Neurodiversity-Affirming
Autism Assessment for Adults
Dr. Philip MacEachron, PsyD
Licensed Clinical Psychologist, PSY 22427
3155 College Avenue, Berkeley, CA 94705
510-859-8553
WHAT IS A NEURODIVERSITY-AFFIRMING ASSESSMENT?
In this kind of assessment, we respect the wide range of neurodiversity in ways that go beyond a model based in ideas of deficit, disability, and impairment. While we may consider the pros and cons of identifying a medicalized diagnosis as a means to access important supports, we primarily operate from a stance of acceptance and validation, working collaboratively to understand how your neurodivergence works and how it may have affected the course of your life and your experience of interacting with others. Many people have felt brushed off or invalidated by providers when they asked about Autism assessment, often because those providers were not familiar with more subtle presentations, or the ways Autism can manifest in women, people of color, trans, and nonbinary people.
IS FORMAL DIAGNOSIS RIGHT FOR YOU?
In many cases it may be better not to pursue a formal diagnosis of Autism or a related disorder, and self-identifying as neurodivergent is widely accepted. You may want an informed professional opinion about whether the traits or struggles you have seem to line up with a general sense of "being on the spectrum," or might be more connected to other issues like complex trauma. If the goal is greater awareness and clarity of how neurodevelopmental concerns may impact aspects of your life like challenges in workplaces or relationships, we can sometimes get a good understanding of this after a detailed clinical interview and it may not be necessary to go forward with in-office tests or other aspects of the assessment. If, on the other hand, you think you may be in need of supports or accommodations at school or work due to autism-spectrum related concerns, it may be a good idea to do formal testing to more clearly identify your neurocognitive strengths and weaknesses to support those efforts.
If you have never had an ADHD assessment, we can incorporate that into this assessment. ADHD and ASD are highly comorbid, but there are often more easily accessible treatments and accommodations for ADHD, so it can be beneficial to identify whether that is part of the picture for you. Under a past diagnostic system, ADHD was not coded separately in children diagnosed with Autism, but was considered part of the Autism. Because of this, many adults who had ASD diagnoses in childhood may not have ADHD diagnoses despite having all the symptoms. Now the custom is to co-diagnose things like ADHD and anxiety disorders, because these are often the main focus of psychiatric treatment. From a neurodiversity affirming perspective this makes sense, since these are often the areas in which people are suffering, whereas their Autism-related neurodivergence may be something that needs to be understood and accepted rather than treated.
STAGES & COMPONENTS OF AN ASSESSMENT
In the interest of informed consent and transparency, I've broken down the stages of a typical assessment below. Most people will not require every component listed here, and you are welcome to opt out at any stage.
Initial Consultation (20 minutes, no charge): We will start with a brief phone conversation so I can get a sense of what you're looking for, if it is something I can provide, and talk about scheduling.
Online Questionnaires & Rating Scales: I will send you some online forms to fill out and and will take some time to review them before we meet.
Clinical Interview (2 to 4 hours, includes time reviewing your written materials): We'll meet, usually by video call, to discuss your concerns and your history in depth. This will usually take one or two sessions to complete (I often do two-hour sessions for these interviews, but some people prefer shorter sessions), and by the end of it I can usually give you an informed clinical opinion, and we can discuss whether it makes sense to proceed with more in-depth assessment.
In-person Tests & Diagnostic Interview (2 to 4 hours): At this stage we'll meet in person for more formal tests, including a structured diagnostic interview & observation
Collateral Contacts (About 2 hours): I will ask for your permission to speak with people who knew you when you were a young child and/or people who know you very well in the present time. Often for an accurate diagnostic picture these collateral contacts are invaluable, but not everyone may be comfortable with involving family or other close contacts, so I will work with you to find the best way to gather this kind of informations.
Tests of Cognitive and Adaptive Functioning (4 to 8 hours): In some cases it may be beneficial to administer further tests to get more clarity on your neuro-cognitive strengths and weaknesses, and the challenges you may have with daily living or functioning in different domains of life. This is usually only necessary for people who may need a higher level of support, and while it can be informative it will be time-consuming and expensive, so is not recommended for everyone.
Interpretation & Feedback (2 hours): I will review and score all the tests and meet with you (usually by video call) to discuss my impressions and recommendations. In a collaborative, affirming assessment, we will work together to think about ways this information can be of help to you.
Formal Report (2 hours): A formal report may not be required for most cases. I can write a brief summary of our conclusions at no additional charge, but in some cases it will be beneficial to have a more formal report (for instance if you are seeking services from an agency, school, or other institution).
Fees: Because there is considerable variability in the complexity of cases, and in individual communication styles, it can be difficult to give an exact estimate of how long an assessment like this will take, so I've estimated the usual range of times above. I bill my time at $250 per hour, and I use a secure credit payment system to process payments. I believe in fair and transparent pricing, and from my experience at a busy medical center I've learned to work at an efficient pace so I will not waste your time by administering unnecessary tests or writing extensive formal reports if they are not required. I am not on any insurance panels, but I can provide superbills to facilitate reimbursement.