CHILD/TEEN AUTISM & ADHD ASSESSMENTS

Before the session

Questionnaires are completed by:

• A parent or guardian

• A teacher, if possible (only for younger children)

• The child, if possible (only for adolescents)

School report cards and/or previous paediatric or psychological reports are requested to be sent to us (if available).

Assessment session

The assessment session is conducted via videoconference. The session typically lasts 2.5-4 hours (with breaks!), depending on the type of assessment.

During the session, the psychologist will generally spend some time speaking with the child/teen being assessed, some time with their parent/guardian, and some time with both together.

Various empirically validated measures may be used, such as the ADI-R, ADOS-2*, MIGDAS-2, TELE-ASD-PEDS (TAP), and CARS-2, depending on the age of the child and the purpose of the assessment.

An assessment of relevant areas of functioning (a requirement for access to some supports) is also included.

If additional assessment is required a follow-up appointment may be arranged (at no additional cost).

After the session

If you are also being assessed for ADHD, you may be asked to arrange for the child/teen to complete a 20-minute neuropsychological task on your computer at a time that works for you (if this is relevant your psychologist will send you the link after the session).

Once all the required components of the assessment are completed the assessment report will be produced (including diagnosis and recommendations). This usually takes up to 2.5 weeks.

* Please note, while the ADOS-2 can be a useful tool in assessing autism, there is evidence that it may be less sensitive to traits of autism in more subtle presentations such as those with more developed language abilities and women/girls.

Listed fees are inclusive of assessment session(s) and report.

Children/Teens (9-17 years)

• Autism Assessment 1980

• ADHD Assessment is 1980

• Combined Autism and ADHD Assessment 2490
  

Half the fee is payable before the assessment session, and the balance is due before the report is produced.

Once you have completed the assessment process a report will usually be available within 2.5 weeks.

Autism (also referred to as Autism Spectrum Disorder or ASD) is an experience associated with differences in social communication and interaction.

For example, an individual on the autism spectrum may have difficulties with:

· Starting and engaging in back-and-forth conversation.

· Sharing of emotions and interests.

· Nonverbal communication (e.g. facial expressions and gestures).

· Developing, maintaining, and understanding relationships.

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Individuals on the autism spectrum also often experience restricted or repetitive patterns of behaviour, interests, or activities, such as:

· Repetitive motor movements or speech.

· Inflexibility in routines or ways of doing things.

· Interests that seem more restricted or fixated than typical.

· Under- or over-reactivity to sensory experiences (e.g. touch, temperature, pain, lights, sounds).

For example, here are some young people explaining how they experience autism:

Here, Professor Andrew Whitehouse discusses some common myths about autism:

Attention-Deficit/Hyperactivity Disorder (ADHD) describes a persistent pattern of difficulty sustaining attention and/or hyperactivity-impulsivity that interferes with functioning.

Here is a useful description of what ADHD is from someone who experiences it:

Autism is often accompanied by other forms of neurodivergence or mental health diagnoses.

For example, 50 - 70% of those who meet the criteria for ASD also meet the criteria for Attention-Deficit/Hyperactivity Disorder (ADHD).

Anxiety, depression, and some physical difficulties (e.g. hypermobility) are also more common among those with diagnoses of autism.

Some individuals with autism may not display autistic traits or symptoms of ADHD publicly due to attempting to 'fit in' or appear 'typical' around others i.e. 'masking'. This appears to be especially likely among women and girls, but many neurodivergent individuals engage in masking, regardless of gender.

The possibility that the child/teen being assessed may engage in frequent masking would be explored as part of the assessment process.

Here is a useful description of masking and the impact it can have on functioning at school and other environments:

The following cartoon represents how children who frequently 'mask' may become very fatigued or 'burned out':

While no screening questionnaire is 100% accurate (in particular for children/teens with more subtle traits of Autism or ADHD), it may be worthwhile completing the following screening questionnaires to gain insight into the degree to which your child/teen relate to common traits of autism or ADHD.

• Autism brief screening questionnaires:

Children 6-17 years

https://psychology-tools.com/test/autism-spectrum-screening-questionnaire

Children 4-11 years

https://psychology-tools.com/test/cast

Children 16-30 months

https://www.autismspeaks.org/screen-your-child (NB while the MCHAT-R was intended for

use up to 30 months of age, the authors indicate that it may be used with children up to 48

months of age)

• ADHD brief screening questionnaire:

Children 4-17 years

https://psychology-tools.com/test/vadrs-vanderbilt-adhd-diagnostic-rating-scale

Please note, some individuals with autism may have lower scores on screening questionnaires due to 'camouflaging' or 'masking' behaviour i.e. attempts to 'fit in' or appear 'typical' around others. This possibility would be explored as part of the assessment process.

A diagnosis of autism and/or ADHD may also be more likely if there is a family history of diagnoses or traits of autism or ADHD.

When you receive your report you will have an opportunity to debrief with the assessing psychologist.

You will also received recommendations to assist with achieving goals and managing and overcoming challenges. These often include:

• Accommodations/adjustments to assist your child's functioning at school.

• Therapy/counselling. Though mental health symptoms such as depression or anxiety often improve to some degree when previously undiagnosed autism/ADHD is diagnosed.

• Social skills training (in groups or individually).

• Learning more about how autism and/or ADHD influences your child's life and relationships. Many parents also find professional support (e.g. psychological or occupational therapy) helpful with understanding their child's experiences and empowering them to support their child's development and pursuit of valued life directions. There are also many fantastic self-help resources available to assist with this process.

• Medication/behavioural strategies for ADHD. Each of these can assist with improving capacity to sustain attention.

• NDIS funding. In cases where functioning is substantially reduced.
  

The Harbour Clinic can assist with any documentation that is required to access supports or accommodations.

Reports from our assessments include an official diagnosis (including severity levels in the case of Autism), assessment of functional impairment, and support recommendations.

Please note that a diagnosis is not a guarantee of an approved application for NDIS supports (as this depends on other factors such as level of support needs).

More information regarding applying for NDIS supports may be found here: https://www.ndis.gov.au/applying-access-ndis

Queries regarding applications for educational supports or accommodations should be directed to your child's educational institution, but your assessing clinical psychologist will be happy to complete any application forms, letters etc which are required.

A clinical psychologist is able to provide official diagnoses, however we do not prescribe medication.

If medication is recommended/desired (either for ADHD or mental health difficulties) a GP referral to a paediatrician or child & adolescent psychiatrist is required.

Often children and teens with undiagnosed Autism, ADHD, or other difficulties have been struggling for years without knowing why. Some unfortunately see their difficulties as evidence of character flaws.

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For many it is a relief to understand the source of their difficulties - whether it be Autism, ADHD, or another diagnosis. This can then facilitate increased understanding of oneself and engagement with sources of support. Parents are also often relieved to have an explanation for and strategies to manage challenges.

​Although we do not prescribe medication, having an existing diagnosis if you do end up seeing a paediatrician or psychiatrist can also save time. Some paediatricians or psychiatrists ask for a prior assessment (e.g. by a psychologist) before prescribing medication.