Autism Facts Assessment Testing
Autism Testing in San Jose — Adults and Children
Most adults who come to me for an autism evaluation have already been given a different diagnosis. Sometimes several.
Anxiety. ADHD. Social anxiety. A personality disorder. Depression. Sometimes those were correct and sometimes they were what a clinician reached for when the picture didn’t resolve. Autism presents subtly in adults, and especially in women, and it is routinely missed for decades.
An autism evaluation is not a checklist. It’s a structured process of ruling out and ruling in — and the ruling out is most of the work.
What an autism evaluation involves
An autism spectrum evaluation is sometimes similar in structure to a learning disability evaluation. Many components of the neuropsychological testing are the same, but if someone is high functioning, and poses no language issues, the process is different.
A complete assessment usually includes:
- Assessment of intelligence
- Clinical interview
- Collateral information from multiple sources
- Academic functioning
- Executive functioning
- Learning and memory
- Adaptive functioning
- Pragmatic and social language ability
- Mental health variables
- Visual-motor skills
- Evaluation of autism-related behavior, both currently and across the person’s history
An autism evaluation typically requires one long visits and “occasionally” a second short visit, depending on the presentation and on what the evaluation needs to accomplish.
Why the ruling out matters
Compiling an autism diagnosis takes an intense amount of background investigation and a great deal of psychological and neuropsychological testing.
Ruling out additional or conflicting conditions, detailed testing, and a significant amount of collateral information from multiple sources is the best way to diagnose an autism spectrum disorder. A brief interview and a questionnaire cannot do it.
This matters in both directions. A missed autism diagnosis costs someone years of being treated for the wrong thing. An autism diagnosis assigned without ruling out the alternatives can be rejected by the agency, school, or program you needed it for — and it can send treatment in a direction that doesn’t help.
The evaluation is built around what you need it to do
An individualized assessment is necessary, and it depends on your goals — or your child’s.
If the goal is access to San Andreas Regional Center services, or another local Regional Center, the documentation has to meet that agency’s criteria. If the goal is an IEP or a 504 plan, the school district has its own standards. If the goal is simply understanding — for an adult who has spent thirty years wondering — the evaluation looks different again.
The more stringent the agency’s guidelines, the more comprehensive and detailed the assessment needs to be. Tell us which door you’re trying to open, and the evaluation gets built for that door.
What changed in the DSM-5
Autism is now classified as a spectrum-based disorder. Asperger’s Disorder is no longer a separate diagnostic possibility under the DSM-5. If you were diagnosed with Asperger’s before 2013, that diagnosis is still real — the manual reorganized, not your history.
Social (Pragmatic) Communication Disorder is a separate DSM-5 diagnosis. It describes someone who does not meet the full criteria for autism — specifically, the restricted and repetitive patterns of behavior — but who still has the pragmatic language differences that create social difficulty. In some cases, a person previously diagnosed with Asperger’s meets this condition rather than autism, if a well-established prior diagnosis isn’t documented. This is a controversial diagnosis, and requires a very careful analysis.
That distinction has real consequences for services, so it’s worth getting right rather than assumed.
Current prevalence
From the CDC’s Autism and Developmental Disabilities Monitoring Network, 2022 surveillance year, published April 2025:
- About 1 in 31 (3.2%) eight-year-old children in the United States were identified with autism spectrum disorder — up from 1 in 36 in the 2020 data
- Prevalence is 3.4 times higher in boys than in girls
- Autism is identified in every racial, ethnic, and socioeconomic group
The CDC has not concluded whether the increase reflects a true rise in prevalence or improved identification. Broader diagnostic criteria, better screening, and better access in previously underserved communities all contribute.
The girls-and-women figure is the one worth sitting with. A 3.4-to-1 ratio in identified cases does not mean autism is 3.4 times less common in girls. It means girls are diagnosed less often, later, and after more wrong answers.
Adult autism evaluation
Late diagnosis and subtle presentation are difficult work. Difficult is not the same as impossible.
Adults generally require less in-depth cognitive testing than children do, but more historical reconstruction — because the diagnosis depends on developmental history, and yours is thirty or fifty years back. That means collateral sources, school records where they exist, and careful interviewing about a childhood you may remember unevenly.
It also means taking seriously that you might be right. Adults who arrive having researched this themselves are usually not wrong to be asking. They are frequently wrong about which parts are autism and which are something else, and that distinction is the entire purpose of the evaluation.
Where the testing happens
My office is at 1120 McKendrie Street in San Jose, in the Rose Garden area off The Alameda.
People come here from across Santa Clara County, from Santa Cruz over the hill, and from up the Peninsula. Because an autism evaluation runs 6 to 12 hours across 1 to 3 visits, it’s worth knowing the travel up front — and worth knowing that it isn’t an open-ended series of appointments.
If you need testing accommodations
If the goal is documentation for the MCAT, LSAT, the Bar, the GRE, or a university, that’s different work with different requirements and different deadlines. Start here instead.
What it costs
Diagnostic evaluations run $6,500 to $7,500, depending on complexity. It’s a flat fee. I don’t take insurance, though many people recover part of the cost afterward — here’s how fees work, including what a PPO typically reimburses and the codes you’ll need.
Some plans have specific autism provisions and reimburse considerably more. It’s worth calling your insurer before you assume.
If the fee isn’t workable, say so. If an evaluation isn’t the right thing for your question at all, I’ll tell you that, and it won’t cost you anything to find out.
Start here
Call. 321-208-1554 or 321-298-8668
Tell us the question you’re trying to answer, and what the evaluation needs to accomplish — Regional Center, an IEP, a 504, or simply knowing. Jessie will tell you what’s involved, what it costs, how long it takes, and what an evaluation can and cannot determine.
No pressure at any point. Some people who call don’t need an evaluation at all, and we tell them so.