Psychological Evaluation 101: Autism

Language note: although everyone has individual preferences, the overall consensus at the time that I am writing this post is that people in the Autism community prefer to be referred to as “Autistic people” rather than “people with Autism,” so that is the language I will use in this post.

Photo by Rakicevic Nenad on

Last week I talked about what an evaluation for ADHD looks like, and today I will talk about Autism. I’ve spoken before about the similarities and overlap between these two diagnoses, so you can check out that webinar if you want more information on this.

Even though we know Autistic children grow into Autistic adults, and even though we know that many Autistic children (especially Autistic girls) go overlooked in childhood, the existing norm-referenced measures for Autism are mostly created for children and teenagers. This does not mean that you can’t get diagnosed as an adult! It just means that the assessment has some limitations. When I get a referral for Autism testing for an adult, I explain this and move forward because that seems better than saying, “Sorry you didn’t get tested as a child! I guess we’ll never know.”

The assessment itself consists of a detailed interview where I get as much information as I can about the client’s background and symptoms, and if they have any previous psychological records, I review that as well. Since personality measures look at symptoms that overlap with Autism, I often use one to get norm-referenced information about symptoms and presentation.

With children and adolescents, parent and teacher observation measures like the Autism Spectrum Rating Scale can be used to diagnose Autism. There is also the Autism Diagnostic Observation Schedule, 2nd Edition, which gives the psychologist observational data about the client’s symptoms. I am not trained in the ADOS-2, but my understanding is that it is a very popular tool for these kinds of assessments.

It can be difficult to determine whether someone should be referred for an evaluation for Autism because, although we have diagnostic criteria, there is a huge range of ways that Autistic people can present. If you’ve seen one Autistic person, you’ve seen one Autistic person. Even though assessment materials have not completely caught up, the good news is you’re never too old to get checked out!

Published by Dr Marschall

Dr. Amy Marschall received her Psy.D. from the University of Hartford in September 2015. She completed her internship at the National Psychology Training Consortium with specializations in assessment and rural mental health. Currently, she specializes in trauma-informed and neurodiversity-affirming care, and she is certified in telemental health. Dr. Marschall runs a private practice, RMH Therapy, where she provides individual and family therapy as well as psychological assessments across the lifespan. Dr. Amy Marschall is an author and professional speaker.