Have you always felt different, without ever being able to say exactly how? Many women carry that question for decades. You may have learned early to watch how other people do things, to copy and rehearse, to blend in well enough that no one noticed the effort. You may have been told that what you were feeling was anxiety, or depression, or simply your personality, and found that the treatment for those things never quite reached what was actually happening.
For many women and girls, autism goes unrecognized for years, not because it isn’t there, but because the picture everyone was looking for was drawn from someone else. This page describes an assessment built to see what that picture misses: what it involves, who conducts it, how long it takes, and exactly what it costs.
Why autism in women and girls is so often missed
The diagnostic frameworks for autism were largely developed by studying boys and men, and the clinical literature is still catching up to how autism actually looks in women and girls. The result is a generation of women who reached adulthood without an accurate diagnostic picture, sometimes after years of being told they had anxiety, depression, a personality issue, or nothing in particular at all. Many of them suspected something else was going on long before any clinician took the question seriously.
In women, autism often looks more internalized than externalized. Special interests can present as a deep, sustained focus that simply gets folded into school or a career. Sensory difficulty can present as exhaustion, withdrawal, or chronic overstimulation that gets read as introversion. Social difficulty can be hidden by careful study of how other people behave: watching, copying, rehearsing, masking. The effort of doing all this eventually produces a burnout that gets diagnosed as depression.
From the outside, it can look like
- A capable student, a conscientious colleague, a good friend
- Warm, articulate conversation, with careful eye contact
- Deep focus that reads as dedication or perfectionism
- Quietness, or a preference for being alone, read as introversion
From the inside, it can feel like
- Performing a version of yourself all day, and having nothing left by evening
- Translating social rules that other people seem to just know
- Sensory environments others ignore that leave you depleted for days
- Friendships that feel like work, when others seem to find them restful
The result, for many women who arrive at assessment, is a long history of self-doubt. They have wondered whether they are imagining the difficulty, whether they are exaggerating, whether their problems are simply who they are. Some have raised the question with a previous provider and been waved off. Others have never raised it, because they assumed they would be.
If you recognize yourself here, the question you are carrying deserves to be taken seriously. That is what the rest of this page is about.
Meet your psychologist
Every assessment here is conducted by a doctoral-level licensed clinical psychologist.
Comprehensive psychological assessment is a specialized area of doctoral practice: years of supervised training in selecting and administering validated measures, interpreting them together rather than one at a time, and weighing competing explanations against each other before concluding. For a masked presentation, that last skill is the whole game. Who conducts your assessment matters, and we want you to know exactly who that is.
Amanda Mead, Psy.D.
Dr. Amanda Mead conducts comprehensive psychological assessments for adults and adolescents with complex or longstanding diagnostic questions. Autism and ADHD in women and girls, particularly when the presentation has been masked, internalized, or missed by other providers, is a particular depth of her assessment work, alongside the tangled questions where trauma, mood, personality, and neurodivergence overlap. Many of the women who reach her have already been evaluated at least once, and are here because the answer they received didn’t account for what was happening.
Amanda Mead, Psy.D.
Licensed Clinical Psychologist
Dr. Amanda Mead conducts comprehensive psychological assessments for adults and adolescents with complex or longstanding diagnostic questions. Autism and ADHD in women and girls, particularly when the presentation has been masked, internalized, or missed by other providers, is a particular depth of her assessment work, alongside the tangled questions where trauma, mood, personality, and neurodivergence overlap. Many of the women who reach her have already been evaluated at least once, and are here because the answer they received didn’t account for what was happening.
Independently verified clinical excellence
Our psychologists are verified by leading clinical directories and credentialing boards.
Could it be something other than autism? The labels that usually came first
Almost every woman who brings this question to us has already been given an answer of some kind. Some of those answers were wrong. Some were partly right. Some were real conditions that were consequences of decades of masking rather than the cause of anything. An honest assessment does not discard those earlier labels; it examines each of them against the evidence, alongside autism, and says which explanation, or which combination, the evidence actually supports. This is what we mean by diagnostic humility: taking the time, before concluding, to consider what fits, what does not, what overlaps, and what earlier evaluations may have missed.
Anxiety
Often present, and often real. The question is which way the causality runs: a lifetime of studying and rehearsing social situations produces anxiety as reliably as anything does, and treatment aimed at the anxiety alone tends to keep missing.
Depression
Autistic burnout, the profound depletion that follows years of masking, is very frequently diagnosed as depression, because from the outside it looks the same. The treatments differ, and so does what recovery requires.
Borderline personality disorder
Emotional intensity under chronic overload, and relationships strained by an unrecognized difference in how social information is processed, are regularly read as personality-level instability. This is one of the most consequential misreadings a woman can receive, and one we take particular care to examine in both directions.
Attention-deficit/hyperactivity disorder (ADHD)
The two can co-occur, and in women both are underdiagnosed for the same reason: presentations the frameworks did not anticipate. Attention and executive functioning are measured directly rather than assumed either way.
Trauma
Trauma can produce vigilance, withdrawal, and sensory sensitivity that resemble autistic traits, and masked autistic women experience more than their share of invalidating and traumatic experiences. Separating the two, or describing how they interact, takes history and evidence rather than impressions.
Nothing at all
Many women were told, in effect, that this is simply who they are: shy, sensitive, intense, particular. Sometimes that was said kindly. It was still an answer that left the question unexamined, and it is one we examine.
What a masked presentation asks of an assessment
Standard screening questionnaires rely on what is visible to others, or on what you report about yourself. A lifetime of masking is precisely the skill of making the traits invisible, sometimes even to yourself. A clinician meeting you for fifty minutes sees a warm, articulate woman making careful eye contact, and concludes she cannot be autistic. What neither the questionnaire nor the single session can see is the developmental history underneath the performance, and that history is usually where the answer lives.
So the assessment is built to look where the shortcuts cannot. It takes the question seriously from the first conversation. It reaches back through your history, not only how things looked from the outside but what they felt like from the inside. It measures directly what self-report alone cannot capture. It considers the conditions that can present similarly or co-occur, including trauma, anxiety, mood, and personality presentations. And it produces an answer you can rely on: autism, ADHD, both, neither, or something the question turned out to be pointing at all along.
Core elements of the work
- Diagnostic humility: we take the time to consider what fits, what does not, what overlaps, and what earlier evaluations may have missed, before concluding.
- Several independent lines of evidence: interview, developmental history, scientific testing, records, and the perspectives of people who know you, considered together rather than any one alone.
- A battery built for you: measures are selected for a masked presentation and for your particular question, with contingencies, not administered from a fixed menu.
- In-person testing, deliberately: sustained observation across long days is one of the few settings a lifetime of camouflaging cannot fully manage, and remote administration does not meet the standard this work depends on.
- Perspectives beyond your own: with your permission, people who know you well, sometimes someone who knew you as a child, add accounts that are weighed against the rest of the evidence.
- Months of synthesis: integrating this much evidence into one accurate formulation genuinely takes months, and we do not shortcut it.
- A report written to be used: by you, and by the clinicians who will make decisions with it for years.
- No surprises: informed consent is an ethos here, from what the process involves to exactly what it costs.
See if an autism assessment is right for you
See whether this is the right work for your question. The free fifteen-minute consultation exists for exactly that, and we will tell you honestly either way.
One comprehensive assessment, built for questions like yours
Psychological assessment is a single phrase that covers very different kinds of work: brief screening tools that take one session, short questionnaire-based evaluations, and multi-day comprehensive assessments that draw together several lines of evidence. These are not the same, and they are not built to answer the same kinds of questions. Briefer evaluations are appropriate for narrower questions, and for a straightforward presentation they can be exactly right. For a presentation shaped by years of camouflaging, the brief formats measure precisely the surface that masking is designed to manage, and the result tends to be either a surface answer or a diagnosis that doesn’t quite fit.
We do one kind of work: comprehensive psychological assessment, over a period that commonly runs four to six months. We would rather tell you plainly whether it fits your situation than let you find out after you have begun.
This work is built for you if:
- You recognize yourself in accounts of autistic women, but never quite in the official criteria
- The labels you were given were real, but never fully explained your experience
- You have suspected for years that something else was going on, and you want it examined with evidence rather than impressions
- You are prepared to give the question the months it takes to answer well
You are likely better served elsewhere if:
- You need an answer quickly, or by a deadline
- You want a brief, narrowly focused evaluation of a single clear question
- You are looking for the least expensive route to a diagnosis
- You want confirmation of a conclusion already reached, rather than a deep examination of it
We work with adult women, with adolescent girls, and with some older children, depending on the young person and the question. If you are not sure where your situation falls, the consultation call exists to answer precisely that.
How the assessment works, step by step
Six steps, across roughly four to six months. Each contributes evidence the others cannot, several exist precisely because masked presentations defeat the shorter routes, and none of them is optional in the version of this work we are willing to put our name on.
- Step 1: A free fifteen-minute consultation call You describe what you are trying to understand; we tell you honestly whether this is the right work for it. If we agree to proceed, we send questionnaires and background paperwork so that your psychologist arrives at the first session already prepared.
- Step 2: Clinical intake interview(s) By secure video, usually about two hours, sometimes longer, sometimes over several days. Developmental history matters particularly here: what childhood actually felt like from the inside, not only how it looked from the outside. The gap between those two is often where a masked presentation first becomes visible, and the interview is built to find it.
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Step 3: In-person testing, typically two full days
Two full days of five to eight hours, occasionally three, at one of our offices or a testing location we arrange and confirm with you well in advance. The battery is built for you: measures relevant to autism alongside cognition, attention, learning, personality, and emotional functioning, because the alternatives above cannot be weighed without measuring them. Testing is in person deliberately. Sustained observation across long days is one of the few settings a lifetime of camouflaging cannot fully manage, and remote administration does not meet the standard this work depends on. -
Step 4: Perspectives from people who know you well
With your permission, and with informants you choose, we gather collateral information, sometimes including someone who knew you as a child. An accurate picture rarely rests on a single account, and this is doubly true when the surface has been carefully managed for decades. What others share is weighed alongside the rest of the evidence, not taken at face value. "She always seemed fine" is itself a data point about masking. - Step 5: Months of analysis and synthesis Your psychologist scores and interprets the measures, weighs them against your developmental history, prior records, and the collateral accounts, tests the emerging picture against every alternative, and follows up where questions remain. This is the slow part, and the part no brief evaluation includes. It is where a collection of data becomes an account of a person.
- Step 6: The written report, and a feedback session to go through it together By secure video, with as much time for questions as you need; feedback sometimes takes more than one meeting, because taking in this kind of information is itself a process. You may offer corrections to the history section before the report is finalized, and at your direction we share it with the clinicians who will use it.
How much does an autism assessment cost?
A comprehensive psychological assessment at Polaris Psychology is a flat fee of $9,885. There are no add-ons and no surprises: the fee covers the consultation and intake, the full testing battery and its scoring, the collateral contacts, the months of analysis and synthesis, the written report, and the feedback session or sessions.
By this point on the page you can see what the fee pays for. Across four to six months, your psychologist spends dozens of hours, and in complex cases many more, in direct clinical work and analysis on your single question: the interview, two to three full days of administering measures, the scoring and interpretation of each one, the records review, the collateral interviews, and the long integrative work of building a formulation that actually holds together. Briefer evaluations cost less because they do less, and for a masked presentation, what they do less of is exactly what your question requires. This fee is what it costs for a doctoral-level psychologist to do all of it.
The fee is paid in three equal installments of $3,295, tied to stages of the process, so payment tracks the work as it happens:
- A $500 deposit reserves your place and is applied toward the first installment. It is refundable if you cancel at least ten business days before your intake session.
- The first installment is due at your intake interview. With the deposit credited, $2,795 is due that day.
- The second installment of $3,295 is due on your first day of in-person testing.
- The third installment of $3,295 is due before your feedback session.
We are an out-of-network practice and do not bill insurance. Some clients use Health Savings Account (HSA) or Flexible Spending Account (FSA) funds toward the fee, and if you have out-of-network benefits, we can provide a superbill you may submit to your insurer for possible reimbursement. Submitting it is up to you, and reimbursement is your insurer’s decision, not ours to promise.
Where does the assessment happen?
Our process is deliberately hybrid. The consultation, intake interview, collateral contacts, follow-up meetings, and feedback sessions all happen by secure video, from wherever you are. The psychological testing itself happens in person, at one of our offices or a testing location we arrange and confirm with you well in advance. Testing days take planning, and we coordinate the logistics with you directly, including travel questions, before anything is scheduled.
Where we can work with you
Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Minnesota, Michigan, Missouri, Mississippi, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Northern Mariana Islands, Ohio, Oklahoma, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. We do not offer assessment in the state of Pennsylvania at this time.
What is a testing day actually like?
A full day, typically five to eight hours with breaks, working one on one with your psychologist through a series of measures: some conversational, some paper-based, some computer-based, some that look like puzzles or memory tasks. It is a long day, and it is designed to be; some of what matters clinically only becomes visible across hours of sustained work. If sensory environment matters to you, tell us; we plan the days with you well in advance so that you know what to expect.
Frequently Asked Questions
These are the questions women most often ask before a consultation. If yours is not here, the consultation call is the place to ask it.
Q: How long does an autism assessment for women take at Polaris Psychology?
A: Commonly four to six months from the intake interview to the final report, and sometimes longer. Seeing past decades of camouflaging takes time and several independent sources of evidence; we do not commit to a fixed timeline, because the case decides it.
Q: Can the assessment be done online?
A: Some of it, but no, not all of it. Interviews, collateral contacts, and feedback happen by secure video; the testing itself is done in person, deliberately. Sustained in-person observation is part of what makes a masked presentation visible.
Q: I score high on online autism tests, but I have been told I do not seem autistic. Which is right?
A: Possibly neither, on its own. Self-report screeners and a clinician’s brief impression can both miss a masked presentation or similar presentations. That disagreement is precisely the kind of question a comprehensive assessment exists to resolve, with evidence rather than impressions.
Q: I was diagnosed with borderline personality disorder, or anxiety, or depression. Could it still be autism?
A: It could, and this is one of the most common stories women bring to us. Earlier labels are not discarded; they are examined as part of the evidence, and the assessment weighs whether they explain your experience, coexist with autism, or were the visible surface of something the frameworks missed.
Q: Will the assessment conclude that I am autistic?
A: We cannot promise any finding, and we would rather say so plainly. Findings follow the data. The answer may be autism, ADHD, both, neither, or something the question turned out to be pointing at all along. Whichever it is, you leave with an honest, carefully built account of what is actually happening.
Q: What if the results are inconclusive?
A: Then the report says so, and says exactly where the uncertainty lies and what could resolve it. That is rare, because the process gathers enough evidence to support real conclusions, but we will not force a label the evidence does not support.
Q: Do you assess adolescent girls, or only adults?
A: Both, depending on the young person and the question; we work with adult women, adolescent girls, and some older children. Fit is something we judge together at the consultation call.
Q: Do you also assess men and boys for autism?
A: Yes, we have a dedicated page for women and girls due to how their experiences tend to be quite different. If you are looking for an autism assessment for men or boys, feel free to visit our page for that.
Q: How much does it cost?
A: A comprehensive psychological assessment is a flat fee of $9,885, paid as a $500 deposit and three installments of $3,295 tied to stages of the process. The full breakdown is in the investment section above.
Q: Do you accept insurance?
A: No. We are an out-of-network practice. Many clients use HSA or FSA funds toward the fee, and we can provide a superbill you may submit for possible out-of-network reimbursement.
Getting started
Beginning can feel like the hardest part, especially if you have raised this question before and been waved off. The first step is a free fifteen-minute consultation call. It is a conversation, not a commitment: you describe what you are trying to understand, we describe honestly how the work would proceed and whether it fits your question, and you decide. If you would prefer to begin in writing, the contact form reaches the practice promptly, or you can email [email protected].
We usually have a waitlist, and that is deliberate. We take on a small number of assessments at a time, so that each one receives the attention it needs. If timing matters for you, it is worth raising on the call.
Most of this work begins where the easy answers have run out. If that is where you are, we would be glad to talk.
A note on language
Many training programs, and much of the literature written by non-autistic professionals, use person-first language: “a woman with autism.” Many autistic people prefer identity-first language, “an autistic woman,” because autism is not something they carry separately from themselves. Both preferences are reasonable and personal, and in our work together we use the language you prefer. The written report uses the formal term Autism Spectrum Disorder where precision requires it, because the report is read by other clinicians, schools, and institutions that rely on the formal diagnostic vocabulary. Ultimately, it is up to every person to decide how to define herself.