Written by Dr. Amanda Kelly
At Firefly Autism, families over the years have often shared with us the challenges they’ve faced accessing autism evaluations in Colorado, such as waitlists stretching from six months to well over a year paired with high cost. While this narrative remains common, we’re also seeing encouraging changes across the state. Access appears to have expanded with several providers reporting short or even non-existent waitlists. As always with autism care, there are nuances, and factors like the age of the individual seeking evaluation and their financial resources or insurance coverage make a difference.
Some providers have little to no waitlists, take Medicaid and most commercial insurance, but only evaluate learners approximately aged 6 or younger. Others welcome individuals of all ages and maintain shorter waitlists, but do not accept Medicaid or only work with select insurers and private pay. Overall, the conclusion appears to be that age, insurance coverage, and/or ability to pay out of pocket influence access. Young children are more likely to receive evaluations quickly, while children over the age of 5, particularly those insured by Medicaid, can encounter longer delays or limits in availability.
Brian Wolff, Ph.D., Director of Wolff Child Psychology, explained some of the nuances. Their team “fast track” evaluations for children under five, thanks to more clinicians who specialize in early intervention. This approach reflects the well-established value of early diagnosis, which allows children to access services that can dramatically improve developmental outcomes. Still, his practice receives many referrals for school-aged learners, and it is a balance to make sure that all referrals can be accepted. Medicaid and select insurance reimbursement rates can be limiting factors, making it harder for providers to offer comprehensive assessments for older learners. Ultimately, providers must balance their commitment to serving families with the economic realities of their practice.
Dr. Wolff noted that while early evaluations are important, younger children are not always identified right away. At Firefly Autism we often see this pattern — subtle signs may be missed in early years, with concerns becoming clearer only once children enter school. As a result, older learners remain an important and sometimes underserved group within the diagnostic system, something many are trying creatively to address.
Despite the challenges, it does seem like progress is being made. Families of younger children can now access evaluations faster, and diagnostic reports are delivered more quickly, allowing support to begin without lengthy delays. This emphasis on earlier intervention makes sense given how much of a difference timely support can make. Yet it also highlights a gap for older children, who face more obstacles even as academic and social expectations grow more demanding.
Firefly Autism is committed to addressing those gaps through our Consultation and Training program, which brings crucial inforamtion systems directly into schools, medical offices, and communities, and can help ensure that more children are recognized early and connected to the right resources. Additionally, Firefly has a well established resource list for diagnostic evaluations and can help guide families in the right direction based on their needs.
