Where do I get a diagnosis?
You may have many questions after deciding to seek a diagnosis: Who do I go to for a diagnosis? How do I find them? What services do they provide?
It can seem quite overwhelming.
The best approach is first to research which health providers in your area are qualified to do an autism assessment. Ideally, they will have a good knowledge of autism, especially in adults. If you are a woman or gender diverse it will be helpful if they also have a good understanding of the differences in presentation of autism from the typical male presentation.
To find resources local to you, contact Autism Connect.
Who can provide an assessment for autism in adults?
There are two distinct pathways when seeking an adult diagnosis. Assessments can be conducted by a psychologist, or by a psychiatrist, with experience in assessing autism.
Both will conduct some form of standardised testing for autism and other conditions, such as ADHD or mood disorders, and provide you with a report.
However, there are some differences between the services and support they can provide. A report from a psychiatrist may not be as detailed as one from a psychologist.
Ensure you ask upfront what is entailed in the assessment and report process.
A psychologist may offer you ongoing therapeutic support after your assessment and diagnosis. They may use evidence-based therapies such as modified cognitive behaviour support (CBT). They can also be helpful in providing a safe space for you to talk through your experiences and support you through the process of understanding your diagnosis. Make sure when you see a psychologist you ask them if they are experienced in seeing people on the spectrum as they will need to modify the therapies for you appropriately.
A psychiatrist primarily focuses on providing assessments and diagnoses—and can prescribe medications. (A psychologist is unable to prescribe medications, but may refer you to a psychiatrist if they feel medications may be beneficial to you.)
Some medications can only be prescribed and reviewed by a psychiatrist (e.g. those used to treat ADHD). Your GP (or doctor) will be unable to prescribe these in the first instance but can then write repeat scripts on behalf of your psychiatrist. You will need to be referred to and reviewed by your psychiatrist, usually every year, with this type of medication.
A psychiatrist usually does not provide therapeutic sessions. Your psychiatrist may recommend you see a psychologist for further mental health support and therapy.
In addition, there can be standardised assessments such as the Autism Observation Schedule 2 and the Autism Diagnostic Interview Schedule Revised that are often used to supplement the clinical assessment. These interviews are conducted by people who have been trained in them over many months and require many checks to ensure they are conducted well. People who are trained to conduct these assessments can vary across many allied health professions. The costs will also vary but it is important if you get one of these assessments that they have been trained appropriately and demonstrate adequate reliability in the assessments.
Sometimes it will be important to obtain speech and language, movement, and neurocognition assessments. These assessments are usually done by speech therapists, occupational therapists, and neuropsychologists. While these individuals may not be able to confirm a diagnosis, they may make important contributions to understanding what is needed in terms of interventions and supports.