You have a referral, or you are about to ask for one, and someone has just told you the public wait is "a year or two". Now you are staring at a private clinic's fee and wondering whether paying is buying your child time or buying yourself a receipt. This page walks through that choice the way a calm friend who has done it would.
What the two routes actually look like
Public route. You raise the concern with your family doctor or pediatrician and ask for a referral. You also contact your CLSC, which is the front door to the CIUSSS in your territory, and ask for a developmental assessment. Montreal Island has four mandated public hospitals for child autism assessment: Sainte-Justine, the Montreal Children's, the Douglas and Rivière-des-Prairies. Which one sees you depends on where you live. Autisme Montréal reports waiting lists that "fluctuate and vary from one hospital to another, but range between 6 to 24 months". official The assessment is free under RAMQ.
Private route. No referral is needed. You call a clinic, pay a deposit, and are usually seen within weeks to a few months. Autisme Montréal lists fees that "range between $1,600 to $4,200 (depending on the clinic)". RAMQ does not cover private psychological assessments; some group insurance plans reimburse a portion. official The Fédération québécoise de l'autisme gives a similar picture: costly, faster, sometimes partly insured.
In both routes the diagnosis itself can only be signed by a physician or a psychologist (including neuropsychologists). A speech-language pathologist or occupational therapist can be part of the team but does not conclude the diagnosis. official
Side-by-side
| Public (CLSC → hospital or CIUSSS) | Private clinic | |
|---|---|---|
| Cost | Free (RAMQ) | $1,600–$4,200 (Autisme Montréal, 2026) |
| Typical wait | 6–24 months, varies by hospital | Weeks to a few months |
| Referral needed | Usually a doctor's referral plus CLSC intake | No |
| Who signs | Physician or psychologist on the hospital team | Psychologist or neuropsychologist; sometimes a physician |
| Insurance | Not applicable | Some plans reimburse part; ask before booking |
| Accepted by CLSC, CPE, school, Retraite Québec | Yes | Yes, if signed by a licensed professional |
| Keeps you on the public list | Yes | Yes, a private report does not remove you |
Wait times and prices move every year. Confirm on the Autisme Montréal page and with your CLSC before you decide.
When private is worth the money
Paying makes sense when a specific door is waiting on a signed report and the delay has a real cost:
- Daycare support hangs on it. Extra support hours in a subsidized CPE are funded through the Retraite Québec Supplement for Handicapped Children (SEH) and the integration allowances, and the SEH application needs a professional's report. A diagnosis is not the only report that counts, but it is the clearest one. See Agir tôt, CLSC, CPE and school.
- School entry is next September. School registration runs late January to March 1. If your child is 4 and the public date is 18 months away, a private report lets the school plan a plan d'intervention and classroom support before day one.
- Money you are leaving unclaimed. The federal Disability Tax Credit and the Quebec SEH both depend on a professional describing how your child's functioning is affected. A report written with those forms in mind can pay for itself. See Money and benefits in Quebec.
- Your own regulation. Some parents cannot function inside an 18-month question mark. That is a legitimate reason, as long as the fee does not become a second stressor.
When it is not worth it
- You would go into debt. The report changes what services are called, not what your child needs this week. Supports can start now. See Waiting is not wait-and-see.
- Your child is under 3 and the public date is under a year away. Very early profiles shift, and a good public team will see your child at an age where the picture is clearer. Meanwhile Agir tôt and CLSC early stimulation do not require a diagnosis.
- The clinic promises more than an assessment. A fast diagnosis bundled with a costly therapy package is a sales funnel, not a pathway. Buy the assessment, take the report home, and decide about therapy separately.
- Nobody is asking for the paper. If your CPE is already accommodating, the CLSC file is open and the benefits can wait for the public date, the private fee buys reassurance only.
Doing both, in the right order
- Ask your doctor for the referral and get it documented. Ask the CLSC to open a file the same week. See What to say to your doctor.
- Ask for Agir tôt or early stimulation through the CLSC. In Quebec this can start before a diagnosis. official
- Call your insurer: "Does my plan cover psychological assessment, and what is the annual cap?"
- If you go private, choose a clinic that assesses with a team (psychologist plus SLP or OT), writes recommendations for CLSC, CPE and school, and will fill the SEH and T2201 forms.
- Keep the public referral active. If the public team calls first, take the appointment. A second opinion is not wasted.
Where the disagreement is
Some clinicians and parent groups argue that paying private is buying your way past a queue that low-income families cannot skip, and that pressure should go on the public system instead. Others argue that a year of a child's early development is not a fair price for a principle. Both are right about something. This site's position: the queue is a policy failure, not a parent's moral test. Use the door you can reach, and keep the public door open behind you.
This week
- Ask your doctor for a written referral, and call your CLSC to open a file.
- Call your insurer and write down the exact coverage for psychological assessment.
- Write one sentence about what the report would unlock for your family. If the answer is "nothing yet", the public list is enough for now.
Sources
- How to get a diagnosis — Autisme Montréal, accessed 2026
- Diagnostic et premières démarches — Fédération québécoise de l'autisme, accessed 2026
- Frequently asked questions, ID-ASD-PD — CIUSSS de l'Ouest-de-l'Île-de-Montréal, accessed 2026
- The Agir tôt program — Gouvernement du Québec, accessed 2026
- Brain, Development and Behaviour program — Montreal Children's Hospital, accessed 2026
- Parcours scolaire d'un enfant handicapé, guide pour les parents (PDF) — Office des personnes handicapées du Québec, 2025