A Clinical Psychologist’s Guide to Neurodivergence and Assessment

Neurodivergence is a concept that challenges the traditional view of neurodevelopmental differences as “abnormal” or “disordered”. It recognizes that different thinking styles are a natural and valuable part of human diversity. People with thinking style difference that fall under neurodivergence may find themselves in challenging situations due to having to navigate through a ‘neurotypical’ world.

Neurodivergence includes diagnoses such as autism, attention deficit hyperactivity disorder (ADHD), dyslexia, dyspraxia, and others. Each neurodivergent person will have their own profile, and strengths and challenges.

Assessments for neurodivergence vary depending on the query. For the focus of this blog post I will focus on assessing for autism and ADHD.

An autism assessment typically consists of the following:

  • Use of standardised screening tools to measure levels of autistic traits.
  • A clinical interview with the person to collect information related to autistic traits (i.e. differences in social communication, social interaction and restricted or repetitive thinking and behaviour). This can be completed alone or with a friend or family member.
  • A developmental history – this is where we ask you or someone who has known you for a long time (e.g., parent, carer, sibling) about key areas of your childhood.
  • A standardised semi-structured assessment which includes activities and observations to evaluate social interaction, communication, and other behaviours we might see in autistic people.

An ADHD assessment consists of the following:

  • Standardised screening tools to measure levels of ADHD related symptoms (i.e., inattention and/or hyperactivity/impulsivity).
  • A structured interview format where a trained clinician asks a series of questions to gather information about the individual’s symptoms and history. Again it may be helpful to bring a parent, carer or family member to this appointment.

The interview covers various aspects of ADHD symptoms, including inattention, hyperactivity, and impulsivity. It also explores how these symptoms impact different areas of the individual’s life, such as work, relationships, and daily functioning.

  • Computer based testing is also widely used as part of an ADHD assessment. These tests involve tasks that measure attention, such as responding quickly to certain stimuli or inhibiting responses to others. During the test, you might see different shapes or symbols on the screen and be asked to respond to them in specific ways, like clicking a button when you see a certain shape but not clicking when you see another.

Both an autism and ADHD assessment should ensure that they follow the ‘gold-standard’ assessment pathway (e.g., NICE Guidelines) and that the diagnostic criteria outlined in widely recognized classification systems, such as the DSM-5 or ICD-10 should be met, to ensure consistency and accuracy in diagnosis.

A clinician who is completing a neurodevelopmental assessment should also be able to consider differential diagnoses. Exploring differential diagnoses is like detective work. For example, let’s say someone is having trouble focusing and staying organized. Those symptoms could be because of ADHD, but they could also be caused by other things, like stress, depression, or even certain medical conditions. The clinician would look at all the possible explanations and try to rule out each one until they find the best fit. This process helps ensure that the person gets the right diagnosis and support.

We are delighted to offer high quality and robust assessments for neurodivergence at The Fitzrovia Psychology Clinic!

Written by Dr Samir Pathan, Associate Clinical Psychologist in The Fitzrovia Psychology Clinic’s Neurodivergence Team