Autism Evaluation
Autism Evaluations
Laura Tewel, MA, LMFT offers neurodivergent affirming Autism evaluations for adults. Evaluations focus on identifying Autistic/ADHD traits, empowering strengths, validating struggles, and affirming identity. They are designed to be collaborative, therapeutic, and informative. If you meet diagnostic criteria for Autism, you can choose if you'd like a formal diagnosis on your report or if you'd prefer the report to provide feedback with no diagnosis.
Email laura@wwcspokane.com to schedule.
Autism assessments are offered in-office or telehealth and will include the following:
- Fifteen minute phone consultation
- Up to six hours of clinical interviewing, scheduled in 90 or 180 minute appointments.
- Optional: Additional two hours of clinical interviewing for ADHD screener
- Take home questionnaires
- One hour feedback session
- Report with summary of results and recommendations
Price:
Autism assessment: $1300
- This includes 15 minute phone consultation, up to 6 hours of clinical interviewing, 1 hour feedback session, 1 diagnosis report
- Additional time for clinical interview available at a rate of $150/hour
- Additional two hours for ADHD assessment available for $300.
More details and questions (if that's your thing)
Is this a neuropsych evaluation?
No. A neuropsych evaluation is a comprehensive evaluation conducted by a psychologist.
Does it matter that you only have a masters degree? You're not a psychologist.
It does matter. In Washington state, masters level clinicians can diagnose autism and ADHD if they've received additional training. A diagnosis by a masters level clinician can help you with identity, treatment goals, and advocacy. It does NOT qualify you for social security disability or many other resources. It is also common for workplaces and healthcare providers to be more dismissive of a diagnosis by a masters level clinician than a psychologist, so it could make advocacy less successful for you.
Will this evaluation be less information or help than getting a neuropsych evaluation?
Yes and no. Each clinician chooses the questionnaires and time for assessments. Many people report that neuropsych evaluations spend about 20-60 minutes discussing autistic/ADHD traits plus many other standardized assessment forms. This interview will be about 4-6 hours of conversation focusing on autism plus standardized assessments forms (way less forms). Neuropsych evaluations are comprehensive and consider all potential diagnoses, cognitive function, personality, and history. So neuropsych evaluations gather significantly more information about other parts of your experience and functioning. This assessment will consider other potential explanations, but will primarily be focusing on autism.
What else should I consider when finding a provider for assessment?
The amount of specific training a provider has received on Autism/ADHD and how recent that training is. Also their training regarding the impact of race, gender, and culture.
What’s your philosophy on ADHD and autism?
I celebrate autism and ADHD. I believe it has been misunderstood, underdiagnosed, and stigmatized for far too long. All brains have patterns of how we experience and process the world, autism and ADHD are just one of the many types of brains. Autism is not defined by can you do things, but rather, how much energy does it cost you? How draining is it to live the neurotypical lifestyle? Autism commonly has traits characterized by being extreme one way or the other, so there is a lot of diversity in the presentation. Someone may be very excited to meet new people and try new things, someone may be excited to be alone and have quiet time. Someone may be very aware of the emotions around them, others may be very unaware of the emotions around them. ADHD also has many diverse presentations. Someone may have a classic presentation of being scattered, losing things, always running late. Or they might have created systems to accommodate their ADHD and present as anxious, rigid, and perfect. The focus of assessment is not just to look at the observable traits, but to also discuss your experience and effort you put into your life.
What should I expect in the interview?
The clinical interview primarily uses the MIGDAS-2, an evidence-based assessment that prioritizes affirming, strength based questions. Questions will focus on special interests, sensory preferences, communication patterns, social relationships, and work/school functioning. We’ll discuss your current traits and any childhood traits you can remember. This is a transparent, direct, and collaborative assessment. There aren’t trick questions, confusing prompts with ulterior motives, or sneaky observations to catch you in contradictions. I do observe behavior, speech pattern, and other non verbals, but not in a way to confuse you. I am also always happy to answer the purpose of the question or my thoughts about your answer. There will be additional take-home questionnaires and other questions as needed.
How do I prepare?
The best way to prepare is to research autism/ADHD to learn about what it is, reflect about yourself and how you may or may not fit the traits, and try to remember examples from your past. I’d love to hear about your relationships now and in childhood, sensory preferences (things you loved or hated) now and in childhood, what you do to calm yourself, what stresses you, what energizes you, what drains you.
Can I email you a list of my thoughts/examples that may be neurodivergent traits?
Absolutely! If it helps you to write down your examples before we meet, that’s great! A bulleted list of examples can be helpful. It’s even better if you organize it by social, sensory, behavioral examples.
What if I have a lot of trauma? How can we tell what’s trauma or autism?
That’s an excellent question that I may not have a perfect answer to. There are notable distinctions between autism and trauma, so an interview may be able to help distinguish between the two. The timeline of the trauma and traits can also add information. It’s also common for neurodivergent people to have higher rates of trauma, so it could also be both. Sometimes, it really is too much overlap to confidently distinguish between the two. If you’re concerned about this, we can discuss in the phone consultation if this is the appropriate type of assessment for you. A neuropsych evaluation may be a better fit.
Can I just have an ADHD assessment and not autism?
At this time, no. There are many ways to assess ADHD. I prefer to spend time learning about someone’s history, pattern of communication, and behavior before assessing. The autism assessment provides a strong history that provides a foundation for an additional ADHD assessment.
How do I know if I’ll need additional time for the clinical interview?
Most people answer all of the questions in 4-6 hours. The additional time is an option if you find it beneficial to be very detailed or thorough in your answers. I’m happy to help pace you if you’d like to track your answers and make sure you stay brief enough to stay under six hours.
Six hours is a lot of talking, is that the only way?
Nope! We have a lot of options to support you sharing the information. We can break it into smaller sessions, switch to using chat/email, do audio only sessions. I’m happy to be open minded to the best way you communicate.
Do you take insurance?
Not for assessments. This provides the opportunity to give affirming, accommodating assessments as I define it, not as insurance does. Plus, insurance requires a diagnosis and this will only be a screener.
Why would someone choose to not get a formal diagnosis?
A formal diagnosis can be a powerful and beneficial label that supports you and your advocacy. A formal diagnosis may also risk discrimination, political targeting, and unknown impacts for future needs. Every individual has different circumstances, risks, and motivations for understanding their neurodivergence. The option to receive a formal diagnosis at the end of the assessment provides flexibility for you to choose what is best for you. If you choose to not receive a diagnosis, then the report will provide feedback and information on if your traits "suggest" autism or not.
What's unknown impacts mean?
Our society and culture is always evolving. Autism has a history filled with misunderstanding, stigma, and discrimination. We recently saw a wave of affirming research, celebration, and care. There is also a newer wave that is eliciting fears of harmful attention. I can discuss your current levels of safety and risk; I cannot predict your future risks and safety.
Can I see you for therapy?
My waitlist for adding new therapy clients is fairly long. We can discuss if you’d like to be added to the list. I've helped develop a list of providers who have some training in neurodivergent affirming care. You can review this list to see if others may have sooner openings. https://pnwneurodiversitynetwork.com/list-of-providers
I’m worried that you’ll tell me I’m not autistic and I made this all up in my head.
My goal is to listen to your thoughts, research, and reasons. I am confident that both of us will feel positive about the results of your testing. New research indicates that adults are very accurate in self-diagnosing autism. In the event that autism/ADHD does not fit, we would thoroughly discuss it and make sure you agree with my conclusion. High-masking does not rule out autism.