No previous assessment --> Adults who have not previously had an assessment for autism spectrum disorder can access an assessment through Core Clinical. We suggest you attend your GP to discuss the reasons you think you may have autism and ask your GP if they feel an assessment would be helpful.
Previous assessment --> If you have a previous diagnosis of autism, we advise you seek copies of the assessment report, either from the service you attended or your GP, and include these with your referral to Core Clinical. We take previous reports into account when triaging referral information and adapt the assessment you need with us accordingly. Often, a full new assessment is not required but an assessment by two team members is essential. Of note, the more information available in previous reports or assessments which included an ADI-R or ADOS assessment tool are the most helpful.
At the beginning of an ASD clinical assessment, we ask you and a family member, nominated by you, to complete a number of screening questionnaires which we use to triage your information towards a more efficient assessment. This information can also assist in developing an individual profile for each person attending our service allowing for a more informative feedback session following review.
ASD Clinical Assessment
Each ASD assessment at Core Clinical is undertaken in a multidisciplinary format in line with international best practice. Both a psychiatrist and psychologist will interview you and your nominated family member(s) to ensure the assessment is appropriately comprehensive. We use structured interview, clinical observation and evidence-based diagnostic tools to reach a diagnosis. The assessment is expected to last 3 to 4 hours with each clinician.
ASD Observational Assessment
Occasionally, in cases where individuals experience co-existing conditions such as mental illness or a history of trauma, a diagnosis of ASD can be more difficult to accurately identify. To prevent misdiagnosis in such cases, if necessary, we provide a second appointment to complete a further diagnostic test of observation.
Consensus Meeting, Feedback & Recommendations
Before reaching a clinical decision in relation to a person’s diagnosis, the multidisciplinary team engage in a consensus meeting. This meeting combines information gathered over the course of the assessments to allow a multidisciplinary diagnostic formulation and the development of individualised recommendations. As a team we will meet with you and your nominated family member(s) to discuss our findings and outline our recommendations. We endeavour to complete this process on the day of your assessment. Where this is not possible due to factors such as missing information, co-existing disorders or a requirement for further assessment (e.g. IQ assessment) we will explain the reasons why and offer you options as to how to proceed.
It is our preferred practice to meet with each individual that receives a diagnosis of ASD within 6 weeks of their assessment appointment. This follow-up session is to provide space for further discussion of the diagnosis and to address questions the individual may have.
Sensory processing disorder is ‘a condition in which a person has difficulty organising and integrating sensory information for use’ (Vaughn 2014, p.1176). It is not a standalone diagnosis, rather it is a condition resulting from another developmental or behavioural disorder (Zimmer 2012).
In relation to ASD, sensory hyper-reactivity or hypo-reactivity or unusual interests in sensory aspects of the environment is a recognised symptom within the diagnostic criteria as outlined in DSM-5 (American Psychiatric Association 2013).The criterion suggests ‘apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement’ as examples of sensory issues seen in ASD (American Psychiatric Association 2013, p.28).
However, more detailed writings in the area suggest sensory issues can be more global and disabling and include sensory defensiveness, sensory seeking, sensory disorder, sensory dysfunction and sensory overload (Kern 2006). Individuals with ASD can struggle with sensory overload resulting in avoidance or sensory under-stimulation resulting in sensory seeking behaviours in each of the sensory modalities; tactile, oral, olfactory, visual and auditory and also in relation to proprioceptive and vestibular input (Kern 2006, Lane 2011).
Sensory Integration Therapy
Sensory processing disorder is a relatively frequent comorbid condition in ASD with research showing that over 94% of individuals with ASD have extreme levels of sensory processing difficulty in at least one sensory modality (Crane, Goddard & Pring, 2009). Greater degrees of sensory processing difficulties are seen for those with higher range IQ and those with high rates of stereotyped interests and repetitive behaviours (Wiggins, Robins, Bakeman & Adamson, 2009).
Individuals with difficulty tolerating or processing sensory information can benefit from engagement with a comprehensive treatment plan which could include sensory integration provided by a trained clinician, generally an occupational therapist (Zimmer et al, 2012). Sensory adaptations allow for reduced sensory overload and improved attention and concentration in those with ASD (Williams, 2006). Use of proactive and reactive strategies to help those with ASD and sensory processing difficulties is a critical part of this process.
Art Therapy is a form of psychotherapy which can be used to improve mental health and maintain emotional wellbeing. Art therapy uses art media and creative intervention to encourage self-expression and reflection within a therapeutic relationship. It is a non-invasive form of therapy which uses art materials to create expression and bring forward the unconscious and inner workings of a client, allowing them to communicate. Words are not necessary for art therapy and it can be of particular benefit to non-verbal clients or those with difficulty expressing inner thoughts or emotions. A fully trained art therapist will find meaning in the image, body language, movement, just about anything that happens within a session.
There is no ‘right or wrong’. You do not need to be amazing at art in order to benefit as it is not about the aesthetics of the work created, but the process and what it may evoke in a client. The art therapist works together with the client to explore their images and reach their own personal understanding and insight.