Assessments

What is Neurodiversity?

Neurodiversity (ND) is a broad term that acknowledges that some people think and process information differently from the way a statistical majority may expect. Among these particular neurological configurations, ADHD and Autism happen to be two DSM-5-TR diagnosable genetic neurotypes that differ from other forms of neurodivergences, which can include sensory sensitivities, complex developmental trauma, personality differences and other specific learning differences.

As an independent assessor, Vivien cares deeply about the professional obligations to maintain objectivity while practicing in a Neuroaffirming/ Neurodiversity-affirming manner. This involves wholeheartedly believing that each person has a unique brain, that there is no one ‘right’ brain and that people are ultimately the experts of their own lives.

To be truly ND-affirming, an unbiased and trained perspective is required to accurately identify an individual’s specific neurotype and life narrative. This ensures that clients’ unique neurodivergences are clearly traced so that there is authenticity in knowing themselves. To that end, specific professional development in the area of formal diagnostic assessments had been undertaken, including those for ADHD and Autism. Vivien adheres to national clinical guidelines for diagnostic assessments (e.g. Autism CRC, AADPA Clinical Guideline), which also acknowledge that due to a lifetime of unmet ND needs, a history of mental health concerns and personality structures may have developed and should be identified with compassion for self-awareness and further support.

Why a ‘comprehensive’ ND assessment?

A comprehensive ND assessment acknowledges the complexity of human life experiences, and approaches the opportunity to reflect on them with care and attention. Rather than restrict lines of inquiries to answering specific diagnostic questions (e.g. “Has the diagnostic criteria for ADHD and/or Autism been met?”), a comprehensive ND assessment asks, “What are the stories and frameworks that can more completely describe someone’s journey thus far (and does ADHD and/or Autism form at least part of this picture?)”

This holistic approach enables an individual to be understood in a more nuanced manner. It aims to identify all the relevant strengths, challenges and specific needs so as to develop useful person-specific support strategies. By being extremely thorough and careful in naming diagnoses, prospective clients can be more reasonably sure that they are arriving at an accurate self-concept and receiving treatment that will be appropriate for their actual support needs.

Who might benefit from a comprehensive psychological assessment?

Clients who seek a comprehensive psychological assessment often described feeling lost in their journeys and wanting guidance for the road ahead. The following clients, may find it particularly useful to take stock of their mental health, personality structures, and inquire whether ND applies to them: -

  • Those who are wanting to deeply know themselves and are open to all possible assessment outcomes, including negative or uncertain ones

  • Those who had received multiple diagnoses and formulations over the years and felt that something doesn't quite fit

  • Those who had received diagnoses after a single session assessment and felt unsure about their validity

  • Those who wonder about disentangling ND from the everyday challenges of intersectional identities, e.g. chronic illness, culture, disability, gender, sexuality, migrant, physical bodies, upbringing etc.

  • Those who are unsure about a previous ND assessment’s outcomes and would like another opinion

  • Those who intend to formalise identification of their neurotypes for education/ employment access

 

What does an assessment for ADHD and/or Autism involve?

Stage 1: Pre-Assessment Intake

  • Accessibility Check
    Clients are encouraged to consider their health, literacy, communication, technological and personal capacities before undertaking an assessment. If requesting particular types of service access needs (e.g. text-based communications, support person), clients are invited to be in touch beforehand so that the service can aim to facilitate them.

  • Complete Intake Form
    An online intake form will be sent through, inviting clients to provide written informed consent, and complete screeners and background history (psychosocial, developmental, educational).

  • Prepare Information
    Clients are advised that any available information they feel may be relevant and wish to provide would help support the process. These include but are not limited to: -

    • School/ teachers’ reports (3 - 18 years old)

    • Childhood photos and/or videos

    • Creative output (e.g. drawings, artwork, writing, digital works)

    • Early childhood stories (e.g. developmental milestones, temperament)

    • Previous medical/ psychology reports or letters

    • Personal notes of any relevant information

Stage 2: Assessment Sessions

The overall assessment process takes place over one hour-long sessions scheduled approximately weekly. By the end of the first interview session, clients will be advised the specific number of additional sessions that will be required to complete their goals for the assessment (e.g. total 3 or 4 assessment sessions).

Clients can generally expect the following to be discussed in the assessment interviews (in no particular order): -

  • Goals for comprehensive psychological assessment

  • Current life situation (e.g. concerns, self-care)

  • Past relevant history (e.g. childhood, school, family of origin)

  • Reviewing prepared information

  • Standardised questionnaires (for clients and any appropriate observers to complete between sessions)

  • ND-specific semi-structured interview(s)

  • Other relevant mental health assessments to consider co-occurring and differential diagnoses

Stage 3: Feedback Session with Report

During the feedback session, the outcomes of the psychological assessment will be reviewed, along with the goals of the assessment. The written report would have been prepared in advance and will be discussed in session.

  • Diagnostic outcomes

  • Support recommendations for wellbeing

 

Which assessment is recommended for my specific goals?

Committing to any type of assessment is a decision that reflects courage whilst in search of truth. The following notes may be of interest to clients with particular sets of circumstances in mind in considering the type of ND assessment to request: -

  • ADHD
    Within the ND-affirming clinicians’ community, it is generally recommended that possible referral options with a psychiatrist via a GP referral be explored instead if clients are inclined to consider a trial of medication related to managing possible ADHD. However, medication is not always an appropriate option for all potential ADHD-ers such that if you are not at all interested in a medication trial, then a comprehensive psychological assessment is appropriate to carefully disentangle other possible causes of executive functioning challenges from ADHD.

  • Autism
    Some clients have reflected that upon already receiving ADHD diagnoses and trialling medication, they had noticed a type of unburdening or ‘unmasking’ that led to wondering about whether they might also be Autistic. Alternatively, some clients relate strongly to having fundamentally different worldviews and values from the people around then, and while there may be some difficulties with organising life admin, do not feel that they are the same as the type experienced by ADHD-ers. An Autism-only assessment would thus be appropriate for these queries.

  • ADHD and Autism
    The AuDHD neurotype is distinct from either ADHD or Autism such that at least 4 assessment sessions will be required to systematically trace the origins of clients’ neurodivergences with this diagnostic query. Despite the high co-occurrence between ADHD and Autism, this neurotype is less common than it seems. It is recommended that those who strongly identify with the particular strengths of the AuDHD neurotype undertake this assessment.

  • Functional Capacity Assessment
    Clients who are identified as Autistic would automatically have their Functional Capacity assessed so as to determine the level of support needs as per clinical guidelines.

    However, the following client groups may also benefit from a Functional Capacity Assessment: -

    • Autistic clients who had previously been assessed as having Level 1 support needs and feel that their support needs have since changed due to the dynamic nature of disability

    • Clients who are not Autistic, but whose psychosocial impairments in their adaptive functioning should be identified to facilitate support for their wellbeing

    Note: Due to recent policy changes in NDIA, prospective applicants to funding access schemes are encouraged to also consider referral options from fields outside of psychology. In the interest of achieving holistic outcomes, it is recommended that when applying for access to the National Disability Insurance Scheme (NDIS), the services of an occupational therapist for a functional capacity assessment is also considered.

 

It is important to note that Vivien is trained to provide clinical psychological assessment and treatment only. Vivien does not provide forensic, family court nor medico-legal support to clients in this service, as this is an area of expertise in the psychology profession where an independent expert forensic opinion is often required. Please inform Vivien of any potential legal proceedings as soon as possible as it would be difficult to continue assessment and therapy if clients may have goals that Vivien is unable to help with (i.e. legal reports).