Embrace Autism is a diagnosis mill and here's why

I was recently contacted by one of the co-founders of Embrace Autism who wanted to correct me on some of the information I was spreading about their services. I will admit, there are a few things I got wrong. The main correction being that Naturopathic Doctors are technically allowed to diagnose mental health conditions in Ontario Canada, where the practice is based out of.

However, regardless of the clinician at Embrace Autism's qualifications, people who have received a diagnosis through this practice have revealed concerning details about the diagnostic process which makes it clear that Embrace Autism operates like a diagnosis mill. According to several testimonies, here is how Embrace Autism operates:

Step 1: Screening ($500 CAD)

The screening is conducted without meeting with a clinician. You are to fill out self-report questionnaires at home at your own pace. You submit the documents through the patient portal. This isn't uncommon for a screening, but it is uncommon to pay $500 for something like this. You must pay the fee at the time of your screening.

Step 2: Assessment / Interview ($1050 CAD)

Assesment -

The assessment is also conducted without meeting with a clinician, and is done through submitting documents into a portal at your own pace. These documents include more self-report questionnaires.

Interview -

You meet with the clinician for the first time, and a 1 hour interview is conducted. Here is a quote explaining how this interview is conducted:

"The interview was not that interactive. It was mostly just her explaining my results and her theories about autism while I listened. She maybe asked like 2-3 questions. It seemed like she basically had decided I was autistic based off of my test scores. "

Part 4: Diagnostic Report

Much of the report is a summary of what each self-report score means and how it indicates autism. Meaning the diagnosis is based solely off of the at home questionnaires submitted through the portal and not from any tests that were performed in a clinical setting or with an actual clinician. Notably, a portion of the report is just the patients written responses copied and pasted, as mentioned in this testimony:

"I was surprised to see that part of the report was basically a copy/paste of what I had written myself"

Part 5: MD Signature ($400 CAD)

Embrace Autism provides their evaluations internationally, but many locations do not accept psychiatric diagnosis from a Naturopath Doctor as valid. Infact, you can not get a licence to practice naturopathic medicine in 28 US states. Of these 28 states, there are 3 states where it is actually illegal to practice naturopathic medicine. In order to get accomodations and services, some institutions only recognize a diagnosis from a clinician with a doctorate degree such as a psychologist or physician. The diagnostician at Embrace Autism doesn't have PhD, PsyD, or MD, and is not a psychologist. So for those who live in an area where naturopathic medicine can not be licensed, the only way for their diagnosis to be accepted is to have an MD employed by Embrace Autism to sign off on their diagnostic report. This Doctor does not meet the patient and is not involved in any part of the diagnostic process, they simply look over the report where the diagnosis has already been made and sign it off.

Conclusion:

My main takeaway from this is that this process is nothing like a typical comprehensive diagnostic evaluation. Even with telehealth services, the clinician is meant to meet with you over a video call and they administer the tests in a clinical setting in real time. These tests jnclude behavioral observations.

At Embrace Autism, you complete the tests alone, at home, and submit the documents. That's the entire assessment. Then the interview is really just a meeting explaining your results. Does that sound normal to any of you?

The cofounder tried to tell me word for word "the Embrace Autism evaluation is far more comprehensive than anywhere else" when I tried to argue that the price is way too expensive for what they offer. They also said I was wrong when I said you couldn't get a more comprehensive test for cheaper, and said that autism evaluations are always $2000 to $6000. If that's the case, then why did I get my autism evaluation from an actual PysD licensed Neuropsychologist, where we actually met face to face for 5 hours, where he administered all of the tests and behavioral observations and wrote a detailed diagnostic report, for only $675?

Dr. Riva Ariella Ritvo is the creator of the RAADS-R, which is one of the tests used in the Embrace Autism evaluation. Ritvo states that "the test as a whole is best utilised as a clinical tool completed with a clinician present". When I brought this up to the Embrace Autism co-founder, she said "the authors of the tests do not state this, and they are described as self-report tests". Except the creator of the test did state this, and just because a questionnaire is self-report doesn't mean that it's meant to be taken at home without a clinician present. Self-report just means that the symptoms you are reporting are from your internal observation rather than external.

What do you guys think of all this?