You do not need a diagnosis
to start.
This comes up on almost every first call, and it is usually phrased as an apology. I think I might be autistic, but I have never been tested. I was told I had ADHD as a kid and nobody wrote it down. I do not want to waste your time if I am wrong. You are not wasting my time. You do not need a piece of paper to be allowed in the room.
I am pragmatic about this.
Half the music this city is famous for was made by people who never learned to read a chart. Nobody asked Professor Longhair for paperwork. Tell me what is not working and we have somewhere to start, because most of what brings people in was never going to fit tidily in a category anyway, and sitting in the waiting list for an evaluation can cost you a year you did not have to spend.
Tell me what is not working. That is the whole entry requirement.
A transcription
is not a performance.
You may well want both of these and they are not rivals. A good evaluation is a careful transcription of what has been playing all along. It is slow, skilled work that sits outside my training, and the people who do it properly earn their fee.
Therapy is the playing. A transcription tells you what the notes were. It will not tell you how to sit in with a band on Tuesday night, and the people I see who arrive holding a good report have usually worked that out already.
When testing is worth paying for.
Sometimes the paperwork is the point, and there are four situations where I will tell you to go get it. An employer or a school asking for documentation. A prescriber who needs something on file before writing for stimulants. A disability or legal process with its own rules. And the fourth is simply that some people cannot let the question go until somebody qualified has sat with it, which I have never found to be a bad reason.
Outside those four, the assessment is often a delay dressed up as diligence.
Where my job ends.
Testing is its own discipline and I do not do it. What I do is the hour, and the hour does not wait on anybody’s report. If it turns out along the way that an evaluation would help, you will hear it from me first, and I will help you weigh the choices rather than emailing you a list of names. That is the same coordination I do with your prescriber and your physician when there is one.
Working it out on your own
is not nothing.
A lot of people get here sideways. A child gets assessed, a parent reads the criteria over their shoulder, and something about their own school years stops adding up. That route is common and it is not a lesser route. The criteria were drawn largely from studies of boys, which is one documented reason women reach this question decades late.1
Recognising it yourself at thirty eight makes you somebody who spotted what the system was built to miss. Bring it to the first call and we will start there. The specifics live on their own pages: ADHD, autism, and both at once.
What people ask on that first call.
Do I need a diagnosis to start therapy?
No. Bring the pattern you would describe first. That is enough to begin with, and it is usually more useful than a report.
Will you run testing?
No. I do the therapy. If a formal evaluation would serve you, I will help you find someone good and choose among the options, the same way I coordinate the rest of your care.
I was assessed as a child. Does that still count?
Often yes, though the criteria have moved since. Bring what you have and we will work out together whether anything needs revisiting.
- Rynkiewicz A, et al. Girls and women with autism. Psychiatria Polska, 2019. doi.org/10.12740/PP/OnlineFirst/95098
Start by ear.
The first consultation is free, by phone or video, and there is nothing to prepare. No records, no history, no right words required. Virtual across Louisiana, insurance and private pay. What is the pattern you would describe first?
Currently accepting new clients. I reply within 24 hours.