Considerations Before an Autism or ADHD Assessment
Written by Jamie Roberts, LMFT and Kylie Kirkwood, ACSW
Are you curious if you may be Autistic? Are you deciding if you want to pursue a formal diagnosis from a mental health professional? While self-diagnosis is completely valid, there are situations that a formal diagnosis is helpful, especially if you are interested in pursuing accommodations for school or work. Luckily, we provide both Autism and ADHD assessments for adults at Equilibrium Counseling. This blog will explain the difference in types of assessments and things to consider before pursuing a formal diagnosis.
Many traditional assessments rely heavily on observation, and collateral interviews. At Equilibrium, we prioritize a person’s lived experience, you are the expert of your own life and your internal experience is most important. You are welcome to bring in family, friends or your partner but it is not required. Our goal is to help identify highly masked/camouflaged individuals through a nuanced understanding of neurodevelopmental differences.
Here are some common questions that may arise as you begin your assessment journey:
What Assessment Options Are Available at Equilibrium Counseling?
There are two types of Autism and ADHD assessments you can receive at Equilibrium Counseling: informal and formal.
The Informal Assessment includes a 1 hour clinical interview and a 1 hour feedback session where you will review provided information, diagnostic criteria, and resources. You will also receive a letter stating the diagnosis and recommendations. This assessment is primarily for clients who are confident in their self assessment, looking for confirmation, and plan on using this information for personal use.
The Formal Assessment includes client self-assessments including a sensory profile, a 90-minute comprehensive clinical interview to gather qualitative data, additional assessments measures for quantitative data and a 10+ page detailed assessment report. In the 1-hour feedback session you will review the report to make sure it accurately represents your experience. This is for clients who are looking for a concrete, formal diagnosis to seek work, college accommodations and/or psychiatric medicine. If you need an additional letter or form for accommodations this will also be included. Always check requirements with the administrations you will be submitting to prior to starting an assessment process.
How Are These Different From A Neuropsychological Evaluation?
A neuropsychologist is a mental health professional who specializes in the relationship between the brain and behavior/cognitive skills. Neuropsychologists are trained to evaluate neurodevelopmental disorders such as Autism, ADHD, learning difference and traumatic brain injuries. They utilize numerous testing measures, assessments, and comprehensive interviews with the client, family and schools. For folks under 18, insurance often covers a neuropsychologist evaluation for Autism. For folks over 18, insurance is not likely to cover a neuropsychologist evaluation and neuropsychologist evaluations can be expensive. This is why it may be more financially feasible to receive a diagnosis from a Masters level clinician who is trained to provide Autism assessments, as long as the accommodations you are seeking do not require a diagnosis from a neuropsychologist.
What Should I Consider Before Getting Diagnosed with Autism and Diclosing my Autism Diagnosis?
What need will the diagnosis meet for you?
Depending on your needs, who you see and what type of assessment is important to consider.
Work Accommodations- Per the ADA an employer can not request you disclose your disability. You will need to describe the difficulties you experience and accommodations you are requesting. This letter can be written by: LMFT, LCSW, LPCC, NP, PhD, PsyD, MD. This is a great resource for determining which supports may he helpful https://askjan.org/
Academic Accommodations- Every higher education institution has a department for student disabilities, we recommend looking into the requirements needed in order to request accommodations. Most institutions will accept letters from a LMFT, LCSW, or LPCC. Some will only accept PhD, PsyD, MD. Occasionally they request comprehensive details of the diagnosis and necessary accommodations. K-12 for an IEP will only accept assessments from an PhD, PsyD. For a 504 they will likely accept from an LMFT, LCSW, LPCC.
Medication - Whether a psychiatrist will accept an assessment is provider specific. If you have a psychiatrist that you like, check with them about what type of assessment they would like in order to incorporate a new diagnosis. If you do not yet have a psychiatrist or are open to referrals then we are happy to provide a list of affirming doctors.
State Disability- Will not accept a diagnostic assessment from a masters level therapist (LMFT, LCSW, LPCC). If you are needing an assessment inorder to apply we recommend working with an psychologist (PhD or PsyD)
Will an Autism Diagnosis impact my health insurance?
Insurance tends to have an out of date understanding of Autism, as such they may or may not cover psychotherapy when Autism is the primary diagnosis.
Superbills - If you are paying privately and planning to submit a superbill a diagnosis will be listed on the superbill. Most neurodivergent people have multiple comorbidities, only one diagnosis must be listed.
Some states do have an Autism registry, once a person is diagnosed they are added to this list. California is not one of those states.
It is worth looking into your insurance provider and if they list Autism as a pre-existing condition. (though it does seem difficult to track medical history… if you’ve ever changed doctors offices, or insurance plans, you know none of your information transfers over if you don’t provide it. So I don’t know how well a diagnosis is actually tracked).
Are there any laws or legal impacts on an Autism diagnosis?
There are many laws that impact disabled people, it is wise to familiarize yourself with local and state regulations.
Immigration - Some countries have more strict immigration restrictions for disabilities, including Autism. www.expatsi.com
States with anti-trans laws also have a direct impact on Autistic youth and choices of bodily autonomy. Depending on the political climate where you live, this is something to be aware of. www.19thnews.org
It is completely understandable to have concerns about getting formally diagnosed with Autism and disclosing your diagnosis. We love this Tiktok by Riki Faith Quinn who breaks down common fears and misconceptions regarding formal diagnosis of Autism.
It is your decision to get formally diagnosed as well as to disclose your Autism diagnosis. We encourage you to discuss any concerns you have with the mental health professional who is providing your assessment. If you are interested in assessment services at Equilibrium Counseling, feel free to reach out here.