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Autism Assessment
A comprehensive assessment of the individual's development, skills, strengths, and any areas of difficulty can help to identify if they have an Autism Spectrum Disorder (ASD). Dr Hancock accepts referrals for pre-school aged children through to mid-adolescence.
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Formal diagnosis of ASD involves assessment by multiple professionals and is commonly initiated and coordinated by the child's Paediatrician. The professionals involved include psychology and often speech pathology, but may also include occupational therapy and others.
The process for an Autism assessment can vary for individuals, but it commonly begins with the child seeing a Paediatrician who will make referrals to Psychology and other professionals as part of the assessment. Dr Hancock recommends that the speech and language assessment be completed prior to the psychology assessment.
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Clinical Psychological Assessment & Formulation
While the main referral questions is whether the child/adolescent has autism or not, Dr Hancock also considers other possible explanations for the presenting challenges. This is important to ensure that other factors or conditions are not missed, and also that autism is not over-diagnosed in our community. Such considerations commonly include ADHD, anxiety, trauma, life experiences, and various other individual factors. Careful clinical consideration, assessment where appropriate, and formulation of all factors relevant to the individual is the cornerstone of Dr Hancock's assessment work. This helps to increase confidence in the conclusions reached and ensure that recommendations made are most helpful.
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What does the Psychology component of an assessment for Autism involve?
To ensure that the individual is well-understood, and that both their skills and any difficulties are accurately measured, a comprehensive assessment is important. While each assessment is tailored to the child and goals of assessment, it generally involves the following components:
- Interview session with the parents/carers
This will include discussion of any concerns raised as well as completion of the Autism Diagnostic Interview - revised (ADI-R)1. The ADI-R is a standardised measurement tool used to identify ASD and to distinguish from other developmental disorders. It involves the Psychologist asking the parents/carers various questions about the child's development and current functioning.
Other measurements tools, or questionnaires, may also be administered or given to parents to complete.
- Individual session(s) with the child/individual being assessed
This will allow the Psychologist to observe and interact with the child. The Autism Diagnostic Observation Schedule - 2nd edition (ADOS-2)1 will be administered. The ADOS-2 is an interaction-based assessment allowing the Psychologist to assess the individual's play, interaction, and behaviours. The assessment is tailored to the child's age; more play-based for younger children and more conversational for adolescents.
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- Contact with the kindergarten or school teachers (or as otherwise appropriate)
Consultation with care and educational staff is important to ensure that the child's functioning in such settings is considered, This can include speaking with the staff member, conducting an observation at the centre or school, and/or having the staff member complete a standardised questionnaire. The parent's consent will always be obtained before any contact is made.
Other professionals, such as the child's speech therapist, occupational therapist, wellbeing teacher, etc, will also consulted where appropriate.
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- Feedback Session
Once all of the above mentioned components of the Autism assessment have been completed, a feedback session with parents/carers is held. Adolescents are welcome to join to0!
During such session, the Psychologist will discuss the information collected and how it leads to the assessment conclusions. This may include a diagnosis of Autism, other difficulties, or general needs for support. The child's areas of strengths will also be highlighted, as these are important for building confidence and supporting further learning.
Recommendations will then be discussed, which may include therapy, supports in school, strategies in the home, etc. Options for accessing funding and financial supports will be discussed.
The clinical diagnostic assessment report will provided on the same day.
The overarching aim of the feedback session is for parents/carers to leave with an understanding of their child's functioning, ways that they can help to support their development and wellbeing, where and how to access appropriate supports, and with a sense of empowerment.
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Autism assessment for females
We know that females can present with unique and less-observable characteristics of autism. They may not show many of the quirks that have been traditionally identified as part of autism. Further, they commonly engage in notable masking and camouflaging i.e. efforts to hide their differences and appear as their peers do.
To help work through and understand all of this, Dr Hancock includes additional components to the assessment as needed. This may include use of The Camouflaging Autistic Traits Questionnaire (CAT-Q) and focused queries and questions to both parents and the young person.
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1 Research and best practice guidelines advise that the ADI-R and ADOS, used together along with wider assessment, provides the most reliable and valid diagnostic assessment of Autism.
Falkmer, T., Anderson, K., Falkmer, M., & Horlin, C. (2013). Diagnostic procedures in autism spectrum disorders: a systematic literature review. European child & adolescent psychiatry, 22(6), 329-340.
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