Do I Need an Assessment for Autism or ADHD?

Autism, ADHD, giftedness, and neurodiversity can impact so many areas of a person's functioning and well-being—from school, social life, work, and just overall mental health. You may read an array of articles and relate difficulties of autism symptoms, ADHD symptoms, or possibly both. Or maybe it’s social anxiety or depression? Sometimes it may be difficult to distinguish without professional guidance or assessment. This post will help walk through what to consider and what to expect.

Do I Need an Assessment?

A comprehensive assessment can be a big investment—of time, energy, and money. When considering the need for an assessment, it’s important to think about:

• The chronicity of difficulties.
• The extent of the difficulties.
• If difficulties have resulted in other apparent mental health concerns, like depression or anxiety.
• If you tried other interventions that have not resulted in sustained relief.

Many times, we can feel like we’re coping with our difficulties in a constructive way, without realizing that we've developed maladaptive ways of coping to get by.

When attempts at therapy, behavioral interventions, or change of environment have not resulted in any sustained relief, it may be time to consider a comprehensive assessment. It may have been that without truly understanding the underlying source of our difficulties, we end up treating the wrong disorder. For example, if you believe you have a viral infection, and treat it with antibiotics, it will not address your illness. The same goes for mental health.

What to Look For

A comprehensive and robust psychological assessment holds immense value in being able to discover the underlying sources of our difficulties. It can also uncover strengths, differences, and limitations that have been present throughout your life and provide recommendations to address your overall well-being and functioning in these areas. It should provide a thorough understanding of your cognitive, interpersonal/social, intellectual, neuropsychological, and psychopathological strengths, difficulties, and adaptive coping in different areas of functioning. It involves screeners, questionnaires, testing and assessments, interviews, and observations to collect a broad range of objective and subjective data.

What your assessment should likely not entail is a basic screener or brief interview that leads to your diagnosis. Many mental health disorders can manifest as difficulties with social interactions, paying attention, or task initiation. As shared above, if you are diagnosed incorrectly, you could engage in treatment that may not be relevant to the underlying issue, and thus likely exacerbating your difficulties.

A comprehensive assessment should include:

1. Accurate Diagnosis: A tailored, comprehensive assessment is crucial for obtaining an accurate diagnosis. There are many overlapping traits in neurodiversity, including difficulties with attention and focus, working memory, sensory sensitivities, other executive functions, and social skills. Therefore, an in-depth assessment of different neurodevelopmental conditions such as autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), specific learning disorders, giftedness, twice-exceptionality, and intellectual disabilities is imperative to target treatment and interventions around the correct symptomatology. An accurate diagnosis forms the foundation for personalized interventions and support strategies.
2. Understanding Individual Strengths: Assessing an individual’s cognitive abilities not only highlights challenges but also uncovers their unique strengths that can be beneficial to their day-to-day quality of life. Recognizing and capitalizing on these strengths promotes the development of a personalized and strengths-based approach to improve mental health, self-esteem, and well-being.
3. Recommendations and Accommodations: An assessment provides valuable insights into an individual’s learning style, cognitive strengths, neuropsychological functioning, and areas of difficulty. These insights inform the development of individualized education plans (IEPs), work accommodations, and tailored approaches to learning and working environments. This can be most useful to access support services and provide accommodation recommendations to unlock potential and create more purposeful functionality in these areas.

When seeking a comprehensive psychological assessment, it is essential to work with an evaluator who is qualified and experienced in the specialization in the area in which you are seeking assessment. Because you are investing your time, money, and energy, you want to make sure that you are obtaining the optimal benefit.

Questions to Ask a Potential Evaluator

1. Do you specialize in assessing for neurodiversity? What kind of testing is under your scope of practice? Neurodiversity is a unique niche that must be carefully understood due to its complexity and the depth of knowledge necessary to understand its nuanced presentations. It can be helpful to be assessed by an evaluator who is licensed and qualified to provide the broadest capacity of assessments, including individually administered intellectual and neuropsychological assessments. The use of these types of tests is imperative in determining differential and dual diagnoses of other neurodiversities, including learning disabilities, developmental disabilities, and giftedness.

2. What procedures will be utilized? The American Psychological Association recommends that evaluators use evidence-based, multi-method procedures for diagnostic evaluations. This will include a robust developmental and lifetime clinical interview, screeners, questionnaires, individually administered, standardized neuropsychological, psychopathological, and personality testing (tailored to the individual), and collateral interviews and documents (as needed and available).

3. With my particular concerns, what is your estimate of how long the assessment process will take, what tests will you administer, and what can I expect during that time? These should be standardized, evidence-based assessments and procedures that are tailored to your primary concerns, along with testing that can provide differential diagnostic information for other disorders that may be co-occurring or have overlapping features with your primary diagnostic concern. Depending on the battery used, a thorough assessment can range anywhere from 8 to 23 hours, depending on the clinical interview, types of testing required, and type of report being requested.

4. How will my observations and reports from other professionals be considered in the assessment? It is important that a diagnosis not be taken directly from other evaluations but can be utilized as collateral information for understanding prior functioning. This information can be helpful to integrate into your current assessment for assessing fluctuations in your cognitive, adaptive, or intellectual functioning.

5. Will the assessment include a differential diagnosis? If so, why is it important? A differential diagnosis can be imperative when it comes to your assessment recommendations. If you seek treatment for an inaccurate diagnosis, it can prolong or worsen symptoms. Similar to treating a viral infection with antibiotics, it will not address the underlying issue. Therefore, your evaluator must consider other possibilities that may be contributing to your difficulties and concerns.

6. What are some potential differential diagnoses that may be considered based on my concerns? Within the assessment of neurodiversity, there are many overlapping features of each diagnosis, including difficulties with working memory, attention and focus, social skills, and executive functioning. Mental health symptoms can also impact these areas, including trauma, anxiety, depression, OCD, personality features, etc. It is therefore important to screen and assess for the differential of each of these disorders, as they can appear similar but will have unique nuances in an accurate diagnosis. It will be important to provide accurate recommendations that will support and treat your difficulties and symptoms.

7. How can I use the results to access support services or occupational and/or educational accommodations? If you are seeking work or academic accommodations (i.e., a quiet environment at work, using dictation devices, or longer time on the SAT or LSAT), your evaluator must be licensed and credentialed in the requirements set forth by your work, college admissions, or board. Without the proper license or credentialing requirements, your accommodation request may be denied. Furthermore, make sure that your evaluator is also utilizing the proper testing procedures and has experience providing the types of accommodation recommendations that are required for your specific purposes.

8. (Based on preference) If you feel comfortable sharing, do you have any neurodiversity? This can be a very personal but also meaningful question for some individuals looking for an assessment for autism, ADHD, or giftedness. Some individuals want to know if their evaluator can empathize and understand the struggles that they have experienced. While it's not essential that an evaluator is neurodiverse to provide a comprehensive and valid assessment, it is up to the individual being evaluated if this is an important personal aspect for their assessment.

Conclusion

A comprehensive psychological assessment can be a fundamental tool for understanding your or your child’s unique strengths, challenges, and cognitive and socioemotional functioning. Understanding areas that have led to long-term struggles and empowering your strengths can greatly enhance your overall sense of self, success, and well-being. Your dedicated involvement in the process can advance the depth, validity, and benefits of your assessment.

By asking important questions, actively participating, and having the fortitude to uncover possibly vulnerable reflections, you and your support network can gain invaluable insights to foster a more fulfilling quality of life. We all have needs, and identifying your or your child’s unique brain functioning can uncover much-needed support for long-term quality of life.

To find a therapist, visit the Psychology Today Therapy Directory.