What are the different types of Autism Assessments?
There are two basic kinds of autism assessments for adults: Neuropsychological Testing, and a Psychodiagnostic Interview. With both of these methods, a clinician can make a diagnosis if a person’s experiences match the current criteria in the DSM (Diagnostic and Statistical Manual). However, they use different ways of collecting information about you. Regardless of the method, the bottom line is the same: if your experiences are consistent with the DSM, then you will be identified as having an Autistic neurology. Here is a outline of the general differences between these two approaches:
Neuropsychological Testing
$4,000-$10,000
Several hours of standardized tests. This may include Intelligence Testing, Personality Testing, an ADOS-2, and more.
Includes an extensive written report that includes your life history, test results, relevant diagnoses, and reasoning for diagnoses
Often required by schools, universities, and workplaces to qualify for accommodations due to a documented disability, such as autism.
Diagnosis is made based on whether a person matches current DSM diagnostic criteria.
Psychodiagnostic Interview
$1,500-$2,250
Two to four sessions that involve getting to know you over time, through a collaborative conversation, designed to learn about parts of your life that are relevant to being autistic.
One feedback session to review results, ask questions, and share reflections
There is an option of receiving a brief letter confirming your diagnosis, but there is no option to receive a written report.
May not meet criteria to receive disability accommodations through school or work.
Diagnosis is made based on whether a person matches current DSM diagnostic criteria.
Weir Psychological Services, Inc. does not provide neuropsychological testing. WPS only offers adult Autism Assessments using a Psychodiagnostic Interview.
Which is right for me?
Neurospsychological Testing
Neuropsychological Testing has the benefit of providing a detailed, written report about your assessment. This can be essential for providing access to disability support services. Because measures such as intelligence testing and personality testing are often included in this, it can provide you with detailed information and quantitative data related to these domains. It can also articulate useful insights about how you process information and relate to the world. It does so in a written format that you can refer to in the future whenever it would feel helpful for you to review.
One significant drawback of neuropsych testing is that it can be expensive. Not only does the testing itself take time; it also takes a lot of time for the assessor to review the data collected, thoughtfully interpret it, and then write a report about it. Because it is time intensive, it is expensive.
The nature of neuropsychological tests is to be given a series of tasks to complete. A neuropsychologist learns about how a person’s brain works by observing how they respond to and complete each task. Often assessors are not able to provide feedback during a testing session. During a particular task, there may not be space to ask questions or describe one’s internal experience. This can be particularly challenging for Autistic people, who may have questions about how to interpret something, or who may want to ask for more time to ensure they understand a task. Once an assessment module is complete, there may be space to share more about your experience, but often this is not the case in the middle of a task. Some people find this kind of experience to be interesting. Others find it to be stressful or anxiety-provoking.
This is one aspect of using the ADOS for assessing autism that many autistic people find to be tricky or uncomfortable. They can feel put on the spot, and like they are asked to perform tasks without clear, explicit instructions — because they are. And although the psychologist gets useful information by watching how someone responds to that situation, it doesn’t make it any more comfortable for the person going through it.
Neuropsychologists work with people to explore a wide range of concerns. Some neuropsychologists are neurodiversity-affirming, others are less aware of autistic culture and still subscribe to an outdated, pathologizing, or deficit-defined model of autism. If you choose to pursue neuropsychological testing, take care to ask questions ahead of time about their commitment to affirming autistic experience and culture in their assessment process and report writing. Also ask about how they identify high masking autistic adults. A neuropsychologist who is truly neurodiversity-affirming should be able to support you in feeling empowered during this process, even if some aspects of the experience are uncomfortable.
“Neuro-affirming means... Feeling safe to ask for accommodations. Having my feelings validated and heard. Freedom to be me. Listening to people when they tell you something doesn’t work for them. Having my sensory needs taken seriously. Not feeling pressured to do things outside my comfort zone...”
Psychodiagnostic Interview
The Psychodiagnostic Interview that Dr. Weir uses for exploring autistic identity is called the MIGDAS-2. It is designed to explore Autistic experiences through a collaborative discussion. Although the MIGDAS helps to ensure that we ask you about several important areas of your life, there is a lot of flexibility to follow the conversation in ways that feel authentic. You can drop deeply into areas where you have a lot to say, and we can move into other topic areas when it feels natural to do so. There is an emphasis on your comfort and meeting your sensory needs. There is freedom to speak about your experiences in ways that feel right to you. The conversation is designed to be adapted to your own individual needs, and in getting to know you personally. Because this kind of conversation allows you to share more of your personal experience, this type of assessment can be more accurate than neuropsychological testing in identifying autism. This is especially true of higher masking people, including women and gender diverse people, who may present is less stereotypical ways, but who are still equally autistic.
During your feedback appointment, Dr. Weir will review the results with you in detail, and you will have time to ask questions and share your reflections. If you request it, she can provide a brief letter, noting the outcome of the assessment. As a reminder, you will not be provided with a detailed written report.
Why don’t you provide a written report?
Dr. Weir has decided to operate without providing written reports for several reasons. Many people who want to know if they are autistic for their own personal reasons don’t care about a written report; they just want to know. By omitting the time and expense of report writing, she can serve more people, at a lower cost, which makes diagnosis more accessible. This approach will not be a good fit for everybody. If this approach does not meet your needs, that is OK. It also means that Weir Psychological Services, Inc. is not a good option for you to pursue your autism assessment. It is very important for you to get your needs met. If you want that report, you should get it. The best way to do that is to pursue your assessment with a different agency who will provide you with a written report.
What if I need a written report?
If you want a detailed report for your own personal reasons, then there are agencies that will provide that to you, regardless of whether you pursue a neuropsychological assessment or a psychodiagnostic Interview. If you need a detailed report to submit to a government agency, an HR Department for accommodations at work, or an office of Disability and Support Service for accommodations at school, then it is highly likely that they require a report describing the outcome of neuropsychological testing in order to be eligible for disability services. Double check with them directly to be sure.