At Jigsaw-DX, our team of talented and experienced doctorate-level diagnosticians is at the core of our ability to support families. In our Diagnostician Spotlights, we highlight their accomplishments and give a glimpse into their unique perspectives and expertise.

Meet Lindsay Wray, Psy. D.

Dr. Wray holds Doctorate in Clinical Psychology, and has completed over fifty evaluations for families at Jigsaw Diagnostics.

Dr. Wray specializes in psychological assessment for all ages, covering cognitive, academic, attention, executive function, behavior, accommodations, and autism.

She recently completed a seven year fellowship with Reiss-David Child Study Center in Los Angeles, CA, specializing in psychological assessment with children and adolescents. She also previously taught psychological assessment to doctoral-level students as an adjunct professor with Reiss-Davis Graduate School.

What brought you into this field, Dr. Wray? 

I was pursuing a career in forensic psychology, which led me to do more intense assessment training than would typically be provided for a clinical psychology program. Then I happened to get an internship working with Reiss-Davis Child Study Center, doing only assessments. and that’s what I really wanted to do! Then, my first post-doc was with a company doing all autism assessments… and it just became my specialty.

I realized I have a good eye for assessments in terms of being able to pick up things behaviorally - the nuances of what people say and do in the room versus just their answers to questions, and being able to conceptualize more holistically. That really called to me.

The other side of it was the reward of helping people and identifying children that need services. I was working with lower-income, Medi-Cal cases. I really wanted to help families who may not have access in the same way other people do and get them the services they need.

Describe your typical work with Jigsaw Diagnostics.

I usually see about 4-5 kids a week. Jigsaw Dx’s platform provides me with everything I need to prepare based on the child’s current language level and functioning. I then conduct the assessment with the parents and child over a Zoom meeting. From there, it’s scoring and report writing.

In your experience, how do video diagnostic evaluations for children compare to in-person diagnostic evaluations?

In some cases, it is more challenging to do full cognitive measures, but more than half the time children refuse to do those in person anyways. They’re running away from you, they’re tantruming, and so in this situation, because it’s online and because they’re in their space, they’re comfortable - I’m not seeing the same level of the resistance that I would see in person.

Even if they don’t want to pay attention to me or engage with me during the remote session, I can watch them for two hours. I can watch them play with their parents…play with their toys… play with their siblings… with their dog. I can see all these behaviors in their most comfortable setting. So I feel like I get a lot MORE information this way than I did previously in person… behaviorally for sure.

Being able to implement traditional diagnostic tools that we use is a little bit harder because we have to ask parents to do what I would typically do in the room with their kid (like hide a toy and say, “Look” and point). I have to have parents do that, which can sometimes be a little bit difficult because you have to take time to explain to the parent what they need to do. I have to use my clinical judgment, obviously, in any of these cases…but we are still able to capture what we need captured.

What stands out to you about the families and children you've helped? 

Well, kids are kids! Especially when you have children on the spectrum, they’re living their best lives, for the most part. They’re doing what they want to do, which can be very difficult for families. Children with autism can get easily distressed and upset about things in their environment or not getting their way, being denied access, wanting things to happen a certain way…but for the most part, they’re the ones who are just living and going through their day-to-day.

The parents on the other hand - I think it’s really hard sometimes for us as adults to not want our children to have what we had. There’s a loss there sometimes, especially for individuals who might be on the severe side of the spectrum. The parents really want their child to have close relationships, want them to be doing well in school, want them to have social engagement, and want them to be able to go out to a concert or an amusement park and not be overwhelmed… there’s a little bit of a loss there.

There’s a triage that happens in the support of parents. Assuring them that they’re doing the right things, they’re helping them, they’re recognizing that both their child and themselves need additional support. It’s important to stress that they haven’t done anything wrong. This is giving those parents a way to feel like they’re not responsible for what their child is going through. In being able to help them, I really admire them because some of these parents, and even parents who foster or adopt kids on the spectrum, are just incredible to me.

Parents themselves tend to be really incredible human beings with the patience of saints. Because a lot of people wouldn’t be able to attend to the needs of a child on the spectrum. I really admire the parents for that.

What are the must-knows for parents and caregivers who are on the fence about having a child evaluated? 

It’s better to know than not know. The earlier you can get a child identified with any type of developmental delay - it could be a motor delay, a type of sensory disorder, a speech delay - the better off the child will be. Early intervention is key and has shown the best outcomes long-term.

Get your child assessed if you have concerns. Listen to your own instincts. This is your child and you know them best. If you feel like there’s something going on, ask your pediatrician, and demand a referral to rule out Autism. They might be able to provide you with some direct services to help you and your child with development… to identify and address issues that might be impairing or negatively impacting the child’s functioning. We want our children to be the best they can be.

What else would you like to share about the stigma and fear around evaluations? 

If you were having fainting or dizzy spells, you would go to the doctor to test your blood pressure. And if you had high blood pressure or low blood pressure you would accept treatment (e.g., take medication or change your diet] to address your symptoms.

Assessing for autism, or any developmental delay, is no different. Many people seem to have such an unusual or maybe skewed understanding of what autism is and how it presents or what developmental delay means in general for children. It’s not a bad thing. I think, as a society, we need to stop looking at it from the lens of ability and disability… or good or bad. Everyone moves through this world differently regardless if they are on the spectrum. Autism is a way of being, and most people diagnosed with autism spectrum disorder are very capable in many ways. They should be viewed and accepted as such.