What to Expect From Your Evaluation
SheSpectrum provides a focused adult autism diagnostic evaluation conducted entirely by telehealth. The evaluation is designed to determine whether your developmental history, current experiences, clinical presentation, and other available information support a diagnosis of Autism Spectrum Disorder.
This is more than an autism screening or a collection of questionnaires. No single test or score determines the diagnosis. Information is considered together to develop the clearest possible understanding of your individual presentation.
Before Your Evaluation
Before your appointment, you will provide information about your developmental and clinical history and complete questionnaires selected for your evaluation. Relevant records may also be reviewed when available.
Because autism is a neurodevelopmental condition, understanding your experiences across your lifetime is important. The evaluation considers early development, friendships and relationships, communication patterns, sensory experiences, routines and interests, school and work functioning, and how these patterns have affected everyday life.
Your Diagnostic Interview
Your primary appointment includes an in-depth developmental and diagnostic interview, typically lasting approximately 90 minutes.
The interview goes beyond a checklist of autism symptoms. We explore concrete examples from childhood through adulthood, when particular characteristics first appeared, how they have changed over time, and how they have affected relationships, education, work, and daily functioning.
We also look at how you learned to navigate social situations. Behaviors that appear natural today may have required years of observation, practice, rehearsal, or conscious effort.
Understanding Masking and Camouflaging
Autism may be more difficult to recognize in adults who have developed effective ways of adapting to social expectations.
The evaluation specifically considers masking and compensatory strategies, which may include observing and imitating others, rehearsing conversations, preparing topics in advance, consciously monitoring eye contact or facial expression, suppressing sensory or repetitive behaviors around other people, or developing different ways of presenting yourself in different social settings.
We also consider the effort behind the presentation. Someone may appear socially comfortable while experiencing substantial internal monitoring, fatigue, or a need to recover after social interaction.
Masking alone does not establish an autism diagnosis. It is considered within the larger developmental and clinical picture.
Clinical Observation
Clinical observation takes place throughout your secure video appointments. The clinician considers conversational reciprocity, communication style, narrative organization, flexibility, affect, and other aspects of social interaction that can appropriately be observed by videoconference.
Telehealth observations are interpreted carefully. The limitations of video communication are taken into account, and behaviors such as looking toward a camera are not treated as equivalent to naturalistic eye contact.
Standardized Assessment Measures
Standardized measures are used as part of the evaluation, but they are not used in isolation to diagnose autism.
Measures related to autism characteristics and camouflaging may be included, while additional measures are selected when there is a specific clinical reason to examine areas such as attention, anxiety, mood, trauma-related symptoms, obsessive-compulsive symptoms, or everyday functioning.
The goal is not to give everyone the largest possible test battery. It is to gather the information needed to answer your individual diagnostic question.
Developmental History and Other Sources of Information
When available and clinically useful, information from someone who knew you earlier in life or relevant childhood records may help clarify your developmental history.
A parent is not necessarily required. Depending on your circumstances, useful information may come from siblings, relatives, a long-term partner, school records, previous evaluations, report cards, or other sources.
We recognize that many adults seeking an autism evaluation do not have access to complete childhood records or an available childhood informant. When developmental information is limited, that limitation is considered as part of the diagnostic process.
Additional Clarification When Needed
Every evaluation is individualized. Sometimes the information gathered during the initial evaluation raises additional questions.
If your needs extend beyond what can appropriately be answered through a focused telehealth autism evaluation, recommendations may be made for additional or in-person assessment.
How a Diagnosis Is Reached
At the conclusion of the evaluation, all available information is considered together. This includes your developmental history, current experiences, clinical interview, behavioral observations, standardized measures, records and collateral information when available, functional impact, and possible alternative explanations.
Evidence both supporting and not supporting an autism diagnosis is considered.
The outcome may be that Autism Spectrum Disorder is supported, that it is not supported, or that additional information is necessary before a responsible diagnostic conclusion can be reached.
Your Report and Feedback
You will receive a written diagnostic report explaining the findings, diagnostic conclusions, and individualized recommendations.
You will also meet with the neuropsychologist for a feedback appointment. During this session, we review the results and the reasoning behind the diagnostic conclusion, discuss any relevant co-occurring concerns or limitations, answer your questions, and review recommendations and next steps.