What happens in an adult autism assessment

Before the appointment

Adult Autism Assessment Perth arranges autism and ADHD assessments for adults and adolescents across Perth and WA. You will usually be sent a set of questionnaires to complete in your own time. They ask about childhood, sensory experience, social preference, routine and communication. They take most people under an hour, and there is no clock on them.

Some clinicians ask whether a parent, sibling or long-term partner can answer a short developmental history. This helps, because autism is developmental by definition and adults are often poor witnesses to their own childhood. It is not compulsory. If that is not available to you — and for plenty of adults it is not — say so, and the assessment proceeds without it.

The interview

Two to three hours, by video, from wherever you are comfortable. It is a structured conversation rather than a test. Expect questions about how you manage work, relationships, noise, change, and the parts of ordinary life that other people appear to find easier than you do.

You can pause. You can keep your camera off for parts of it. You can stim, pace, knit, or sit under a blanket. None of that counts against you, and a clinician who assesses adults will have expected it.

Cognitive testing, when it is relevant

Not everyone needs it. It is added when the question involves learning, giftedness, a workplace or study adjustment, or an NDIS application — anywhere a number is going to be asked for. It adds time and cost, so it should be a decision you are part of, not a surprise on the invoice.

The report

A written diagnostic report, usually within about two weeks. A good one states the outcome plainly, explains the evidence behind it, and then says what it means in practice: what to ask an employer for, what a university's disability service needs, what to take to a GP.

Ask what the report will contain before you book. A report that only another psychologist can use is a report you will have to pay to have rewritten.

What the psychologist is actually assessing

Australian practice follows the National Guideline for the Assessment and Diagnosis of Autism in Australia, which sets out what a best-practice assessment involves. In plain terms, the clinician is looking at two domains and then at how much they affect your life.

• Social communication and interaction. Not whether you can do it — most adults being assessed can — but what it costs and how it is done. Learned versus intuitive.
• Restricted and repetitive behaviour. Deep interests, routine, sensory sensitivity, a need for predictability, and repetitive movement.
• Developmental history. Traits must have been present in early development, even if nobody noticed or they were masked. This is why childhood comes up so much.
• Functional impact. What it actually costs you day to day. This is the part that matters for workplace adjustments and for NDIS evidence.

The instruments

A structured assessment uses standardised instruments rather than only a conversation, because consistency is what makes a report defensible to a third party. Which ones vary by clinician and by question, and may include self-report questionnaires, a structured diagnostic interview, and where relevant an informant measure completed by someone who knew you as a child.

If ADHD is being considered at the same time, that adds its own measures — see autism and ADHD together.

What it is not

It is not a test you can fail or revise for. It is not a personality assessment. And it is not a single questionnaire with a cut-off score — see RAADS-R and AQ for why a screener cannot do this job.

Afterwards

Most clinicians offer a feedback session to walk you through the findings. Some people want support after a diagnosis; many want nothing at all beyond the answer. Both are normal. A diagnosis is information, and what you do with it is yours to decide.