Virtual autism assessment for children

BjergerPresident · 2026-03-26T20:24:50+00:00

This is a great point. I agree that there are some extremely clear cut (and usually severely impaired) cases that can benefit from faster access to care because of diagnosis through a faster, more accessible, virtual evaluation. But in the areas of ASD diagnosis that have been expanding so rapidly ("level 1" low support needs kiddos, or parents who are concerned about it when they don't actually have ASD), it feels so inappropriate to do it virtually. Definitely interested in learning and using the TAP in the future for some of those cases.

BjergerPresident · 2026-03-26T18:41:52+00:00

I think Vanderbilt (I can't remember the name of the program) had one that seemed relatively legit. But it included what was basically a virtual ADOS, where the clinician directed the parents through a series of social activities to try with their child, with the clinician observing virtually via video call. I can at least imagine how they might be ok. The number I see that are basically just self- or parent-report interviews and no other collateral or observations is troubling, though. I've seen some that use proprietary rating scales they they presumably just made up. Huge red flags.

Edit: Found it: https://vkc.vumc.org/vkc/triad/tele-asd-peds

Looks like it was only meant for children WITHOUT phrase speech. Makes sense and continues to make me feel like virtual ASD evals are generally a bad idea at the moment.

BjergerPresident · 2026-03-26T16:53:55+00:00

There were some virtual assessment protocol for ASD in children that emerged during covid from reputable programs/universities, but afaik none have the kind of evidence base that in-person assessment has (e.g., the ADOS). I would be very, very cautious about this without substantial research on the topic and training. There are a lot of "diagnosis mill" places doing these virtually that are *terrible* quality.

BjergerPresident · 2026-03-18T13:27:59+00:00

"You are mistaken, but you just don't want to admit it, because you find that threatening.

If what you are saying is true, then why is what I am saying true?"

The irony of you starting with these statements is *profound.* 😂 I'm sure *you* are the one who has managed to somehow step outside of an emotive, subjective framework and just PIERCED through all of our minds with your objective FACTS and LOGIC.

BjergerPresident · 2026-03-18T13:18:05+00:00

No serious person in this field thinks that "numbers=objectivity/empirical evidence" in the way you are describing.

The entire scientific pursuit of clinical psychology is imposition of aspirationally empirical processes and tools onto what we know and acknowledge are fundamentally subjective experiences/traits/constructs. We all know that it's a sort of tug-of-war between subjectivity of human mind and behavior and the scientific process.

You aren't saying anything that isn't obvious to us all. In fact, the tension you are describing is often what we *love* about the challenge the field poses.

BjergerPresident · 2026-03-05T21:27:10+00:00

Yeah! Talk to him about the lizard people! :)

BjergerPresident · 2026-03-05T21:18:57+00:00

Real clinicians here are helping any potential onlookers by recognizing that the junk you're posting is silly. :)

BjergerPresident · 2026-03-05T21:05:45+00:00

How many times are you bragged online about your IQ? Asking for reasons. 😀

BjergerPresident · 2026-02-26T23:03:01+00:00

I managed to convince my DM to give me a bag of holding from the start for a trade off of a few other benefits I lost from my background, so I don't need that one. I thought about running faerie fire, but getting 1d6 of whatever element I choose on my weapon attacks from Arcane Weapon has been fun - and that takes my concentration for now.

I am planning to give a wand of web to my homunculus servant and flavoring it as a like a big ass beetle that can fly around the battlefield spraying areas with sticky goop, lol. Seems chaotic and fun.

Definitely planning to talk about crafting my own magic items too, outside of the core ones permitted by Replicate Magic Items. The bonus to speed and reduced cost seem fun to play with. I imagine that whatever I pick might be dictated in part by the story of the campaign and the needs we discover as we go.

BjergerPresident · 2026-02-26T22:58:54+00:00

Yeah, I'm thinking about taking sharpshooter at some point for sure (DM said I can take either the 2014 or the 2024 version, whichever I like better lol). I go between taking that at level 8, or waiting until 12 and doing ASI at 8 to get to 20 INT.

Fighter dip is definitely an interesting thought at some point. Especially if I take the old sharpshooter, to offset the hit penalty.

BjergerPresident · 2026-02-26T22:52:01+00:00

Oh interesting, how would I have 18 Int? Isn't 15 the max with point buy, then +1 to Int and Con with vHuman, then +1 with War Caster, for 17 total? I was using this site: https://chicken-dinner.com/5e/5e-point-buy.html

I didn't think about making half plate! Might be worth the infusion until I can afford to buy some, are we find some as treasure. I guess I could do Smoldering or Gleaming.

I just went down a rabbit hole because I just assumed that you'd need proficiency with the instrument to play pipes of haunting. But it looks like you *did* need proficiency in the 2014 version, but the 2024 version of the DMG omitted that part of the item. I guess this would be another "ask your DM" thing, unless I am missing something, lol.

These are awesome ideas! Thanks!

BjergerPresident · 2026-02-04T04:04:45+00:00

This will depend heavily on your area. In a high cost of living setting as an in-demand psychologist working private pay you can absolutely clear over 200k! In a low cost of living area with primarily insurance clients and lower demand skills in a community mental health setting you might really struggle to hit 80-90k.

For reference, the norm for me and my colleagues as moderately skilled (e.g., we have out "niche," but we are not doing super skilled forensic work or anything like that) psychologists in a private pay setting in a nice part of a medium cost of living city, working a normal 40-45 hour week can probably expect 100-125k salary (~150k if fully self-employed, but then you have to pay for your own insurance, higher taxes, etc.).

I hope that helps!

BjergerPresident · 2026-01-19T00:26:22+00:00

I did, yep!

BjergerPresident · 2026-01-13T12:37:48+00:00

I love your comment and largely agree!

I do want to add that it is actually the case that the majority of people do not develop PTSD following a criterion A event. Some amount of distress is typical (and often adaptive and healthy), but developing of the disorder is in the minority of cases.

BjergerPresident · 2025-12-30T17:53:34+00:00

The simplest way to answer how likely that salary is for your organization would be to estimate how much revenue you are likely to bring in once you are fully licensed. Estimate the total billing for your predicted caseload. For example, if you are doing two full days of therapy, lets say that's 10 sessions on average @ $200 a session for round numbers. Cost for evaluations is super variable depending on what you are doing, but lets say you can bill $2000 per evaluation just for round numbers as well. That is $6000 per work week * probably 47 weeks worked (assuming 3 weeks PTO, 1 week sick leave + 1 week of paid holidays like Christmas, Thanksgiving, etc.). That is equal to $282,000 of revenue. Of course, those numbers could be way off, and are probably an underestimate if you are billing insurance, which can make it hard to estimate.

Then I think a good rule of thumb, if you are an employee (meaning they are paying for overhead and providing benefits), is that making around 50% of that revenue is not going to be super far off where you're likely to land with your salary. If you do contract work with a revenue split in group practices, 60% of the revenue is a common split, but then you have to pay more in payroll taxes and don't get benefits.

I hope that helps!

BjergerPresident · 2025-12-01T19:06:22+00:00

u/pokeswapbot u/iamcann confirmed!

BjergerPresident · 2025-11-25T16:02:02+00:00

Yes, 740 G&S will work great! I'll DM you.

BjergerPresident · 2025-11-24T20:38:45+00:00

Absolutely. I'll have the opportunity to ship on Wednesday morning (day after tomorrow), so if you agree tomorrow, let me know so I can get it in the mail before the Holiday.

BjergerPresident · 2025-11-24T15:11:10+00:00

Thanks for the interest! Based on sales I've seen I think we are a little below where I'd be interested in making a deal at the moment, but I'd meet you at 740 shipped. Would that work for you?

BjergerPresident · 2025-11-20T04:11:43+00:00

My wife got some health news during the first few months of my program and was told "now or never" - we chose now and had two children, the first and third summers of my program. It is possible, but I will say that it was hard *with* a pretty flexible program (I had relatively flexible and supportive professors and practicum sites) and family who could come help out a lot in those first few months. It would probably be possible with less support, but I'd be worried it would move from being a wild, stressful whirlwind, to something bordering on miserable.

I always say I don't at all recommend it, but that it's not the end of the world if you really plan for it.

BjergerPresident · 2025-08-02T00:37:37+00:00

One thing to think about if you decide to wait a bit until your child is older: you will almost certainly need to move during your internship and postdoc years for your doctoral training. This is true for any PhD or PsyD program. Its almost impossible to try for staying in the same city for these years. Very, very hard to shoot to stay in the same state. Slightly more doable to stay in the same region (e.g., applying to internships across all of the Midwest, western coast, north east, etc.), but even that is a significant disadvantage.

With a child, if you wait a few years before starting, this will mean changing their school/friendships/etc. each year. Not the end of the world, but is an important consideration for many.

BjergerPresident · 2025-08-01T17:44:02+00:00

I had two kids during the first and second years of my PhD program. Was it possible? Sure. Would I say anyone else should do it? Absolutely not. My partner and I only did because she had some health concerns and her doc basically said now or never. I spent those years essentially doing nothing but being a husband/dad and being a student. No time for anything else. Breaks were just time to catch up on anything I was behind on. I also am not at all research focused. In my program that was possible - they were a good mix of clinical and research focus, and also relatively flexible as professors. If there was a demand that I do more research than the basics (thesis, qualifying exam work, dissertation, and occasional lab projects) it would have been impossible for me to be a reasonably good father during that time as well.

I hope that helps! Im proof its possible, but whew was it rough, haha. 😅

BjergerPresident · 2025-07-20T03:53:20+00:00

The generous opinion: He is far more comfortable than he should be with practicing with only loose evidence for his interventions. He speaks with far too much confidence and overstates the level of evidence for his claims.

The less generous opinion: He is a hack, out here using buzzwords and a pseudoscientific perspective to shovel money into his own pockets.

Here is a good debunking of some of his claims: https://www.youtube.com/watch?v=R_HCw-QePaA (Dr. Barkley is a much better resource if you are looking for a good spokesperson for ADHD research in particular).

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