Adult ASD assessment, diagnosis & treatment
Assessments for adults vary according to the particular situation and degree of complexity but there are some standard components.
An initial interview with the adult (and their partner or other family member) is always conducted to obtain detailed information about the person’s situation; this ensures that expectations about the assessment and diagnostic process are explored and the individual has the information to decide if it is in their best interests to pursue a formal assessment. Janine assists in this decision making process.
A structured clinical interview is conducted with the adult (and their partner, if relevant) to obtain information about the areas in which individuals with ASD typically have difficulty (i.e., social interaction, social communication, restricted and repetitive patterns of behaviour). Assessment with the ADOS is also conducted. Other tests and questionnaires designed to capture the unique characteristics of individuals with ASD may also be used. In some cases, an IQ assessment is administered to gain more specific information about the adult’s intellectual strengths and weaknesses. Depending on the situation, this information may then assist with workplace issues, including suitability of employment. Any previous assessments and reports, and the person’s history of interventions, are also obtained.
Some adults may have some or many features of ASD yet not meet the formal criteria that results in an official ASD diagnosis. For example, the person may not have any clinically significant impairment in social, occupational or other important areas of functioning. However, Janine can work with adults in this situation to help improve their life in whatever areas they need assistance with (e.g., intimate relationships or workplace situations).
Therapy and support for adults is highly individualised but initially the focus is on helping the individual to understand the aspects of their personality that are most likely attributable to ASD and those that are not. Increasing their insight into themselves and understanding their particular life journey through the lens or framework of ASD can be very beneficial, not only in terms of self-understanding but also in terms of understanding the behaviours, thoughts and feelings of others.
Other important areas of therapy are when the adult is having difficulty with significant relationships, their partner is having difficulty, or the client is having issues in the workplace. Strategies to enhance communication skills, including listening skills, are often an important focus. Additional areas of intervention have a practical focus, such as helping adults to deal with planning and organisational issues, and to achieve a better balance between work and family life.
Janine uses Professor Tony Attwood’s “Emotional Toolbox” concept in her work to tailor a specific treatment plan, and promotes the use of modern technologies (e.g., Apps). For adults who are more isolated, she explores ways in which they might connect with community networks and activities. Identifying any mood disorder is also important in order to recommend the best treatment options. In terms of best practice, consultation with a medical practitioner (usually a GP) is often advised to monitor mood and medication. However, other non-medical interventions, such as mindfulness* and regular exercise, are an important component of the adult’s Emotional Toolbox to help them to feel less stressed and cope with the demands of everyday life. In more recent times, Janine has referred adults for Social Thinking Therapy (often with a speech pathologist) and, although no systematic research has been done in this area, many adults have found this helpful in terms of improving their communication skills and understanding the perspectives of, and connect more with, others.
*mindfulness is a technique that improves your mental health by helping you to focus on what’s happening in your life in the present rather than focusing on the past or worrying about the future. Mindfulness helps you to focus your attention, slow down your thoughts, be more relaxed and helps you to cope with stress.
Video – Focus on Adults
Exploring the issues surrounding adults with ASD.