For adults, getting an assessment for Autism or ADHD can be incredibly challenging. There are few clinicians who offer psychological assessments in general. Just getting an appointment can be an ordeal. Unfortunately, even when you get an appointment, there is no guarantee that you will be working with a clinician who has training in how Autism and ADHD present among adults.
Because Autism and ADHD are primarily thought of as conditions that present in childhood, many clinicians use the diagnostic criteria for children to evaluate adults – ignoring the fact that Autism and ADHD manifest differently in adults. I’ve worked with many clients who have gone for an evaluation only to feel that they were judged, their concerns were dismissed, and their experiences invalidated.
Neuroaffirmative assessment is a transformative approach to assessing Autism and ADHD that addresses many of these challenges (Hartman et al, 2023). At its core, neuroaffirmative assessment aims to create an inclusive, empowering evaluation experience by shifting the focus from deficit-based models to strengths-based exploration. These assessments acknowledge the unique cognitive profiles and strengths of individuals, and they take account of how these profiles can present in different ways depending on your cultural background, your gender, and where you are in your lifespan.
Neuroaffirmative assessment embraces the idea that neurological differences are natural variations of the human brain. It recognizes and celebrates the diversity of neurological traits and conditions, challenging the notion that there is a single, “normal” way for the brain to function. Neurotypical individuals are those whose neurological development and functioning are within the widely accepted range of what is considered typical or “normal.” Neurodivergent individuals are those whose neurological development and functioning differ from the neurotypical standard. This includes people with conditions such as Autism and ADHD, but also other conditions such as dyslexia. It emphasizes that neurodiversity is a spectrum and that differences in neurological functioning should be acknowledged and respected.
Traditional evaluation methods often fall short in capturing the full spectrum of neurodivergent experiences. Most traditional tests are constructed in a way that assumes neurotypical experience is the default, and anything that does not match this default is inherently flawed. As a result, these tests often lead the assessor to focus on identifying deficits and trying to match the client’s experiences up to DSM diagnostic criteria – causing them to overlook the individual’s unique experiences, strengths, and cognitive style. Moreover, most of the traditional tests were developed using a process that predominantly involved a narrow demographic, typically young, white, male children and adolescents, further limiting the applicability and accuracy of these assessments for a broader range of individuals.
If you are seeking an assessment for Autism, a Neuroaffirmative approach will help you go beyond diagnostic criteria to delve into the intricate facets of your cognitive profile. Your unique communication styles, sensory sensitivities, and special interests are recognized and validated. This process aims to unveil your strengths—like pattern recognition, attention to detail, and deep focus on specific expertise—all contributing to your valuable contributions across various fields.
Similarly, if you are undergoing a Neuroaffirmative Assessment for ADHD, we acknowledge that traditional markers might overshadow your nuanced strengths. Beyond impulsivity and inattention, we explore aspects like creativity, adaptability, and hyperfocus, recognizing them as assets in various contexts.
Neuroaffirmative assessment is distinctive in a number of ways:
- Lived Experience: Neuroaffirmative Assessment privileges lived experience by placing a profound emphasis on the individual’s narrative and subjective understanding of their neurodivergent journey. This approach values the first-person perspective, ensuring that the assessment procedure is informed by the unique insights and nuanced experiences of the person being assessed.
- Strengths-Based Inquiry: Assessments focus on your strengths. Instead of immediately honing in on challenges, we will inquire about areas where you feel confident, excel, and have natural aptitude. Your assessment report will include a comprehensive strengths profile that highlights your unique abilities, talents, and accomplishments.
- Flexible Assessment Formats: Unfortunately most traditional assessments rely on a set battery of tests that are given to almost everyone who seeks an evaluation. These assessment batteries are often lengthy and overwhelming. We offer a custom battery of tests to every client and focus on keeping the battery as brief as possible. We offer assessment materials in various formats, such as visual aids, verbal discussions, or written responses. Providing flexibility ensures that you can showcase your abilities in a way that aligns with your preferred mode of expression.
- Sensory-Inclusive Environments: We offer an assessment environment that is responsive to your sensory needs. We minimize distractions, offer sensory-friendly tools, and provide regular breaks during the testing.
- Mental Health: Neuroaffirmative Assessment acknowledges the mental health impact of navigating a neurotypical society. By recognizing challenges in communication, sensory sensitivities, and societal expectations, the assessment addresses issues such as anxiety and depression in Autism and impulsivity in ADHD. This approach informs interventions that consider both neurodivergent strengths and mental health challenges shaped by the demands of a neurotypical world.
- Flexibility Regarding Family Involvement: Traditional assessment procedures insist upon gathering collateral information from family, co-workers, and friends. While collateral information is important, we believe in being flexible based on your life circumstances. For instance, you may be estranged from your family or believe that your parents are not able to accurately recall details of your development. Because of this, we do not rigidly insist upon their involvement in the assessment.
- Understands Masking: Masking in neurodiversity involves concealing neurodivergent traits to appear more neurotypical, often by mimicking behaviors, suppressing stimming, or camouflaging sensory sensitivities. In Neuroaffirmative Assessment, understanding and acknowledge masking behaviors are prioritized to ensure a comprehensive evaluation that accurately captures an individual’s authentic neurodivergent experience and needs.
- Cultural/Gender Sensitivity: We recognize and respect cultural and gender differences in the assessment process. Cultural norms may influence communication styles, expressions of emotion, and perceptions of success. A neuroaffirmative approach considers these cultural nuances, promoting a more inclusive and culturally competent evaluation. To minimize bias, we use culturally-fair assessment procedures and ensure that the tools we use were developed on a diverse sample of individuals.
- Ongoing Feedback and Reflection: We create a continuous feedback loop throughout the assessment process by regularly checking in with you and seeking your input on the assessment experience and outcomes. We encourage self-reflection and provide opportunities for the you to express your thoughts and feelings about the assessment, promoting a sense of agency and collaboration. Your feedback will be integrated into the final assessment report, ensuring that your voice and perspective are front-and-center for people reading the report in the future.
Neuroaffirmative Assessment stands as a beacon of progress in the landscape of adult Autism and ADHD evaluation. By recognizing and appreciating the unique cognitive profiles of individuals, we can move beyond a deficit-based approach and embrace a more inclusive, affirming, and empowering paradigm. As we continue to champion neurodiversity, Neuroaffirmative Assessment paves the way for a future where every individual is understood, supported, and celebrated for their distinctive neurocognitive gifts. If you are interested in completing a Neuroaffirmative Assessment with our team, please click here to contact us about setting up a consultation.
References:
Hartman, D., Kavanagh, M., Azevedo, J., O’Donnell-Killen, T., Doyle, J. K., & Day, A. (2023). The adult autism assessment handbook: A neurodiversity affirmative approach. London: Jessica Kingsley Publishers.