Frequently Asked Questions

• We currently have a waitlist for services. If you would like for your child to join the waitlist, you can join the waitlist on our website.
• Families will be contacted in the order that they have joined the waitlist when the next appointment becomes available (e.g., cancellation).

• Infants and toddlers with a history of premature birth
• Young children with a history of and/or ongoing medical complexity 
• Young children presenting with concerns for development delay, Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), behavioral challenges, behavioral feeding issues (e.g. picky eating), behavioral sleep difficulties, elimination/toileting concerns, trauma/stress/adjustment difficulties, and relationship/attachment challenges

Testing appointment duration is between 3 and 5 hours. During this time, you will have private access to the office suite including a reception area, a small kitchenette with provided snacks and beverages, a restroom, and free Wi-Fi. Appointment structure varies, but parents can expect to take part in the interview portion of the appointment, complete online questionnaires on a provided tablet, and possibly be engaged in portions of the standardized testing when directed. We require at least one parent/caregiver to remain in the office suite throughout the duration of the appointment. Your child will have several breaks throughout the appointment and you and your child are welcome to take an extended break outside of the office (~30 minutes) should you desire.

WHO TO BRING

Parents/Caregivers

We encourage up to two parents/caregivers to attend testing appointments; however, two-parent attendance is not required. 

Siblings

Unfortunately, due to the nature of the appointment, we ask that you make arrangements for your other children and do not bring them to appointments.

WHAT TO BRING

Toys

While we provide toys in the office and your child will engage with specific toys during standardized testing, you are welcome to bring your child's favorite toys. We ask that you refrain from bringing tablets, phones, or other electronic toys for your child.

Food/Beverages

You are encouraged to bring your child's favorite snacks and drinks. You will have access to the beverages and snacks provided in the office.

Parents' Personal Items

As parents may have some disposable time during the appointment, you are welcome to bring laptops, books, or other items to the appointment to use during that time.

Yes, our Comprehensive Developmental & Psychological Testing service assesses for Autism Spectrum Disorder (ASD). In order to provide the best diagnostic clarity, it is important to both "rule-in" and "rule-out" diagnoses. Conducting comprehensive developmental & psychological testing for an Autism concern allows us to more accurately provide you and your child with appropriate recommendations should your child not meet diagnostic criteria for Autism Spectrum Disorder (ASD). There are many concerns that can look like ASD, and our comprehensive testing is designed to "rule-out" those other concerns while "ruling-in" a diagnosis of ASD, when appropriate. Our standard of care is to answer the question, "What is impacting my child's current behaviors/concerns?" rather than just determine a "Yes/No" diagnosis for ASD. We want to provide you with the most accurate information about your child's development and functioning so that you can make informed decisions about their care.

Moreover, we believe it is important to consider many aspects of a child's development to highlight their strengths. Comprehensive testing is conducive to this practice. 

Yes, we use the ADOS-2, along with other high quality standardized assessment tools when there is a concern for Autism Spectrum Disorder (ASD).

With your permission, collateral information is gathered from other caregivers for your child, therapists, daycare providers, teachers, pediatricians, etc. when deemed clinically relevant. It is up to you as the parent to determine who we are permitted to gather additional information from. It can often be especially helpful for us to gather information from daycare, preschool, or school providers when applicable. 

It is also very helpful to have access to your child's medical records from their pediatrician and/or other medical specialists. You can give us permission to request those records.

You will receive the results of the testing, along with the written evaluation report at the Feedback Appointment. Families are provided with an electronic version of the report. For in-person Feedback Appointments, families are also provided with a printed copy of the report. This appointment is scheduled for 1-2 weeks after the Testing Appointment. The time between appointments allows Dr. Kulish-Avery to gather collateral information, score and interpret test results, and prepare the evaluation report.

Children between the ages of 3 and 6 whose parents would like support in school readiness and school placement planning to foster their child's early and future academic success. 

Children who have turned 4-years-old by April 16th of the current year and who are significantly academically and socially advanced in development compared to same-aged peers. This testing is one part of the application packet that parents complete when interested in determining whether their child qualifies for Early Kindergarten Entry in North Carolina. All application procedures and early entry decisions are made by the School Districts.

• Pregnant parents/caregivers and/or those planning to become pregnant or adopt/foster and their partners/co-caregivers
• Parents/caregivers of young children (birth through age 6) and their partners/co-caregivers 

• Autism Spectrum Disorder (ASD) group: parents/caregivers of young children (ages 2 through 6) with a diagnosis of ASD and their partners/co-caregivers
• Medical complexity group: parents/caregivers of infants, toddlers, and young children (birth through age 6) with medical complexity and their partners/co-caregivers

We take health very seriously. All toys, testing manipulatives, and surface areas are thoroughly cleaned and disinfected after each family visit.  

We ask that you reschedule your appointment if you, your child, or anyone in your household has a contagious illness. We will also reschedule appointments if we or anyone in our household has a contagious illness.

When requested, we will take precautions and wear a facemask and faceshield to provide an added layer of health protection for you and your child. In these cases, all necessary modifications will be made to the relevant testing battery and assessment tools. If interested in this accommodation, please communicate this prior to your child's scheduled Testing Appointment to allow for appropriate preparations.

All initial appointments for Comprehensive Developmental & Psychological Testing and Autism Testing are conducted via Telehealth. We also offer Telehealth Feedback Appointments upon request for all testing services. This is the appointment that occurs after your child has completed a Testing Appointment; parents/caregivers are provided with the testing results and recommendations during this appointment. 

All Testing Appointments take place in-person. In certain circumstances (e.g., depending on your child's age, insurance coverage, and presenting concerns), an Autism Testing Tele-evaluation can be requested. In this case, the entire Autism Testing process would be completed virtually/remotely. There are pros and cons to the provision of this service via Telehealth. If interested, please Contact Us to learn more.

The secure Client Portal is a platform that will allow you to access paperwork sent by the practice, communicate securely with us, submit payment, manage appointments, and access shared documents. When you schedule an appointment, you will be invited to sign up for access to the secure Client Portal.

Strong Start Psychological Services, PLLC, is an in-network provider with several insurance carriers for the Comprehensive Developmental & Psychological Testing and Autism Testing services. Please see our 'Insurance' page under the 'About Us' tab on our website for details. 

Our fees for Early Kindergarten Entry Testing, Psychoeducational Testing, and Early Intervention Parenting Services (Parenting Workshops & Parent Support Groups) are listed at the bottom of the pages on our website describing each service. These services are self-pay services.

Parenting workshops and group sessions are about 60 minutes in duration. During this time, participants will have access to a small kitchenette with provided beverages and snacks, an in-suite restroom, and free WiFi.

PARENTS/CAREGIVERS

We encourage up to two parents/caregivers per family to attend workshop and group sessions; however, two-parent attendance is not required. 

CHILDREN

Unfortunately, due to the nature of the appointment, we ask that you make other arrangements for your children and do not bring them to the workshops/groups.

Individuals who are Licensed Psychologists and who have a Ph.D. in Clinical Psychology complete a rigorous training program. While career pathways vary based on each individual's professional goals, most Clinical Psychologists have completed a total of 12-14 years of higher education, training, and supervised clinical experience relevant to the field of psychology prior to receiving their license to practice. 

Clinical Psychology Ph.D. training programs are highly selective, with an average acceptance rate of ~ %5 (Golding et al., 2020). Many training programs are also accredited by the American Psychological Association (APA), and must adhere to strict standards of training. Like other professional fields, psychologists can specialize their work, including expertise in working with various presenting concerns (e.g., Attention Deficit Hyperactivity Disorder (ADHD), depression, Autism Spectrum Disorder (ASD)), age groups (e.g., young children, children, adolescents, adults), and types of services (e.g., evaluation vs. therapy) among other specializations.

Golding, J. M., McGavran, M. B., Susman, D., & Wright, R. (2020). Demystifying One’s Chances of Acceptance into Clinical PhD Psychology Programs. Teaching of Psychology, 47(1), 97–101. https://doi.org/10.1177/0098628319889537

We offer services in English and Spanish. Dr. Kulish-Avery is fluent in Spanish and has received  training and experience in the provision of mental health care services in Spanish.

Spanish Services

All interactions with parents are available in Spanish (e.g., intake paperwork, online questionnaires, message/email communication, clinical interview for evaluations, Parenting Workshops, Parent Groups). Testing services with children are available in Spanish when appropriate depending on presenting concern, child's developmental level and age, language preference, language exposure, etc. Our practice has necessary standardized testing tools in Spanish available for our use when clinically indicated. 

Strong Start Psychological Services is centrally located just north of Research Triangle in North Carolina, with easy access for residents of Raleigh, Durham, and Chapel Hill. Our address is 2310 S. Miami Blvd., Suite 135, Durham, NC 27703.