Autism and ADHD Assessment

Autism and ADHD assessment is a primary focus of our work here at Cup of Tea Psychology. We pride ourselves on our work in identifying neurodivergence and supporting you through all stages of this journey.

Here you can learn about what we do differently to provide you with high-quality, neurodiversity-affirming care.

The assessment process may vary for individual clients as we tailor our approach to each person.

Once you get in touch with us for an assessment and we gather basic information, the first step is our consent process. We provide you with information on our practice policies, confidentiality, billing, and any other information you need and have you complete a consent form.

After this we gather additional background information from you, either during an intake session or online, to establish:

  • What you hope to get out of the assessment

  • Whether a formal assessment is the right choice for you, and

  • The appropriate methods to use.

We then move to the assessment stage, which will most likely involve some online questionnaires and clinical interview sessions.
For younger children, questionnaires and interviews are usually completed by parents/caregivers, plus a separate session with the child. We also seek input from teachers, preschool educators, or other significant people in the child’s life, with parental/caregiver consent.
For adolescents, both self-report and parent/caregiver questionnaires are usually completed. Caregivers may participate in the same or a separate clinical interview to their child (generally at the adolescent’s preference). We will also seek input from teachers, provided the adolescent consents.
For adults, the assessment consists primarily of self-report information. It is up to the client whether they would like to have a parent, friend, partner, or other support person complete additional questionnaires or participate in the clinical interviews - but it is not necessary.

Once the clinical interviews and questionnaires are completed, your psychologist will compile all of the information and evaluate it against the relevant diagnostic frameworks to determine the outcome. A comprehensive report is written which includes the outcome, as well as recommendations for the client or their support people.

The report is generally returned to you during a feedback session to allow your psychologist to explain and clarify any information or conclusions, and help you plan any next steps.

Our Process

Our Assessment Methods

We aim to use the most neurodivergence-affirming and evidence based assessment methods available. Unfortunately, not all commonly used psychometric tools are affirming, however we use our clinical judgement to ensure that results are interpreted through an affirming lens.

The primary tool we use to identify autism is the Monteiro Interview Guidelines for Diagnosing the Autism Spectrum (2nd edition), or MIGDAS-2. This is an interview protocol that helps us to gather qualitative information about your experience and any traits that are consistent with autism. The MIGDAS-2 is a flexible, strengths-based protocol that facilitates deeper engagement with clients and provides valuable narrative information. It emphasises clinical judgement and provides a less stereotyped or pathologising approach than other commonly used tools.

The primary tool we use to identify ADHD is the Diagnostic Interview for ADHD, or DIVA-5. This is an interview protocol that seeks qualitative information about the clients experience of ADHD traits. The DIVA-5 is helpful in gathering feedback from the client and their loved ones about the presence of each trait, with examples provided as prompts. Clinical judgement plays an important role in identifying non-stereotypical expressions of ADHD traits.

We also use a variety of shorter questionnaires or screening tools in our assessments to gather a robust body of information. Examples of some of these tools are:

  • Ritvo Autism Asperger Diagnostic Scale–Revised (RAADS-R)

  • Camouflaging Autistic Traits Questionnaire (CAT-Q)

  • Adult ADHD Self-Report Scale (ASRS)

  • Vanderbilt ADHD Diagnostic Parent/Techer Rating Scale (VADPRS/VADTRS)

  • Executive Skills Questionnaire – Revised (ESQ-R)

  • Toronto Alexithymia Scale (TAS)

  • Multidimensional Assessment of Interoceptive Awareness – Version 2 (MAIA-2)

  • Sensory Processing Measure, 2nd Edition (SPM-2)

  • Social Responsiveness Scale, 2nd Edition (SRS-2)

The exact measures used for an assessment depend on demographic factors, individual circumstances, and the purpose of the assessment.

What about the ADOS-2?

There are some assessment tools that are frequently used by other clinicians, but we do not use at Cup of Tea Psychology. One of these is the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). Some still consider the ADOS-2 the ‘gold standard’ in assessing autism, however it is generally not used by neurodiversity-affirming practitioners.

We believe it is important to be transparent around topics like this, and to inform our clients of the reason for our clinical decisions. Some of the reasons that we don’t use the ADOS-2 at Cup of Tea Psychology are:

  • Evidence indicates it is less effective in identifying autism in females, those with high intellectual and/or verbal ability, and those with less stereotypical communication differences

  • It follows a deficit-based framework and reinforces non-affirming language like impairment, abnormal, deficit, and the term ‘Autism Spectrum Disorder’

  • Evidence indicates that there is a higher risk of false positives for individuals with other psychological conditions

  • The assessment follows a rigid, score-based structure and leaves little room for clinical judgement

  • Feedback from autistic individuals who have been assessed with the ADOS-2 includes finding the process infantilising, uncomfortable, and invalidating.

Our aim is to provide a safe, validating, and affirming experience for all clients, whether they are neurodivergent or neurotypical, and our selection of assessment tools is part of this.