More than four years ago, Karrie Walters saw a need to make diagnostic services more accessible in Eugene. She decided to address the problem herself by launching a comprehensive diagnostic clinical service in 2019 to assess a range of learning, attention and developmental disorders.
Walters directs the Comprehensive Diagnostic Assessment Clinic, one of the clinical service lines offered within the HEDCO Clinic at the UO’s College of Education. The center evaluates for attention deficit/hyperactivity disorder and learning disabilities including dyslexia, dyscalculia and dysgraphia. Services are available to children age 7 or older, adolescents, college students and adults.
Walters is responsible for overseeing the services offered at the center. She also teaches and supervises graduate students who gain experience working with clients and delivering assessments.
The doctoral students use a comprehensive diagnostic process that’s strength-based and considers ecological factors. That approach means the center examines multiple elements of each client’s life, including school experience, mood, environment and health, among others. Local clinics offering similar services don’t usually investigate these factors the way the assessment center does.
“It’s almost like we’re gathering all the puzzle pieces to put together a more comprehensive and strength-based picture,” Walters said. “So we want to look at and gather as many puzzle pieces as possible.”
It is critical to Walters’ mission that the services are culturally responsive. That means clinical practices reflect an understanding of how racial or cultural biases can affect how symptoms are described in different contexts. The center also looks at ADHD, autism or any other specific learning disability through a neurodiversity lens.
“We highlight the individual in context and see the ‘dis’ in ‘disability’ as often a mismatch between the individual and the environment,” Walters said, “instead of something solely intrinsic to the client.”
The center now serves 80 clients in the Eugene area and contributes to the HEDCO Clinic’s overall mission of multidisciplinary teaching and integrated care. It regularly refers clients to the other internal therapeutic services offered within the HEDCO Clinic, and vice-versa.
In addition to responding to community needs, the clinic also works with other services and units across the UO campus. Before the clinic was founded, the Accessible Education Center didn’t have anywhere to send students on campus to get assessments for academic accommodations.
The quality of the diagnostic processes offered at the center is unique, but the training it offers stands out as well.
Doctoral students in school psychology, counseling psychology and clinical psychology work at the center and receive one-on-one guidance from Walters as they learn how to independently work with patients and practice diagnostic work.
“Training in the CDAC program feels like a big responsibility and privilege because we often work with clients who are at a critical point in the process of self-understanding and accessing services,” said Nathan Mather, one of student externs working at the clinic. “We get to work with clients for the full assessment process, from clarifying the reason for seeking an assessment to providing feedback and recommendation for next steps.”
Maggie Cox and Lindsey Romero, two other student externs at the center, said that Walters’ guidance made a big difference in how they learned essential clinical skills.
“Dr. Walters provides scaffolded and monitored autonomy that creates an incredibly supportive and nurturing space that has allowed me to gain confidence in my competence as a clinician,” Cox said.
Developing this experience is essential for students to prepare for their future careers. Doctoral students need to get clinical experience working in therapy and assessment so they can apply for internships once they complete their doctoral program. The center is a popular location to get that experience. Walters often must turn away applicants because she can only supervise a handful of students at a time.
“Historically, our students have really struggled with getting assessment hours because there are fewer opportunities in the city or in the area to do that,” Walters said. “Because of CDAC, they’ve been able to get more of those assessment hours, which means they’re more competitive for really good internships.”
Walters said that her main goal for the center’s program within the HEDCO Clinic is to make it even more accessible for the community. The cost of comprehensive evaluations in the community range from $1,500 to $3,000. But the clinic doesn’t charge insurance and has a flat cost of $750. That can still be a high barrier for families, and Walters hopes that the clinic can eventually receive funding to offer discounted or free services for clients in Eugene.
Walters has many future plans for the clinic, including offering evaluations in Spanish and expanding the ability to assess for autism spectrum disorder. These future dreams, however, depend on the continued success of the clinic.
With support from donors, including the HEDCO Foundation, the College of Education can support much of this programming but welcomes the opportunity to expand access for all individuals and families in need of the resource.
“Instead of quickly getting bigger, I want the clinic to be more sustainable,” Walters said.
—By Madeline Ryan, College of Education