Adult Autism Assessments: What to Expect

If you or a loved one is considering an autism assessment for an autism diagnosis but feeling overwhelmed about where to start, this guide is here to provide clarity on the process and what you can anticipate.

Autism Assessment & Diagnosis Process for Adults

Clinical History/Interview

The assessment process usually begins with some exploration of your background, encompassing health, development and significant events. Assessors will inquire about your primary symptoms of concern during this phase.

Formal Assessment

Following the background examination, the assessor conducts a thorough assessment to delve deeper into your symptoms. Two commonly used assessments are the ADOS-2 (Autism Diagnostic Observation Schedule-Second Edition) and the MIGDAS-2 (Monteiro Interview Guidelines for Diagnosing Asperger’s Syndrome).

The ADOS-2 is a practical assessment that provides a controlled environment for an assessor to observe symptoms of Autism and can be particularly valuable for those uncertain about how their symptoms impact them.

The MIGDAS-2 is a flexible semi-structured interview, which is preferable for those well-acquainted with their symptoms.

At PsychWest, we currently use the ADOS-2 for both child and adult assessments.

After the main assessment, your assessor may screen for additional conditions that could influence your symptoms, such as ADHD, CPTSD (complex post-traumatic stress disorder), or mood disorders.

References

Assessors often seek input from family, partners or close friends to gather observations. References can be provided in person using the ADI-R or a semi-structured interview, over the phone or in written form. School reports can serve as supplementary information for adults.

Report and Feedback

After gathering information, your assessor should compile this into a report and provide a feedback session.  This session aims to address next steps, potential funding options, and answer any questions you may have.

Who can diagnose autism?

Psychologists or psychiatrists who have had relevant training and experience with autism can diagnose and provide support through the assessment process. If you are seeking assessment, ensure that you let the practice know so that they can direct you to the correct practitioner and you can start the assessment process right away.

It is recommended that you research the assessment processes of available practitioners to make an informed decision. PsychWest is currently accepting appointments for autism assessments and combined autism/ADHD assessments.

What should I do now?

Given the typical waiting lists for autism assessments, take this time for reflection. Whether awaiting an assessment date or contemplating the need for assessment, consider how autism might explain your history and current symptoms.

Embarking on an autism assessment journey can be daunting, but understanding the process and being informed about available resources will help you navigate this important step toward understanding and support.

Start the process today by contacting PsychWest here.

What is Autism?

Autism: Where to Start

Autism is a developmental condition that originates in childhood and is likely to continue into adulthood. Autism begins before the age of three and occurs in all racial, ethnic and socioeconomic groups. It is more common, however, in males.

Little is known about the cause of autism, but some factors have been identified that may make a child more likely to develop autism. These are environmental, biological and genetic.

Autism is characterised by a number of behaviours and differences. People with autism may behave, communicate/interact with others and learn in ways that are different to most people. They have difficulties in the areas of language/communication, social awareness, monotropic mindset, information processing, sensory processing, repetitive behaviours and neuro-motor differences.

Common Symptoms of Autism Include

Social Communication and Interaction Skills

Some common signs or symptoms in the area of social communication and interaction skills include:

• Avoids or does not keep eye contact

• Does not respond to name by 9 months of age

• Lack of facial expressions by 9 months of age

• Does not share interests with others by 15 months of age

• Does not notice others are hurt or upset by 24 months of age

• Does not join in with play with other children by 36 months of age

• Does not role play by 48 months of age

• Children with autism can become non-verbal, or they can be fully verbal.

As older children and adults, it can look like:

• Difficulty engaging with and maintaining friendships/relationships

• Difficulty communicating in social contexts

• Differences with pragmatics (appropriate use of language)

• Prosody (rhythm) of speech

• Difficulty assimilating or adapting to changing environments

Restricted or Repetitive Behaviours or Interests

This can look like:

• Lining up toys or other objects

• Repeating words/phrases over and over

• Playing with toys the same way every time

• Can become upset by changes in routine

• Has obsessive interests

• Hand flapping/body rocking or spinning

• Sensitive to certain smells, touch, tastes or sounds

Other Characteristics

• Delayed language skills

• Delayed movement skills

• Delayed learning or cognitive skills

• Hyperactive/impulsive or inattentive behaviour

• Epilepsy or seizure disorder

• Unusual eating or sleeping habits

• Gastrointestinal issues

• Unusual mood or emotional reactions

• Excessive anxiety and worry

• Lack of fear or more fear than expected

• Effects on body control and movement eg. clumsiness

Why Autism is a Spectrum

The spectrum does not equate to the severity of the condition, which is a common misconception. The spectrum relates to the diverse range (spectrum) of related neurological conditions or abilities. The abilities of people with autism can vary significantly. Some autistic people require more support than others to live their daily lives. Every autistic person presents differently. The saying “if you have met one autistic person, you have met them all” does not stand for this condition. For example, all autistic people will have some type of difficulty with social/communication AND restricted/repetitive behaviours or interests, but to different and varying degrees.

How Autism Affects Daily Life

Autism can affect people’s daily life in different ways - it really depends on the individual and what they have difficulties with. One person could be non-verbal and another person could have an intellectual disability. Some people with autism will never be able to live independently while others can live an independent lifestyle.

How Autism is Diagnosed

In order for someone to be considered autistic, they must have difficulty in multiple categories spanning the spectrum. There is no medical or blood test that can be administered to make a diagnosis. Clinicians (GP’s, Psychologists, Psychiatrists and Paediatricians) look at the child’s (or adult’s) full developmental history and behaviour to make a diagnosis. It often involves more than one specialist, some standardised assessments, behavioural observations and comprehensive interviews.

Difference Not a Deficit

In recent times, the viewpoint that autism is a deficit or disability has been criticised. Many experts are encouraging society to embrace autism as a difference, whilst at the same not underestimating the difficulties this group that experience. The acceptance of difference can go a long way to improving the lived experience of those with autism.

If You Are Concerned

Lachlan at PsychWest is available to assess for and diagnose autism in all ages. Click here to learn more about the assessment packages at PsychWest.