Adult Autism Spectrum Clinic

Adult ASD diagnostic & treatment clinic

ASD ASSESSMENT SERVICES

ADULT ASD ASSESSMENT (based on Autism CRC Australian Guidelines)

Note: Due to the coronavirus pandemic we have made some alterations to our processes which are in ‘red’ below.

Our assessment follows the Australian national guidelines for Autism Spectrum Disorder assessment as outlined by Autism CRC.

As part of the Australian Guidelines, prior to formal assessment it is recommended to have patients go to their GP do a health screen. We email a review list for patients that they can go through with their doctor prior to them attending the formal assessment at our centre. NOTE: given the current Coronavirus Pandemic, we have now decided to only do this GP review if felt required following the formal assessment with the neuropsychologist. Healthy and safety are priority and we feel that it is important to limit attendance at GPs where possible. The assessment is done in 3 parts as per Australian Guidelines, consisting of (1) a GP ASD-based medical review (2) a Comprehensive Needs Assessment and (3) a Diagnostic Evaluation (by a clinical neuropsychologist). The GP review will only be needed now if deemed necessary following the other 2 stages.

 

ASD Assessment Procedure:

(1) Booking & Questionnaires

Once an assessment is booked with our team, the patient (or caregiver) will be emailed a series of questionnaires as well as an information sheet and checklist for their GP. The questionnaires involve standardised assessment and constitute part of both the Comprehensive Needs Assessment and the Diagnostic Evaluation. This will need to be completed at least 1 weeks prior to the assessment at the centre.

(2) Review with GP (With the Covid-19 pandemic this will be deferred to after the neuropsychological assessment, and only required if deemed necessary at this later stage)

The patient will need to undergo a review with their GP, and we will provide information to take to your GP. It is vital that the information sheet is taken to the GP as not all GPs will be familiar with the latest requirements for ASD medical screening. The GP should complete the form and make referrals for additional testing (if needed). If this review is deemed necessary after the neuropsychological assessment, this will slightly delay the final diagnosis and report. That is, all results will be needed to do the final diagnosis and a report cannot be completed until all results are available. If you have concerns about attending your GP, then we can provide an interim ASD report, which can be finalised after the coronavirus pandemic is over and the GP consultation completed. It is noted however that the majority of assessments will now no longer need this medical review so we do not recommend deferring the assessment.

(3) Comprehensive Needs Assessment (approximately 2 hours)

This assessment will involve review of full medical, developmental, educational and mental health history. Family history will be discussed so if you are unclear of current family history you may want to discuss this with family members prior to the consultation where possible. Social and environment factors will be investigated, along with other potential differential diagnoses that may better account for the symptoms. Strengths will be considered in relation to how they inform needs. DSM-5 criteria will be thoroughly explored via clinical interview. This will include:

  • Social issues: Problems in social-emotional reciprocity, issues in nonverbal communication & deficits in developing and maintaining social relationships.
  • Restrictive patterns of behaviour: Issues with repetitive motor movements, inflexibility with routines, fixated interests and hyper/hypo-sensitivities.

It is noted that whilst differential diagnoses and comorbid (co-occurring diagnoses) may be explored, it is unlikely at the initial consultation that diagnosis of disorders other than ASD will be able to be made. In most cases, testing of other disorders will need to be done as part of additional assessment (eg. learning issues, ADHD, language disorders, intellectual disability, motor disorders, emotional or behavioural disorders, sensory processing disorder etc).

(3) Diagnostic Evaluation with a Clinical Neuropsychologist (30-60 min):

All collected information as well as results from the Comprehensive Needs Assessment will then be reviewed and outcomes determined. At this stage one of three outcomes will occur:

(A) A diagnosis will be ruled out. If this occurs, other potential diagnoses will be discussed and if needed, additional assessment into these areas recommended.

OR

(B) If there are any medical issues that need to be ruled out by your GP, at this stage you will be asked to see your GP for review (possibly via Telehealth for safety from Covid-19). If no further testing is needed, then a diagnosis can be confirmed. If this occurs we will discuss recommendations for therapy as well as discuss potential co-occuring disorders that may need further assessment and treatment.

OR

(C) A diagnosis is unclear and further testing will be required. It is noted that sometimes in borderline or unclear cases it can be helpful to get information from caregivers, spouses or even children. In these cases with permission from the patient we will contact these peoples to gain additional information to clarify whether full diagnostic criteria is met. Please note that this may delay the report, hence, if you require the report by a certain date, please make sure you book well in advance.

(4) Report

A report will then be prepared within approximately 3 weeks outlining the results, diagnosis, support needs, potential comorbities (or potential differential diagnosis if a diagnosis is not conformed), along with recommendations and additional resources.

Costs of Autism Spectrum Disorder Assessment

Standardised and clinical questionnaires: $40

Comprehensive Needs Assessment & Diagnostic Evaluation: $300 for the first hour, $280 for subsequent hours (or part thereof). An ASD assessment lasts typically for 2 hours, however for more complex cases with more severe comorbidities it can go up to 3 hours.

Report: $150

Note: There is a $150 deposit to secure a 3 hour appointment time period with our neuropsychologist, and this deposit will be taken off the final invoice. This deposit does cover immediately the costs of questionnaires, as upon booking your appointment we immediately purchase standardised questionnaires from a psychological test company on your behalf. Note: This is a non-refundable deposit.

More about Autism Spectrum Disorder in Adults

Common issues in Adult ASD

People with ASD have a wide range of strengths, weaknesses, skills and difficulties. Common characteristics include:

Social Issues: People with ASD often have difficulty in forming friendships, communication difficulties (such as a tendency to take things literally), and an inability to understand social rules and body language. They are often seen to be weak in empathy.

Anxiety: Anxiety symptoms are very common in adults with ASD and issues coping with change and uncertainty are common.

Anger: Adults with ASD often get easily irritated with other people as they have a poor theory of mind and cannot easily understand why people do certain things. They can appear very judgemental and criticise others for stupidity if things are not done in the way that they think things should be done.

Depression: As adults with ASD get older and realise that they are somewhat different from others, they can feel like they don’t fit in on this planet and often complain that they feel like “aliens”

Cognitive Flexibility: People with ASD often prefer routines and do not cope well with change

Strong obsessions: People with ASD often have strong areas of interest that they like to engage in or read about. They often like to talk to people about these areas and feel like they need to share this information, even if the other person is not interested.

Treatment options for adults with ASD:

At the SCDC we offer the following types of therapy to help address the needs of adults with ASD:

  • Coping skills and resilience: coping with change and the anxiety it arouses
  • Social skill training and couples counselling (if the person is struggling in a relationship)
  • Anger & frustration management
  • Psychological therapy to address emotional issues such as depression
  • Improved cognitive flexibility
  • Neurofeedback

ASD & relationships

Some people with ASD can successfully maintain relationships, however this can be particularly challenging for both parties. A common issue is unfair distribution of household responsibilities. That is, the partner may start to do everything when it is just the two of them. However if they decide to have children, the partner may need practical and emotional support which the person with ASD may struggle to provide. When the partner becomes upset due to the lack of help, the person with ASD can be quite puzzled due to issues with theory of mind. Often things need to be discussed very explicitly with the person with ASD, and there is little point in assuming that the person with ASD will know what help is needed without being given explicit instructions. This can create tension. At the SCDC we have seen many cases where the adult’s diagnosis of ASD often follows their child’s diagnosis of autism spectrum disorder. This can be extremely distressing to the partner who has to cope with both diagnoses simultaneously. Counselling, or joining a support group where they can talk with other people who face the same challenges, can be helpful.

ASD & Work

The government has funding to help people with ASD, and can also provide a range of specialist employment services. A person with ASD may find their job opportunities limited by their disability. It may help to choose a job that takes their issues into account, and maximises their strengths rather than their weaknesses.