Diagnosing autism in Australia just doesn’t start with some magic test result from a lab. There is no super reliable biological marker, no single imaging scan that will give the diagnosis, and no questionnaire that’s going to tell us for sure or rule out autism spectrum disorder. What it comes down to is a whole lot of clinical experience, a bit of guesswork, and a handful of established tools making up the final conclusion. Here in Australia, the people who diagnose autism use the DSM-5-TR; that’s the Diagnostic and Statistical Manual of Mental Disorders, 5th ed. It’s been tweaked a bit. The criteria are pretty straightforward though: we’re looking at problems with social communication and interaction, and repetitive patterns of behaviour or special interests. The Autism Cooperative Research Centre has brought out some new guidelines which are pretty clear about what makes a good autism diagnostic assessment: it’s a thorough, multidisciplinary approach, but only if you really need it.
But let’s be real, when it comes to diagnosing autism, every case is completely different, that makes it really tricky.
And if that’s not enough, throw in the fact that other things like ADHD, anxiety, and learning differences often look a lot like autism in terms of behaviour, that makes it even harder to work out what’s going on. Now, we all know that there’s a bit of subjective opinion involved in these sorts of assessments, but the fact is, we use guidelines and standardised tools to try and keep things as fair and consistent as possible. And when it comes to the good stuff, the really reliable tools, you’re looking at the ADOS2 for observing behaviour, the ADIR for talking to family and carers, and the Vineland for working out how well someone is coping in day-to-day life.
Who Actually Does the Assessment in Australia?
The team that does the assessment is a bit different each time, depending on what’s going on. When it’s kids, you’re often talking about a team made up of a paediatrician, or a child psychiatrist, along with a psychologist and a speech pathologist all working together. With adults, it’s generally going to be a psychologist or a psychiatrist who specialises in ASD. Now, if the signs are pretty clear and it’s a straightforward case, one qualified person can make the diagnosis on their own.
Before we even get started, you need a referral from a doctor or specialist. For families with young kids who are worried about something, the first step would be to have a chat with your GP or a maternal and child health nurse, they can get the ball rolling from there. At a specialist service like Aspect Assessments, we’ve got clinical psychologists and neuropsychologists who do their assessments in a very structured way, it’s all part of making sure we meet the requirements for things like NDIS access, school support and that sort of thing.
What the Assessment Actually Involves: A Step-by-Step Breakdown
The autism spectrum disorder diagnostic assessment process usually takes place over a number of appointments spread out over several weeks. Each stage follows on from the last.
- Stage 1: A meeting to get a sense of the individual’s background, development and current concerns.
- Stage 2: Testing using established tools such as the ADOS 2, ADI R or MIGDAS 2.
- Stage 3: An assessment of how a person copes with day-to-day life using tools like the Vineland or ABAS.
- Stage 4: The test results are scored and interpreted and a comprehensive written report is put together.
- Stage 5: An appointment where the individual or family is given the results and some advice on how to move forward.
Typically the full written report is sent out 2 to 4 weeks after the assessment appointments are all done. The report can be used to help get access to NDIS support, get a school to put a learning plan in place, and also to claim a Medicare rebate depending on what the person was referred under.
How Much It Costs and How Long You Have to Wait?
Assessment costs can vary a fair bit from one place to another and also depending on where you live. Autism SA will charge you $2,000 if you get your child assessed before they turn 18. If you are getting an assessment from Autism Queensland then you are looking at an average cost of $232.99 an hour for a psychologist or $193.99 an hour for an allied health professional. Getting a full assessment done can cost several thousand dollars in total.
- The good news is that Medicare’s Mental Health Care Plan will cover a fair bit of it but not all of it
- Under 25s may be entitled to a Medicare rebate if they get referred by a paediatrician or child psychiatrist but only if they are referred under very specific item numbers
- The NDIS doesn’t usually pay for a diagnostic assessment unless the person has specifically asked the NDIA to do so
University-based clinics can be a more affordable option but you can expect to be on a wait list for 2 to 9 months. Private providers are often quicker but also more expensive. Before you book an appointment make sure the report they will give you meets all the right criteria and that the school you are dealing with and the NDIS will accept it.
What Happens After You Get a Diagnosis?
Getting a final diagnosis is just the start of the process not the end of it. For kids this means that they can get access to support through NDIS early intervention programs. Schools can use the report to come up with an individual learning plan that better suits the child’s needs. In South Australia after a diagnosis the Pathways consultant will be in touch to help guide you through the next steps. Adults who get a diagnosis can get support through workplace adjustment programs and they’ll also get a better idea of how to tackle some of the day-to-day challenges that can come with being on the autism spectrum. The thing to remember is that the spectrum is really broad and getting a diagnosis is just the start of a journey to get the right level of support for your individual needs.
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