Please tell me exactly what happens at an adult ASC assessment?

[RaggyDollSadSack]

I’m considering getting assessed privately on my psychologist’s recommendation. Please tell me exactly what happens at each stage. Is it an interview, questionnaires, tasks, etc?

It's all of the above.

You'll start with a bunch of questionnaires - usually at least the ADOS test, often the rdos.net test (rather outdatedly called "The Aspie Quiz", but gives much more nuanced results than just a number). There will also be some long-form questions about your childhood, teen years and adulthood (mostly focusing on socialisation and habit-forming), as well as questions about sensory input and perception.

If appropriate, there will be questions for your parents and/or childhood friends, and school reports will also be useful if available.

A few weeks later comes the interview part - this takes the form of at least one 2-4 hour interview, where the assessor will dive more deeply into your experiences, using your written responses to the above as a guide and prompt. This is all going to be about determining specific answers to the questions posed in the DSM and ICD diagnostic criteria.

Some assessors also like to use the "here's a series of pictures, please tell me about the story they're telling" type of test, as well as asking you to describe what's happening in individual pictures. This part's not always necessary, but generally-speaking it's the kind of test where NTs will respond by telling the story of what's happening (ie inferring context and motivation) whereas autistic individuals will mostly just describe the things on the page, often focusing on specific details.

A week or two later, you'll get a detailed report on their findings - the headline is a yes/no, and then there can be anything from 15-50 pages explaining why in more detail relating to the diagnostic criteria, as well as recommendations for next steps and support needs.

Hope that helps :)

This is really helpful! Thanks so much.

I didn't do an ADOS.
Filled in forms and questionnaires.
Two interviews over the phone with psychologist (?)(COVID) relative/friend interview
Video call with final check/diagnosis.

NHS

I think ADOS would have been done if there was any doubt. Neither DD nor I needed ADOS.

Mine was across 3 separate sessions:

1 x 1 hour session going over my reasons for seeking assessment, and detailed history of my childhood, schooling, University, career to date, general life as an adult

1 x full day of psychometric testing (exhausting!) ending in a 1 hour session with questionnaires and further discussion around sensory problems & repetitive behaviours. I then received a verbal diagnosis of :ASD without intellectual impairment + ADHD (combined type)

1 x 1 hour session to discuss the report written by my psychologist since the full day session, & diagnosis in general

I assume that different providers will have slightly different approaches, but the above was my experience. I deliberately chose a place that would assess all neurodevelopmental conditions at once, so it may have been more lengthy due to this.

Edited to add that I had to complete a detailed questionnaire prior to the first session & my husband also had to answer a questionnaire.

It's best not to read up what happens in the ADOS, as you might change how you would have acted if you know...

I disagree - preparing for an autism assessment is no different to making a list of symptoms before you go to a doctor for an unknown illness; it's easy to forget something important in the moment.

In fact, the whole point of all the pre-assessment questionnaires and tests is to trigger that kind of preparation, because clinical assessments are incredibly sensitive to missed information causing misdiagnosis by their very nature.

I agree with you about everything but the actual ADOS. It's good to make notes for all the other parts, but not that.