can be a very costly undertaking. Now imagine if there is a problem with your child. Would you attempt to remediate the problem by just trying things out? That could be an even costlier undertaking than your automobile. Early diagnosis is important for neurodivergent individuals, but the manner you go about getting an evaluation and the information you get from such an assessment varies greatly depending on the choices you make for your child.
“Neurodivergence”
First, let’s talk about what a ‘neurodivergent individual’ is. Neurodivergence is just a general term that includes a variety of conditions involving atypical neurological functioning. These differences can be in social interaction, communication, attention, or learning and are often present since birth. That is why parental figures are most likely to first sense that something is not quite right. We all have strengths and weaknesses that can be considered differences, but the differences being identified here are usually somewhat more severe or interfere more with daily life. These differences often make the individual very different than their same aged peers. Neurodivergence may include autism spectrum disorder, attention-deficit/hyperactivity disorder, Tourette Syndrome, dyslexia, dyscalculia, sensory processing disorder, or dyspraxia.
Early Diagnosis Matters.
Often, the first individual who may diagnose neurodivergence is a child’s pediatrician or PCP. A diagnosis of neurodivergency by these individuals is based on your report and observations as there is no blood test or x-ray to identify this difference. While these professionals may provide a medical diagnosis, they don’t often do an in-depth evaluation identifying strengths and weaknesses of your child. The professional you turn to next may depend on the age of your child, but remember, the earlier the diagnosis the sooner interventions can begin. Around the age of 3 years old (or before), children can be evaluated using a variety of instruments. There are some options as to whom you entrust your child’s care.
Educational institutions are required under the Individuals with Education Improvement Act to identify children 3 years of age or older who may be considered disabled and, thus, receive interventions appropriate for their particular weaknesses. These evaluations must be provided free of charge and have a fixed timeline for completion. While an educational evaluation is necessary to receive interventions in the school system (including early childhood education for ages 3-5 years old), keep in mind the qualifications of the professionals vary greatly, especially in smaller school districts. Also, be aware that school districts have very different criteria for identification of a child with a disability than medical professionals have. While your child may be identified as a child with a disability in an educational setting, they may not be identified as a child with a disability as far as medical criteria is concerned, and vice versa. While these evaluations may be necessary to receive interventions, they may not be the best place to start.
Psychiatrists are medical professionals who diagnose and treat conditions and manage medication. While these individuals are highly qualified, they often are so overworked managing medications of their patients that they may prefer to have a psychologist or neuropsychologist complete the assessment first. Speech-language pathologists and occupational therapists often contribute to helping a child but they do not make medical diagnoses for neurodivergency. The best professional to assess your child for a neurodivergent condition is a psychologist, preferably a neuropsychologist. Clinical psychologists and neuropsychologists specialize in brain function and cognition, along with mental health disorders. An evaluation by a psychologist or neuropsychologist will identify a child’s strengths and weaknesses, and provide recommendations for ways to help your child. It is more than just a ‘label.’ Unfortunately, labels are necessary in today’s world in order for a child to obtain the help they need. Once a psychologist or neuropsychologist has evaluated your child, that evaluation can be shared with an educational institution and often little, to no, additional assessment is required. This would allow your child to receive services at no cost through the educational institution.
Getting Assessed.
An assessment may be somewhat anxiety inducing, but it is not difficult. There are some standardized assessment tools that may be used with your child, depending on his/her age. These tools must be administered in a prescribed way to insure standardization so that your child may be accurately compared to other children his/her age. This is not to belittle or speak ill of your child, but to determine those areas where his/her weaknesses are so that remediation and/or accommodation can be more efficiently identified and implemented. Some of these assessment tools are play based assessments, like the Autism Diagnostic Observation Scale-Second Edition (ADOS2) or the Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS2). Other assessment tools may be standardized, like cognitive assessments, academic assessments, or motor skill assessments. There are some performance based assessments that are computer administered, such as those for ADHD, and they can be invaluable in evaluating your child.
Probably the most important portions of an assessment are the interview, questionnaires, and observations. An interview with a child’s parent (and with the child if he/she is older) often provides the basis with which a psychologist or neuropsychologist starts to get a clearer picture of your child’s daily functioning. A psychologist is an expert on typical child development, but a parental figure is an expert on his/her own child. The interview is a vital portion of this assessment. Questionnaires and/or rating scales can be completed by parents, grandparents, teachers, or others who interact with your child on a regular basis. Determining how your child is functioning in a variety of contexts is often important to paint a bigger picture. If the child is old enough, he/she can complete questionnaires and/or rating scales as well. Observations are often vital to the assessment process. Placing a psychologist in a child’s typical environment is often not possible, or will change the child’s behavior, so your responses are important. Direct observation during assessment by the psychologist or psychometrist, however, can provide valuable information as well.
Once this has all been done, the psychologist or neuropsychologist will analyze all the data and will make some diagnostic determinations. Keep in mind that there may be one or more conditions that fall under the umbrella of neurodivergent. A psychologist has experience in helping to identify which condition may be contributing to specific behavior. He/she will also look at what your child does well and their struggles. A parental figure will then meet with the psychologist in order to receive the results, have them explained, and have any of their questions answered as completely as possible. Overall, the process is fairly innocuous, although it can be somewhat anxiety inducing waiting for results.
Just like the diagnostic process for your automobile, an assessment helps pinpoint what is creating the atypical functioning of your child. This saves time and leads interventions to be more efficient and effective. Without this assessment, interventions are a ‘shot in the dark’ at trying to assist your child. According to a 2020 study by Smithe, et al, “it is increasingly apparent that optimal early development has lifetime beneficial consequences for educational achievement, adult productivity and population health.” In turn “child development can be encouraged through intervention in early childhood.” In addition, Smithe, et al reported that “timely identification of children with developmental disabilities is required for early intervention, which strengthens the cumulative process of development, helping children acquire new skills and behaviors to reinforce and strengthen learning.” Early intervention is most effective because it is at this age that a child’s brain is most adaptable. Neural pathways are being built and pruned so it is vitally important to start interventions as soon as possible. It is because early intervention is so crucial that Head Start was launched in the 1960s and the Program for Infants and Toddlers with Disabilities was added in the 1986 reauthorization of IDEA. There are a variety of effective interventions, but those interventions are only effective if they are applied to the right disabilities, much like those automotive repairs we all dislike so much.
Author: Dr. Nancy McBride, PhD, LPC, ABSNP, NCSP
Last updated: 3/30/2026
