After the evaluation: handing a family the next step

I don’t ever recall being handed a sheet of paper with therapy options for Avery. That’s not to say it didn’t happen. It could have been tucked into the binder placed in my arms when we were discharged from the NICU.

I remember being told to get set up with speech therapy for feeding as soon as possible. That was my takeaway once we got home and the beeping of the NICU and PICU machines was replaced by coffee percolating, laundry running in the wash and a hungry baby. We tried ECI first but there was a long waitlist, so we turned to private therapy.

That’s my personal experience. I know other families sometimes get a handout with 10 to 12 options to call, or a link to a resource page with the digital version of that PDF. But even that is just a snapshot of what’s available right now, and there’s no way to tell who’s in network and who has a long wait.

This guide is for the person on the other side of that handoff: psychologists and diagnosticians, pediatric and specialty practices, social workers, case managers, nurse navigators and family-support staff. You did your part: the evaluation, the diagnosis, the recommendation. What follows is what the family faces next, which papers each door asks for, and what you can hand them so the next step is shorter. The rules described are Texas’s, current as of October 2026.

You’re not supposed to know who has room

A pediatrician I spoke with said, “I refer kids all the time for therapy but never know who to send them to!”

Openings change by the week, and which clinics take which plan changes too. No practice can track that for every clinic in town.

A pediatric physical therapist described to me how the hospital social workers he knows handle it. They have the same 10 to 15 options. They ask each family where they live and what insurance they have, then try to find care by hand. It is slow work, done one family at a time.

The doors a family faces

Which door comes first depends on the child’s age and what you recommended. Families often go through more than one at once.

Under three: Early Childhood Intervention (ECI)

Anyone can refer, including the parent, and no diagnosis is needed. Texas Medicaid’s provider manual says health-care professionals must refer within 7 days of identifying a suspected delay. The evaluation and service coordination cost the family nothing; services carry a family cost share. ECI does not diagnose autism. Hand them: Getting started with ECI.

Three and older: the school district

A school evaluation is separate from a medical diagnosis. The family asks for it in writing, and insurers generally don’t accept it in place of a medical diagnosis. Many families pursue both. Hand them: The ARD decoder.

Speech, occupational and physical therapy

Clinics usually ask for a doctor’s order or a referral form, because insurance won’t pay without one. For Texas Medicaid, the clinic needs a signed and dated order on file before the evaluation, and a second order stating frequency and duration before treatment starts. An order that says “evaluate and treat” covers only the evaluation.

ABA

Insurers generally want two separate documents: the diagnosis report and a signed referral for ABA.

If you are a psychologist, this is the part to tell families plainly. Texas Medicaid lists licensed psychologists among the clinicians whose autism diagnosis it accepts. For the ABA referral, its manual lists the child’s primary care provider, or the diagnosing provider when that provider is a physician, physician assistant, nurse practitioner or clinical nurse specialist. So your report is one document, and the family still needs the signed referral from the child’s doctor.

Private plans set their own rules. Texas law frames required autism coverage around what the child’s primary care physician prescribes, so “ask your plan what it needs from the pediatrician” is the safe instruction. Hand them: Full-time or part-time ABA: how enrollment actually works.

Whether ABA is right for a child, and how many hours, is a clinical decision. This guide takes no view on it.

The Texas Children’s Autism Program

A state-funded program that provides focused ABA through contracted community providers, for children and young adults through age 21, with a family cost share based on income. Families enroll through the state, and each contractor keeps an interest list. Hand them: ABA therapy in Austin, which covers the program alongside the other ways to pay.

What makes a referral usable

• Say which papers are separate. The report is not the referral, and a family may not find that out until a clinic asks for both.
• Send the order with them. If you can sign the referral or order, give it to the family before they leave. If you can’t, tell them exactly who to ask and what to ask for.
• Name more than one place, and tell them to get on more than one list. Hand them: The pediatric therapy waitlist survival guide.
• Give them the questions to ask every clinic. Do you take our plan? How long is the wait? Is that the wait for an evaluation or for a regular weekly spot?
• Point them to how they’ll pay. Hand them: Paying for your child’s therapy when insurance falls short.

What a printed list can’t show

A list is a snapshot. It can’t show who has room this month or which clinics take a particular family’s plan. Keep your list. Your judgment about who is good with which kind of child is something no directory has.

Care Connect Kids is what you hand a family alongside it. It’s free for families. It shows them pediatric speech, occupational, physical and ABA therapy clinics close to home in the Austin area, which ones list their insurance, wait times at partner clinics, and how to reach each one.

How the handoff works

Your practice creates one free referral account. One account covers the whole organization; whoever keeps your family resource list is the right person to set it up.

You get a QR code and a short link that belong to your practice. Put them on the after-visit sheet, in the recommendations section of your report, at the front desk, or on your resource page.

You see a count of families who signed up through your link. You never see names, and you never share a child’s information with us.

Create a free referral account. Questions first? Write to hello@careconnectkids.com.

What Care Connect Kids is not

• It is not a care coordination or case-management service. There is no case manager, no records and no scheduling. That work stays with you.
• It does not recommend a clinic or a therapy for any child.
• It does not replace your referral. The family still needs your order, and still confirms insurance and timing with each clinic.

More to hand a family

• Where do you start?
• Coming home from the NICU: who helps next
• Feeding therapy: what to expect, and how to keep going
• When ECI ends: what happens after your child turns three