Neurodivergent-Affirming Assessments

A formal diagnosis opens the opportunity to knock on new doors — to services, accommodations, and a deeper understanding of yourself. For many late-diagnosed adults, a formal diagnosis is a gateway to self-exploration. Until 2012, Autism and ADHD could not be diagnosed simultaneously in most cases and therefore many adults who are AuDHD (Autistic and ADHD) were misunderstood or unable to access the unique or custom supports and interventions available for our brains.

Of course :) If you’re currently working with another therapist, we can coordinate so that our work can include any information about the support you’re already receiving. I can provide you with a summary or suggestions on how to share the assessment results with other providers.

These sessions use a structured but conversational format to explore your lived experience across different domains. There are several tools designed for neurodivergent-affirming assessment through storytelling and dialogue. These conversations are intended to be collaborative, flexible, and centered on your voice & living experience. Along with clinical interview, we will use standardized assessments, These are the standardized measures I use; your goals and assessment needs dictate which ones I choose to utilize. ADHD ADHD-RS-IV** Brown ADD Scales** ASRS v.1.1** CAARS** Barkley Deficits in Executive Functioning Scale (BDEFS for Adults)** DIVA-5 Autism Ritvo Autism Asperger Diagnostic Scale–Revised (RAADS–R)** Camouflaging Autistic Traits Questionnaire (CAT-Q)** AQ** Monotropism Questionnaire** Social Responsiveness Scale, 2nd Edition (SRS-2)** CATI** Adult Repetitive Behaviors Questionnaire-2 (RBQ-2A)** Extreme Demand Avoidance Questionnaire for Adults (EDA-QA)** MIGDAS-2 ADI-R ADOS-2 Sensory, OCD, etc. Sensory Profile 2** Sensory Processing Measure (SPM-2)** Personality Assessment Inventory (PAI)** Alexithymia Questionnaire** Difficulties in Emotion Regulation Scale (DERS)** International Trauma Questionnaire (ITQ)** Obsessive-Compulsive Inventory-Revised (OCI-R)** Dimensional Obsessive-Compulsive Scale (DOCS)** Florida Obsessive Compulsive Inventory (FOCI)** Y-BOCS II Brown Assessment of Beliefs Scale (BABS) **Many of the assessment tools used in adult Autism, ADHD, OCD, sensory, trauma evaluations are technically designed as self-report measures. This means the client is usually expected to read each item independently, interpret what the question is asking, select the "best" response, and complete the form without support. In practice, I have found that this does not always produce the most accurate or useful information, especially for neurodivergent adults. Many self-report tools were developed within clinical and research systems that have historically centered narrow presentations of Autism, ADHD, OCD, and trauma. Some measures were normed primarily on populations that may not fully represent high-masking adults, women, queer and trans people, people of color, multiply-neurodivergent people, trauma survivors, or people who have spent years compensating so effectively that their struggles are mostly internal. As a result, the questions may not always capture the lived experience of the people I most often assess. Self-report measures can also be difficult because the wording is often vague, overly broad, too literal, too narrow, or based on assumptions about how a person’s traits “should” look from the outside. A client may underreport because they have normalized their experience, because they mask automatically, because they compare themselves to people with more visible support needs, or because they answer based on what others can observe rather than what it costs them internally. Another client may overreport because they are distressed, anxious, burned out, traumatized, or trying to make sure their experience is finally taken seriously. Neither pattern means the client is being dishonest. It means the tool needs context. This is especially important in neurodivergent assessment because many clients are asked to answer questions that require executive functioning, abstract interpretation, interoception, memory, emotional awareness, and social comparison, which are often the very areas being assessed. For example, a client may struggle to answer questions about emotional regulation because they experience alexithymia. They may struggle to answer sensory questions because they have adapted around their sensory needs for so long that they no longer recognize them as “sensory.” They may struggle to answer social questions because their outward behavior looks socially typical, while their internal experience involves scripting, rehearsing, monitoring, and exhaustion. For these reasons, I offer clinician-supported completion of selected self-report measures. This does not mean I answer for the client, lead their responses, or coach them toward a particular result. It means I help clarify what an item is asking, define the timeframe, explain confusing wording, and invite the client to consider both outward behavior and internal experience. I may ask for examples, but the response remains the client’s own. This approach can be especially helpful for clients who are autistic, ADHD, anxious, traumatized, highly analytical, perfectionistic, literal, alexithymic, demand-avoidant, or prone to shutdown when faced with long packets of forms. It also reduces the likelihood that the assessment becomes an executive functioning test disguised as a diagnostic process. I use self-report measures as one piece of the assessment, not as the whole assessment. Scores can provide useful information, but they do not replace clinical interview, developmental history, functional impact, differential diagnosis, client narrative, and clinical judgment. A score may point us toward an area to explore, but it does not tell the whole story. In my view, this is a more neurodivergent-affirming and clinically responsible use of self-report tools. It honors the reality that many clients are not confused because they lack insight. They are often confused because the tools were not written with their full experience in mind. Clinician-supported administration allows the assessment process to be more collaborative, more accessible, and more reflective of the client’s actual lived experience.

Yes, but you will need to pay out of pocket and request reimbursement as I am not in-network with any insurance companies. I am able to offer clients a Superbill to utilize your out-of-network benefits. With superbills, clients pay full cost out of pocket and then are reimbursed directly by their insurance based upon their specific benefits. Either myself or my biller are always happy to answer any questions you may have about insurance / billing.

The amount of time can vary slightly, but I generally schedule 3-6 appointments usually back-to-back weeks tp keep the flow but if we need to space appointments apart, that's fine too. I schedule appointments for either 1 or 2 hours, depending on what we've decided together. Some folks prefer longer appointments so they are done with the process quicker and others prefer shorter sessions and don't mind that it stretches the process out. Either way, I encourage folks to consider a timeframe in their week when they have about 1.5 hours available for appointments. Scheduling with "buffer time" can allow for any transition time before or after a session to grab a snack, use the bathroom, or do whatever is helpful when preparing for or finishing an appointment that can mentally feel like a lot. I encourage interested clients to not schedule assessment appointments right before or right after other obligations or anything that may require focus or socializing with others, because sessions can sometimes bring up emotionally challenging content, and having some time for self-care can be incredibly helpful.

Before sessions, (upon request) I can send an overview of what we’ll be discussing and some optional prompts for reflection. These materials can help you consider specific aspects of your life, such as routines or sensory experiences, and gather your thoughts in advance. You’re welcome to bring any notes to our sessions if that helps you feel prepared and/or send notes to me for written review as a part of my report writing. Some clients have found this beneficial - especially those who feel most comfortable expressing themselves via writing vs. speaking. This can be discussed in the intake process and is an option, not an expectation. Additionally, if you have family or friends in your life who you think would be able to offer valuable information, especially about your childhood/teen years, feel free to let them know that I am happy to give you questions to provide them (they can either send you their answers or send them directly to me).

It is totally fine if you need to reschedule; I just ask that you provide at least 24 hours' notice so that I can best plan how to use the open time. We will work together to find an alternative date/time.

A comprehensive report provides a much more detailed record of the assessment. It includes relevant background and developmental history, the assessment process and measures used, interpretation of the findings, diagnostic reasoning and differential diagnoses, individualized recommendations, and a fuller description of how your neurodivergence may affect your daily life. These can be anywhere from 5 - 20 pages long.A diagnostic letter is a concise summary of the assessment findings. It typically includes the diagnosis or diagnoses, a brief explanation of the clinical rationale, and general recommendations. This option may be sufficient when you primarily want diagnostic clarity, documentation for your personal records, or something to share with a medical or mental health provider. These are typically 1-3 pages long. Both options involve the same thoughtful, neurodivergent-affirming assessment process. The difference is the level of detail in the written documentation, not the thoroughness or validity of the evaluation itself.

Totally fine, I offer a neurodivergent consultation that does not include any written documentation. Please let me know if this is something you are interested in. Generally, these services cost about $900 and can be accomplished in 2 appointments.

I am more than happy to discuss whether you would like to continue services post-assessment. Please let me know if this is something you are interested in. Keep in mind, you will need to be put back on the waitlist as I do not typically have immediate availability for new therapy clients. If you haven't already, I would also encourage you to explore the rest of my website to get a feel for my therapeutic style. Additionally, just as with assessment services, my therapy services may or may not be covered in part or in full by your out-of-network benefits, I am happy to help you explore what your benefit coverage is if needed.