Rebecca Krawczak, M.A., TLLP, is a clinical psychology PhD candidate and assessment coordinator at the Wayne State University Psychology Clinic. (Courtesy photo)
For many Detroit parents, the search for a psychological assessment begins with a difficult question: Why is my child struggling?
As the assessment coordinator at the Wayne State University Psychology Clinic, I regularly speak with families trying to answer it. Parents have told me they were quoted between $1,000 and $5,000 in anticipated out-of-pocket costs elsewhere, depending on the testing needed and their insurance coverage. I am still struck by the relief in their voices when I explain that our clinic uses an income-based sliding-fee scale.
But that relief is often followed by a harder conversation. Affordable services are in such demand that the estimated wait at our clinic is currently about five months for children and as long as a year for adults. Those estimates can change quickly as referrals and training capacity fluctuate. Wayne State provides a vital service, but no single university clinic can absorb the unmet needs of an entire region.
The need is substantial. In Michigan, 13% of children ages 3 to 17 were reported to have ADHD (roughly 228,000 children) and 4.3% (about 76,000) have autism spectrum disorder, according to the 2023-2024 National Survey of Children’s Health. More than 55,000 Michigan students had an Individualized Education Program (IEP) and were identified with a specific learning disability during the 2024-25 school year. Yet for families still seeking answers, recognizing that their child needs assistance is often easier than accessing the assessment needed to identify what kind of support will help.
Public schools also carry a heavy responsibility. They must evaluate students suspected of needing special education and provide services to those who qualify. Yet, timely access is a challenge even there: the Detroit Public Schools Community District reported that 72 initial evaluations had missed Michigan’s deadline through March 2026. School evaluations assess a child’s educational needs and eligibility, while a clinical assessment may answer additional questions about diagnosis and treatment. Families can become suspended between systems: a physician or teacher recommends testing, a school considers educational eligibility and private assessment remains financially out of reach.
The Children’s Foundation reports that only 4% of clinical psychologists specialize in child and adolescent care and that Michigan ranks among the worst states for mental health professional shortages. Its Behavioral Health Scholarship aims to build a Michigan pipeline of child- and family-focused clinicians. That investment is essential — and families need care now.
Some local psychologists are trying to answer that need. Tiffany Abrego, Ph.D., LP, founder of Thriving Families Psychological Services, is developing Thriving Communities, an arm of her practice intended to expand access to lower-cost care. Comprehensive assessment is time-intensive work, and individual psychologists cannot solve this structural problem alone.
Still, more practices could make a meaningful difference by reserving even one or two reduced-fee assessment openings each year. Hospitals, universities and philanthropic organizations could help subsidize evaluations. Insurers must begin to treat psychological assessment as essential care: covering all medically necessary testing, adequately reimbursing the many hours required to complete it and ensuring that families can find an in-network psychologist.
Psychology’s own ethical tradition asks us to consider this responsibility. Under General Principle B, the American Psychological Association states that psychologists “strive to contribute a portion of their professional time for little or no compensation or personal advantage.” This is an aspiration, not a requirement, that psychologists disregard the financial realities of their own work. But it asks us to consider what our expertise is ultimately for — and whom it serves — when access depends so heavily on wealth.
An assessment is not merely a diagnosis written on paper. It is an attempt to understand a child accurately enough that suffering is no longer mistaken for defiance, laziness or failure. It can alter how a child is seen and what help becomes possible.
Detroit families should not have to wait half a school year — or spend thousands of dollars — to understand what support their children need. Expanding affordable assessment services, even one or two evaluations at a time, is a modest act with considerable consequences. What families are seeking is more than a diagnosis: they want to know that their child’s struggles can be understood, that help is possible and that the future need not look like the present.
Rebecca Krawczak, M.A., TLLP, is a clinical psychology PhD candidate and assessment coordinator at the Wayne State University Psychology Clinic. She provides psychological assessment and therapy to children, adults and families in Detroit and is the 2026 recipient of The Children’s Foundation of Michigan Behavioral Health Scholarship. The views expressed are her own.
Psychological assessment is a gateway to care. Too many Detroit families can’t access it.
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For many Detroit parents, the search for a psychological assessment begins with a difficult question: Why is my child struggling?
As the assessment coordinator at the Wayne State University Psychology Clinic, I regularly speak with families trying to answer it. Parents have told me they were quoted between $1,000 and $5,000 in anticipated out-of-pocket costs elsewhere, depending on the testing needed and their insurance coverage. I am still struck by the relief in their voices when I explain that our clinic uses an income-based sliding-fee scale.
But that relief is often followed by a harder conversation. Affordable services are in such demand that the estimated wait at our clinic is currently about five months for children and as long as a year for adults. Those estimates can change quickly as referrals and training capacity fluctuate. Wayne State provides a vital service, but no single university clinic can absorb the unmet needs of an entire region.
The need is substantial. In Michigan, 13% of children ages 3 to 17 were reported to have ADHD (roughly 228,000 children) and 4.3% (about 76,000) have autism spectrum disorder, according to the 2023-2024 National Survey of Children’s Health. More than 55,000 Michigan students had an Individualized Education Program (IEP) and were identified with a specific learning disability during the 2024-25 school year. Yet for families still seeking answers, recognizing that their child needs assistance is often easier than accessing the assessment needed to identify what kind of support will help.
Public schools also carry a heavy responsibility. They must evaluate students suspected of needing special education and provide services to those who qualify. Yet, timely access is a challenge even there: the Detroit Public Schools Community District reported that 72 initial evaluations had missed Michigan’s deadline through March 2026. School evaluations assess a child’s educational needs and eligibility, while a clinical assessment may answer additional questions about diagnosis and treatment. Families can become suspended between systems: a physician or teacher recommends testing, a school considers educational eligibility and private assessment remains financially out of reach.
The Children’s Foundation reports that only 4% of clinical psychologists specialize in child and adolescent care and that Michigan ranks among the worst states for mental health professional shortages. Its Behavioral Health Scholarship aims to build a Michigan pipeline of child- and family-focused clinicians. That investment is essential — and families need care now.
Some local psychologists are trying to answer that need. Tiffany Abrego, Ph.D., LP, founder of Thriving Families Psychological Services, is developing Thriving Communities, an arm of her practice intended to expand access to lower-cost care. Comprehensive assessment is time-intensive work, and individual psychologists cannot solve this structural problem alone.
Still, more practices could make a meaningful difference by reserving even one or two reduced-fee assessment openings each year. Hospitals, universities and philanthropic organizations could help subsidize evaluations. Insurers must begin to treat psychological assessment as essential care: covering all medically necessary testing, adequately reimbursing the many hours required to complete it and ensuring that families can find an in-network psychologist.
Psychology’s own ethical tradition asks us to consider this responsibility. Under General Principle B, the American Psychological Association states that psychologists “strive to contribute a portion of their professional time for little or no compensation or personal advantage.” This is an aspiration, not a requirement, that psychologists disregard the financial realities of their own work. But it asks us to consider what our expertise is ultimately for — and whom it serves — when access depends so heavily on wealth.
An assessment is not merely a diagnosis written on paper. It is an attempt to understand a child accurately enough that suffering is no longer mistaken for defiance, laziness or failure. It can alter how a child is seen and what help becomes possible.
Detroit families should not have to wait half a school year — or spend thousands of dollars — to understand what support their children need. Expanding affordable assessment services, even one or two evaluations at a time, is a modest act with considerable consequences. What families are seeking is more than a diagnosis: they want to know that their child’s struggles can be understood, that help is possible and that the future need not look like the present.
Rebecca Krawczak, M.A., TLLP, is a clinical psychology PhD candidate and assessment coordinator at the Wayne State University Psychology Clinic. She provides psychological assessment and therapy to children, adults and families in Detroit and is the 2026 recipient of The Children’s Foundation of Michigan Behavioral Health Scholarship. The views expressed are her own.
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