Medical team
Your pediatrician and specialists can answer health questions, make referrals, and coordinate medically necessary care.
The diagnosis gives you new language and new doors to support. You do not have to open every door at once. Use this roadmap to choose the next useful step for your family.
A diagnosis can feel like an instruction to act immediately. Early support can be valuable, but informed decisions matter too. Take time to understand the evaluation, talk with people you trust, and notice what your child and family need right now.
Families often assume that medical, school, insurance, and regional center services are one connected system. They are not. You may need to contact each separately, and eligibility in one does not automatically create eligibility in another.
Your pediatrician and specialists can answer health questions, make referrals, and coordinate medically necessary care.
California regional centers determine eligibility and coordinate developmental services. For children under 3, ask about Early Start.
Public schools evaluate educational needs and may provide an IEP or other supports. A medical diagnosis alone does not determine the school plan.
Your plan can explain covered benefits, network providers, authorization requirements, and expected out-of-pocket costs.
Children ages 3 through 21 may be eligible for special education services through their local school system. You can request an evaluation in writing, participate in meetings, share outside reports, ask questions, and receive notices about proposed or refused changes.
Coverage varies by plan, even within the same insurance company. Call the number on your insurance card and ask for behavioral health or autism benefits. Take notes, including the representative’s name and a reference number.
Kelton Company can help verify benefits for families considering services, but your health plan makes the final coverage determination.
Your child may benefit from one or more supports, such as speech-language therapy, occupational therapy, mental health care, parent coaching, social or recreational programs, school services, or ABA. A service is useful when it is individualized, respectful, and connected to meaningful life outcomes.
Create one paper binder or digital folder with these sections. You can build it slowly.
Diagnostic reports, developmental assessments, and clinical recommendations.
Evaluation requests, IEPs or plans, progress reports, and meeting notes.
Benefit notes, authorization letters, explanations of benefits, and provider lists.
Your questions, family priorities, child strengths, and observations about daily life.
Tell us where you feel stuck. We’ll listen and help you identify a practical next step, whether or not that step is ABA.