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Autism Assessment
Autism Assessment
A comprehensive assessment of an individual's development, abilities, strengths, and challenges to help determine if they have Autism Spectrum Disorder (ASD).
A formal diagnosis typically requires assessments from various professionals, usually initiated and coordinated by the child's pediatrician. This team often includes a psychologist and a speech pathologist, and may also involve an occupational therapist and others.
While the process can differ, it generally starts with a visit to the pediatrician, who will refer the child to psychology and other specialists for a comprehensive assessment. Grace suggests that the speech and language evaluation be conducted before the psychological assessment whenever possible.
Grace accepts referrals for children from preschool age to mid-adolescence.
Clinical Assessment & Formulation
While the main referral question is whether the child/adolescent has autism or not, as a clinical psychologist Grace also considers other possible explanations for the presenting challenges or differences. This is important to ensure that other factors or conditions are not missed, and also that autism is not over-diagnosed in our community. Such considerations commonly include ADHD, anxiety, trauma, life experiences, and various other individual factors.
Careful clinical consideration, standardised assessment, and thorough formulation of all factors relevant to the individual is the cornerstone of Grace's assessment work. This helps to increase confidence in the conclusions reached and ensure that recommendations made are most helpful.
Autism assessment for females
We know that females can present with unique and less-observable characteristics of autism. They may not show many of the quirks that have been traditionally identified as part of autism. Further, they commonly engage in masking and camouflaging i.e. efforts to hide their differences and appear as their peers do.
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To help work through and understand all of this, Grace includes additional/alternative components to the assessment as needed. This can include the MIGDAS, The Camouflaging Autistic Traits Questionnaire (CAT-Q) and focused queries and questions to both parents and the young person. ​​
What does the Psychology component of an autism assessment involve?
A comprehensive assessment is important for understanding the individual.
It typically includes:
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An interview with parents/carers to discuss concerns and completion of the Autism Diagnostic Interview - Revised (ADI-R), a standardised tool for identifying ASD and differentiating it from other disorders. Additional questionnaires may also be used to explore particular avenues further.
Individual sessions with the child/adolescent for observation and interaction, often using the Autism Diagnostic Observation Schedule - 2 edition (ADOS-2), which assesses play, interaction, and behaviors based on the child's age. For teens, this is more discussion based.​
Consulting with kindergarten or school staff is essential to understand the child's functioning in this unique setting. This may involve discussions with teachers, observations, or standardised questionnaires, with parental consent obtained beforehand. Other professionals, like speech or occupational therapists, may also be consulted as needed.
A feedback session with parents/carers is held (adolescents are welcome to be a part of this too). Grace will review the collected information and discuss potential diagnoses. This can include autism and/or other diagnoses. The goal is for parents/carers to feel empowered by a deepended understanding of their child, learning how to support their development and wellbeing, and knowing where to access helpful supports. The assessment report is typically provided during this session or within a week.
Why see Grace for assessment?
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Thorough clinical formulation:
Beyond just seeing if an individual ticks all of the boxes for autism, Grace carefully compiles a clinical a formulation. This explains all of the factors at play and how they impact each other and the individual. It goes beyond identifying the challenges, it reveals the "why" behind them.
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Standardised assessment tools:
Grace uses various standardised tools which allows an individual's characteristics or abilities to be measured and compared to norms for their age and gender. This helps to show the degree of difference between the individual and their peer group.
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Understanding the internalised experience of autism:
An individual can have and enjoy friends, be described as happy and well-behaved at school, and be building a collection of achievements and still have autism. It takes an experienced clinician to look beneath this and see the conscious effort it requires from them, the exhaustion it can cause, and the many small adjustments that parents and teachers have been making to support their sucess. These factors may not show up in standardised questionnaires therefore are explored through discussions with parents, the individual, and other's involved in their life.
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Considering all forms of neurodiversity:
With increasing recognition of the shared characteristics experienced in autism, ADHD, and other neuro-differences, Grace considers all facets of neurodiversity in her assessments. This can help to clarify which diagnostic category best fits an individual's profile and considers co-occurrence.
