Category: ADHD

The Waitlist Crisis: Understanding the Implications of Lengthy Psychological Testing Waitlists for Children

In ADHD, Autism, Psychoeducational Assessment

February 3, 2025

For many families, seeking a psychological evaluation for their child is an important step toward getting the right support, whether for ADHD, autism, or learning challenges. Unfortunately, a growing crisis in mental health services has led to extremely long waitlists for these crucial assessments, particularly at large hospital-based clinics.

In many cases, families are left waiting six months to two years for an evaluation—an agonizing delay when early intervention is key. During this time, children may continue struggling in school, at home, and socially, without the accommodations or interventions they desperately need.

So, what are the pros and cons of waiting for a hospital-based evaluation? What are the potential consequences of delaying testing? And most importantly, are there faster alternatives to getting answers?

The Reality of Long Waitlists

Large hospital systems and academic medical centers are often the first places parents turn when they suspect their child has ADHD, autism, or a learning disability. These institutions are trusted, well-known, and may even be recommended by pediatricians, teachers, or school psychologists.

However, due to high demand, a shortage of specialists, and systemic inefficiencies, these clinics often have waitlists that extend well beyond a year—and in some cases, beyond two years for a full neurodevelopmental evaluation.

Why Are the Waitlists So Long?

Several factors contribute to these excessive delays:

  • Increased Awareness & Demand – More parents, educators, and medical professionals recognize the importance of early diagnosis, leading to a surge in referrals for evaluations.
  • Limited Number of Specialists – There simply aren’t enough clinical psychologists, neuropsychologists, and developmental specialists to meet the demand.
  • Systemic Inefficiencies – Large institutions often have cumbersome scheduling systems, bureaucratic processes, and insurance requirements that slow things down.
  • Multi-Step Processes – Some hospital-based evaluations require separate appointments with multiple specialists, which extends the overall timeline.
  • COVID-19 Backlog – The pandemic caused massive disruptions in healthcare services, creating a backlog that many clinics are still struggling to clear.

While waiting, parents are left in limbo, unable to get a diagnosis or access the necessary accommodations at school, therapy, or medication options.

So, is it worth sticking it out on a long waitlist, or are there better alternatives?

The Pros and Cons of Waiting for a Large Hospital-Based Evaluation

Potential Benefits of Waiting

While long waitlists are frustrating, some families feel that waiting for a hospital-based evaluation is worth it. Here’s why:

1. Access to Multidisciplinary Teams

One advantage of hospital-based clinics is their access to teams of specialists who can collaborate on complex cases. These teams may include:

  • Clinical psychologists & neuropsychologists (for cognitive and emotional assessments)
  • Speech-language pathologists (for communication and language concerns)
  • Occupational therapists (for sensory and motor issues)
  • Developmental pediatricians (for medical and genetic evaluations)

For children with severe medical conditions, such as those with suspected seizure disorders, genetic syndromes, or complex medical histories, a hospital-based evaluation may be beneficial because they can coordinate medical tests (like EEGs or MRIs) alongside psychological testing.

2. Specialized Research-Based Clinics

Some hospital-based programs participate in ongoing clinical research, which may give families access to experimental treatments, clinical trials, or research-driven interventions that aren’t yet widely available. These programs are typically focused on specific diagnoses or rare conditions, meaning they may not be the best fit for children with more common concerns like ADHD or general learning difficulties.

3. Connections to Hospital-Based Services

If a child receives a diagnosis through a hospital system, they may have easier access to hospital-affiliated therapy programs, medication management, and intervention services. This can be particularly useful for families who plan to pursue ongoing treatment within the same system.

3. Connections to Hospital-Based Services

If a child receives a diagnosis through a hospital system, they may have easier access to hospital-affiliated therapy programs, medication management, and intervention services. This can be particularly useful for families who plan to pursue ongoing treatment within the same system.

The Downsides of Long Waitlists

Despite these advantages, waiting for an extended period without a diagnosis comes with significant risks.

1. Critical Delays in Intervention

The earlier a child receives support, the better the outcomes. Studies show that early intervention is key for children with:

  • ADHD – Untreated attention and executive functioning challenges can lead to academic struggles, frustration, and low self-esteem.
  • Autism – Without early intervention, children may miss out on critical social, communication, and behavioral supports.
  • Learning Disabilities – A lack of proper accommodations can cause children to fall further behind in school, making it harder to catch up later.

Without a diagnosis, many schools won’t offer accommodations, leaving kids without the tools they need to succeed.

2. Increased Family Stress

The waiting period can be extremely stressful for families. Parents often feel helpless watching their child struggle but are unable to take action without a formal evaluation. This can lead to:

  • Emotional exhaustion
  • Increased conflict at home
  • Anxiety about the future

Additionally, navigating insurance approvals, school requests, and medical referrals during this time can feel overwhelming.

3. Potential Worsening of Symptoms

Children who struggle without support may develop secondary issues, such as:

  • Anxiety & Depression – Feeling “different” without understanding why can lead to mental health struggles.
  • Behavioral Problems – Frustration from unrecognized challenges can lead to acting out at home or school.
  • Low Self-Esteem – Repeated failures or negative feedback can damage confidence and motivation.

These secondary issues often persist even after a child finally gets a diagnosis, making treatment even more complicated.

4. Rigid Evaluation Processes

While hospital-based evaluations are often high-quality, they may not always be flexible or individualized. Some programs follow strict protocols and do not allow parents to tailor the evaluation to their specific concerns.

For example, some hospital clinics only diagnose autism but won’t assess for ADHD or learning disabilities in the same evaluation, requiring separate waitlists for each concern.

Are There Alternatives to the Long Waitlists?

Yes! Many private practices and independent psychological testing providers  offer high-quality, comprehensive evaluations without the extended wait times.

The Benefits of Private Psychological Testing:

✅ Faster Access to Answers – Many private practices can complete an evaluation within weeks rather than months or years.

✅ Personalized & Flexible Testing – Independent psychologists can customize assessments based on the child’s unique concerns rather than following a one-size-fits-all model.

✅ Immediate School & Treatment Planning – A quicker diagnosis means that schools, therapists, and doctors can act sooner, getting a child the support they need when they need it.

✅ More Availability for Follow-Up – Some hospital-based clinics provide assessments but offer limited follow-up guidance, whereas private providers can be more accessible for ongoing questions and recommendations.

The Bottom Line

If your child is facing significant challenges and you’re stuck on a months- or years-long waitlist, it’s worth considering other options. While hospital-based evaluations have their place—especially for complex, multidisciplinary cases—the reality is that most children don’t need to wait that long to receive high-quality psychological testing.

Seeking a private evaluation can mean the difference between waiting years for answers or getting the support your child needs now. If you’re concerned about your child’s development, exploring alternatives may be the best step forward.

—Dr. David Butman, Psy.D. is a licensed clinical psychologist and founder of Keystone Psychological Testing & Consulting, a private assessment practice in Doylestown, PA. He specializes in the assessment of ADHD, Autism, learning difficulties, emotional and behavioral challenges, executive functioning, attention, and giftedness.

Understanding Psychoeducational Testing: Benefits for Students, Schools, and Parents

In ADHD, Psychoeducational Assessment

April 24, 2023:

Psychoeducational testing is a valuable tool used by psychologists to assess a student’s cognitive, academic, and emotional functioning. Through a series of standardized tests and assessments, psychologists can gain insights into a student’s strengths, weaknesses, and areas that may require additional support. This comprehensive evaluation can provide essential information to educators, students, and parents, aiding in the development of tailored educational plans that maximize a student’s potential. In this blog post, we will explore the process of psychoeducational testing, the reasons one might seek such testing, and the benefits it offers for students, schools, and parents.

What is Psychoeducational Testing?

Psychoeducational testing is a process that involves the assessment of various aspects of a student’s cognitive, academic, and emotional functioning. It typically includes a combination of intelligence tests, academic achievement tests, and assessments to evaluate memory, attention, and processing speed. Additionally, psychologists may assess a student’s social, emotional, and behavioral functioning through interviews, questionnaires, and observation. The results of these assessments help psychologists to identify potential learning difficulties, such as dyslexia, attention-deficit/hyperactivity disorder (ADHD), or autism spectrum disorder (ASD), and provide recommendations for appropriate interventions and accommodations.

Why Seek Psychoeducational Testing?

There are several reasons why a student, parent, or educator may seek psychoeducational testing. A student may be struggling academically or experiencing difficulties in social or emotional functioning. Teachers and parents may notice a gap between a student’s potential and their actual performance or observe that a student requires additional support or accommodations to succeed. In other cases, a student may already have a diagnosis, and psychoeducational testing can provide a deeper understanding of the student’s needs and help refine their educational plan.

Benefits of Psychoeducational Testing:

The benefits of psychoeducational testing are numerous, ranging from providing a comprehensive understanding of a student’s cognitive, academic, and emotional profile to identifying the root causes of any learning difficulties. This information can be invaluable in creating a tailored educational plan that addresses the student’s unique needs and maximizes their potential. Early identification and intervention can lead to improved academic performance, increased self-esteem, and reduced frustration and anxiety for the student.

How Psychoeducational Testing Helps Students, Schools, and Parents:

For students, psychoeducational testing can provide insights into their learning style, strengths, and areas that require support. This information can empower students to become more effective learners and self-advocates. For schools, understanding a student’s needs can lead to more effective educational planning, including the development of individualized education programs (IEPs) or 504 plans. These plans outline specific accommodations, modifications, and interventions that help ensure the student receives an equitable education. Furthermore, psychoeducational testing can provide valuable data to schools, enabling them to allocate resources effectively and design targeted interventions to support student success.

For parents, psychoeducational testing can provide a clearer understanding of their child’s learning profile, enabling them to become more effective advocates for their child’s educational needs. By gaining insights into their child’s strengths and weaknesses, parents can better support their child’s learning at home and collaborate with educators to ensure appropriate interventions and accommodations are in place. Additionally, psychoeducational testing can provide parents with the tools and resources necessary to navigate the complex world of special education services and make informed decisions about their child’s educational journey.

In conclusion, psychoeducational testing is a powerful tool that can benefit students, schools, and parents. By providing a comprehensive understanding of a student’s cognitive, academic, and emotional functioning, this testing can lead to tailored educational plans, early intervention, and improved outcomes for students facing learning challenges. As a collaborative process, psychoeducational testing helps foster stronger relationships between students, parents, and educators, ensuring that everyone involved in a student’s educational journey is working towards the same goals.

Building a Support Network:

Psychoeducational testing not only benefits the individuals directly involved, but it also has a broader impact on the community. A well-informed support network, consisting of teachers, school administrators, and mental health professionals, can work together to create an inclusive and accommodating educational environment. By sharing knowledge and resources, these professionals can help build a community that recognizes and values the diverse learning needs of its students.

The benefits of psychoeducational testing extend beyond the immediate impact on a student’s education. By identifying and addressing learning difficulties early in a student’s academic journey, they are more likely to develop the skills and strategies needed to succeed throughout their education and into adulthood. This early intervention can lead to increased college and career readiness, improved social and emotional well-being, and greater resilience in the face of challenges.

Removing Stigma and Promoting Understanding:

Psychoeducational testing can also help reduce stigma and promote understanding surrounding learning differences. By fostering greater awareness and empathy within schools and communities, students with learning difficulties are more likely to be met with support and acceptance. This shift in attitude can create a more inclusive environment in which all students can thrive, regardless of their unique learning needs.

In summary, psychoeducational testing is a critical component in identifying and addressing the diverse learning needs of students. By providing comprehensive evaluations, tailored educational plans, and fostering strong support networks, this process can have a profound impact on the lives of students, parents, and educators alike. Embracing psychoeducational testing as a valuable resource helps create more inclusive, equitable, and successful educational environments for all students.

Common Learning Disorders

It is important to note that learning disorders are not the result of a lack of intelligence or motivation, but rather are neurological disorders that affect the way the brain processes different types of information.

Dyslexia (Reading Disorder) is a learning disorder that affects reading. It is characterized by difficulty with decoding, or breaking down words into individual sounds and understanding their meanings. People with dyslexia may have trouble with reading fluency, comprehension, and spelling. Dyslexia is a neurological disorder that is often inherited and typically becomes apparent when a child starts learning to read. There are different types of dyslexia, including phonological dyslexia, which affects the ability to process sounds in language; surface dyslexia, which affects the ability to recognize written words; and mixed dyslexia, which combines elements of both phonological and surface dyslexia. Dyslexia can range in severity and may be present along with other learning disorders or attention-deficit hyperactivity disorder (ADHD). Dyslexia is often treated with accommodations, such as the use of assistive technology, and with specific interventions that focus on improving reading skills.

Dyscalculia (Math Disorder) is a learning disorder that affects math. It is characterized by difficulty with math concepts such as quantity, size, and relationship between numbers. People with dyscalculia may have trouble with basic math skills, such as counting and understanding math symbols. Dyscalculia can also affect higher level math skills, such as algebra and geometry.

Dysgraphia (Writing Disorder) is a learning disorder that affects writing. It is characterized by difficulty with the physical act of writing, including issues with handwriting, spelling, and the ability to express thoughts in writing. People with dysgraphia may have trouble with the proper formation of letters, difficulty spacing words and letters correctly, and difficulty organizing their thoughts on paper. Dysgraphia can also affect reading and math skills. It can be treated with accommodations, such as the use of assistive technology, and with specific interventions that focus on improving writing skills.

—Dr. David Butman, Psy.D. is a licensed clinical psychologist and founder of Keystone Psychological Testing & Consulting, a private assessment practice in Doylestown, PA. He specializes in the assessment of ADHD, learning difficulties, emotional and behavioral challenges, executive functioning, attention, and giftedness.

How ADHD Affects a Child’s Self-Esteem, Mood, and Relationships

In ADHD, Psychoeducational Assessment

April 10, 2023:

Attention Deficit Hyperactivity Disorder (ADHD) affects millions of children worldwide, yet it remains a widely misunderstood condition. Children with ADHD face unique challenges that can impact their self-esteem, mood, and relationships with peers and adults. In this post, we will explore the effects of ADHD on a child’s self-esteem and overall mood, the way children with untreated ADHD may be perceived by others, and share a case study of a 9-year-old boy named “Alex.” We will see how his diagnosis and treatment helped him overcome the challenges he faced, eventually improving his self-confidence and relationships with others.

The Impact of ADHD on a Child’s Self-Esteem and Mood

ADHD can greatly impact a child’s self-esteem and overall mood. Children with ADHD often struggle with impulsivity, hyperactivity, and inattention, which can lead to difficulties in school and social situations. As they consistently face these challenges, it’s common for their self-esteem to take a hit. They might start to believe that they are not as capable or intelligent as their peers, which can trigger feelings of frustration, sadness, and even depression.

How ADHD Affects Relationships with Peers and Adults

Children with untreated ADHD may face misunderstandings and misperceptions from their peers and adults who are not familiar with the condition. Their inattention and hyperactivity can be seen as disruptive, while their impulsivity may lead to conflicts with peers. As a result, they may be labeled as “troublemakers” or “difficult” by adults and face social exclusion and bullying from peers. This can further exacerbate their low self-esteem and negatively affect their mood.

ADHD can significantly impact a child’s social life in various ways, often leading to difficulties in forming and maintaining meaningful relationships with their peers. One of the primary reasons behind these social challenges is the inherent impulsivity that accompanies ADHD. Children with ADHD may struggle to control their impulses and may inadvertently interrupt others during conversations, act without thinking, or have difficulty waiting their turn in games or group activities. These behaviors can be perceived as rude or inconsiderate, causing other children to feel irritated or offended. For example, a child with ADHD may blurt out an answer in class without raising their hand, which can lead to reprimands from teachers and annoyance from classmates. Over time, these interactions can lead to social exclusion, as peers may be less inclined to invite the child with ADHD to playdates or other social gatherings.

Moreover, the inattention and hyperactivity associated with ADHD can also hinder a child’s ability to engage in cooperative play and develop essential social skills. Children with ADHD may find it challenging to follow the rules of a game, pay attention during group activities, or stay focused on conversations with friends. This can create misunderstandings and frustration among their peers, as they may perceive the child with ADHD as uninterested or unwilling to participate. For instance, a child with ADHD might have trouble concentrating on a group project, leading their classmates to believe they are not committed to the task at hand. Additionally, the constant need for stimulation and high energy levels in children with ADHD can make it difficult for them to engage in quieter, more focused activities that often serve as opportunities for bonding and friendship-building. As a result, children with ADHD may miss out on valuable social experiences, further exacerbating feelings of isolation and low self-esteem.

Case Study: Alex’s Journey

Alex, a 9-year-old boy, began to display signs of ADHD in early elementary school. He was easily distracted, had trouble sitting still, and frequently interrupted others. As a result, he struggled to keep up with schoolwork and had difficulty making friends. His teachers became increasingly frustrated with his behavior, and his peers started to avoid him. Alex’s self-esteem plummeted, and he began to feel isolated and unhappy.

After several meetings with his school counselor, Alex’s parents decided to have him assessed by a psychologist who specialized in ADHD. Following a thorough evaluation, the psychologist diagnosed Alex with ADHD and recommended a combination of medication, therapy, and school accommodations.

With the proper treatment in place, Alex’s life began to change. The medication helped him manage his impulsivity and hyperactivity, while therapy sessions provided him with coping strategies to handle his inattention. His school was supportive, providing accommodations like extra time on tests and preferential seating to minimize distractions.

As a result of these interventions, Alex’s behavior improved significantly. His academic performance increased, and he began to develop healthier relationships with his peers. Most importantly, Alex’s self-esteem started to improve. He realized that he was just as capable as his classmates, and he began to feel more confident in his abilities.

ADHD can have profound effects on a child’s self-esteem, mood, and relationships with others. However, with early diagnosis and proper treatment, children like Alex can learn to manage their ADHD symptoms and build a positive sense of self. It’s crucial for parents, educators, and mental health professionals to work together to support children with ADHD, helping them navigate the challenges they face and reach their full potential.

—Dr. David Butman, Psy.D. is a licensed clinical psychologist and founder of Keystone Psychological Testing & Consulting, a private assessment practice in Doylestown, PA. He specializes in the assessment of ADHD, learning difficulties, emotional and behavioral challenges, executive functioning, attention, and giftedness.