Diagnosing ADHD and ASD in Australia
Let me start by confirming to you that YES this process is so confusing. There is so much misinformation, different information, and no real consensus which makes diagnosing neurodiversity (attention deficit hyperactivity disorder or autism spectrum disorder) in Australia really tricky. Working as a psychologist with children, adolescents, and athletes means I have some insight into this process.
As a psychologist who studied at university for 7 years in Australia (pretty recently) there was not a single subject or course dedicated to ADHD and/or ASD, isn't that wild. Granted I did complete a Master of Sport & Exercise Psychology so may not have had subjects aligned with neurodiversity. However, even through undergraduate studies there were very limited options when it came to developmental psychology or neurodiversity.
A large part of my development as a psychologist has been doing my own learning and training on assessment, diagnosis, and treatment in relation to neurodiversity. To me, neurodiversity means a different way of viewing the world. I find it uncomfortable using the word "disorder" because I think it adds to the stigma and deficit based view of neurodiverse individuals. From my practice, I've learnt more about myself, my biases, and assumptions through neurodiverse clients who see the world very different to me. I see and validate the perspective that many with diagnosed ADHD and/or ASD experience deficits and delayed functioning, however these "deficits" come from the way in which we have set up our society that just isn't for every type of brain.
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Knowledge is power! So let me share some knowledge.
*FYI... there is currently no evidence based diagnosis protocol in Australia. That's why you hear of people going to a doctor/psychiatrist/paediatrician and after one appointment getting a diagnosis and medication.
Diagnosing a child or adolescent with ADHD and/or ASD in Australia
Who can diagnose?
In Australia, a child can be formally diagnosed by a paediatrician or psychiatrist. These two professions also prescribe medication. A psychologist can complete assessments and provide an indication of whether they think ADHD/ASD diagnosis is appropriate.
What assessments are used?
There are specific assessments psychologist's can use to help identify potential neurodiveristy.
ADHD - psychologists generally use the WISC, however there are other cognitive assessments they may use. These can be expensive, so check with schools or universities that may be able complete these at a discounted rate.
ASD - psychologists generally use the ADOS, which is the gold standard which many paediatricians will look for. This assessment can be expensive and more difficult to complete due to scarcity of psychologist's able to complete this assessment.
Are assessments required for diagnosis?
Not all paediatricians or psychiatrists will require assessments. Some will make a clinical judgement based on parent, school, and psychologist reports. Assessments are most beneficial when cases are more unclear or there are barriers.
What are the barriers to assessment and diagnosis?
There are a number of barriers that can make it more difficult to accurately diagnose a child. For example, cognitive abilities, gender, and supportive environments can hide difficulties more readily. Also, sometimes it is not until the demands are greater than the skill level that difficulties/delays can become more obvious. This gap between demand and ability usually occurs through transitions i.e. Year 6 to 7, or Year 12 to university, at this point we might start to see the struggle in functioning.
Diagnosing an adult with ADHD and/or ASD in Australia
Who can diagnose?
As an adult, psychiatrist's are able to formally diagnose. Psychologists are able to complete assessments and provide a professional opinion on whether diagnosis is appropriate. It can be quite difficult to obtain appointments with a psychiatrist so it is worthwhile joining waitlists ASAP while exploring potential diagnoses, which you can continue to do with your treating psychologist.
What assessments are used?
There are specific assessments psychologist's can use to help identify potential neurodiveristy.
ADHD - psychologists generally use the WAIS for adults, however there are other cognitive assessments they may use.
ASD - psychologists can use the ADOS for adults as well. This assessment can be expensive and more difficult to complete due to scarcity of psychologist's able to complete this assessment.
Are assessments required for diagnosis?
Not all psychiatrists will require assessments. Some psychiatrist may have their own assessment or questionnaires to complete. Some will ask for parent reports, old school reports, and psychologist reports.
What are the barriers to assessment and diagnosis?
As an adult exploring diagnoses for ADHD and/or ASD there are many barriers. Most likely there would have been a high level of masking, learning personal strategies, and high adaptability. A reason diagnoses may come up later in life could be because the demands of living outweigh the skill level (i.e. a gap is created). Adulting requires ALOT of executive functioning in our society and if we struggle it may not become obvious until we are working full time, or have children, or are in unhelpful environments.
I know this can be a tricky space to navigate and emotions can be high. If you have any questions or want some ideas for places based in Brisbane, Australia that can complete assessments please get in contact at hello@surgepw.com. We will be more than happy to refer to our connections in this space.
If you are looking for psychological support in relation to skill building, ADHD/ASD diagnoses, parenting strategies, executive functioning delays please reach out. If we are unable to assist we will do our best to provide other options!
Thank you for reading!
Leilanie Pakoa
Principal Psychologist
