Adult ASD diagnostic & treatment clinic

ASD ASSESSMENT SERVICES

Tourettes SydneyNEW ADULT ASD ASSESSMENT (based on Autism CRC Australian Guidelines)*

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

As part of the Australian Guidelines, prior to formal assessment we  require patients to have their GP do a health screen, and 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. 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).

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 24 hours prior to the assessment at the centre (but can be completed after the GP assessment).

(2) Review with GP

The patient will need to undergo a review with their 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). We recommend this is conducted as soon as possible once the assessment is booked in case the GP recommends additional  testing (such as genetic testing or brain scanning). Whilst not having these results will not delay the actual assessment at the SCDC, it will 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.

(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:

(1) 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

(2) A diagnosis will 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

(3) 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.

 

Cost of adult ASD assessment:

Standardised Assessment Questionnaires: $80

Comprehensive Needs Assessment: $300 per hour (usually 2 hours)

Diagnostic Evaluation: $300 (1hr) or $200 (30min)

Report: $200

Note: A $150 deposit is required to secure your assessment date, and this amount is non-refundable as it includes the costs of the questionnaires ($80) as well as reserving a 3 hour time slot with a Clinical Neuropsychologist. Please make sure that you are committed to having an appointment as this cannot be refunded if you change your mind.

*Please note: If you have been previously quoted $690 for assessment this is based on our older procedure assessment done by a registered psychologist (2 hrs only). This is a a very similar assessment to the one above (ie. it collects the same information and reviews the same diagnostic criteria), however it does not require medical review and does not require final diagnostic confirmation by an endorsed Clinical Neuropsychologist.

ASD THERAPY SERVICES

We offer a range of different types of therapy for people who have been diagnosed as falling on the Autism Spectrum:

Psychological therapy:

Psychological therapy is aimed at treating any comorbid anxiety, depression, anger or frustration that is commonly seen in people with ASD. Particularly social anxiety is treated if present. We can also work upon certain behaviours such as fixations and issues with flexibility that significantly effect daily functioning. This is individualised according to the person’s needs and goals specified on the initial consultation. We are able to also offer couples counselling specific to ASD.

Social skill training:

This involves typical social skill training, as well as training in theory of mind (ie. understand things from others point of view). It will be individualised and may also include reading emotional expressions and body language, as well as general training in social conventions.

Neurofeedback:

Many people on the spectrum have some significant emotional dysregulation that can also be treated via neurofeedback. Neurofeedback involves conducting a brain scan and understanding which areas of the brain are over- aroused (or even in some cased under-activated). We then train people to regulate their own brain waves. This can be particularly helpful for people on the spectrum who have explosive moods or severe anxiety, as this type of therapy treats from the neurophysiological (ie. brain perspective), changing the way the brain functions utilising principles of neuroplasticity.

Duration of therapy:

All therapy sessions are individualised according to the patient’s needs and goals that are set during the initial consultation

Cost of therapy:

Initial psychological consultation is $260. Follow-up consultations are $230 per session (approximately 1 hr). Medicare rebates available under a mental health treatment plan. Please contact your private health insurance to find out of you are specifically covered for psychology. For neurofeedback rebates are unavailable so we have discounted the sessions to $120-$150 per session (price dependent on time of day).

Note: Some people on the spectrum are able to access NDIS funding. It is noted that we can only take on NDIS patients that are self-managed for their therapy. NDIS only funds $179 per session and does not allow us to charge more than this cap for plan managed and NDIS managed patients. NDIS funded patients will need to contact providers who are able to charge under this cap and your NDIS plan manager will be able to give you a list of NDIS participants. The recommended rate for psychological therapy according to the Australian Psychological Society is $251 per hour. Whilst we aim to be as reasonable as possible in our costs, and come in well below the recommended Australian rate, the NDIS have placed the cap unfortunately out of reach for our clinic.

[This page was updated 22nd January, 2020]

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.