Assessments
Our Assessments for Autism, ADHD and IQ
Dr Bianca Calabria is a neurodivergent clinical psychologist who conducts Autism, ADHD assessments for individuals aged six years and older in Canberra or via telehealth (i.e., video-session). Dr Bianca Calabria also conducts IQ assessments for young people in Canberra (face-to-face). Her processes are comprehensive, and they are aligned with national and international guidelines.
The start to finish assessment process usually takes at least three months. This process can be delayed, and appointments may need to be re-scheduled without warning, due to unexpected staff leave. We understand that delays can be distressing but unfortunately they are unavoidable for a variety of reasons.
Autism & ADHD Assessment Process
1
You book your initial session online.
We email you a quote for your assessment; you need to accept this to proceed.
2
We will send adult clients or parents/carers of young clients an email with a link to book the family member/carer session for the assessment (e.g., booked after initial session for adult assessments, and before initial session for young person assessments).
3
We will send adult clients or parents/carers of young clients an email with links to forms for completion. Forms must be completed before your initial session.
4
We email two invoices, and payment of the first invoice must be received before the initial assessment session. See fees for more details.
5
The initial session is completed. For adult assessments this is with the adult clients. For young person assessments this is with the parents/carers.
6
We email links for measures/questionnaires to be completed. Adult clients self-complete the measures/questionnaires. For young people, measures/questionnaires are emailed to parents and a teacher, and by the young person if they are aged 16 years or older.
7
The second session is completed. For adult assessments this is with a family member/partner. For young person assessments this is with the young person.
8
Once all clinical interviews and measures/questionnaires have been completed, we email a link to book your feedback session.
9
10
Feedback session is completed online.
We send you a letter stating the outcome of your assessment and recommendations via encrypted email.
11
We send you your comprehensive assessment report via encrypted email up to six-weeks after your feedback session.
12
If you have an ADHD assessment with Dr Bianca Calabria (clinical psychologist) you will receive a comprehensive assessment and report including recommendations for supports and accommodations. Dr Calabria cannot prescribe medication. If Dr Calabria identifies ADHD, she recommendations:
Adults see their GP for a referral to a psychiatrist to discuss ADHD medication.
Young people see their GP for a referral to a pediatrician (or a psychiatrist if the young person has co-occurring mental health conditions) to discuss ADHD medication.
Psychiatrists have their own processes, that can include conducting an ADHD assessment themselves, even if the client has a previous ADHD assessment from a clinical psychologist or a different psychiatrist.
What to Expect
-
Adult Assessments
The initial clinical interview for an adult assessment is booked for three hours with the client (face-to-face in Canberra or telehealth across Australia). The session will continue as long as the client can, and if they become overwhelmed the session will end and the remaining time re-booked. Clients can choose to sit in one of two armchairs, on the lounge or on the floor, if the clinical interview is conducted in person. Movement around the room during the clinical interview is welcomed by Bianca. Fidget toys are available in the room, and clients can bring in items that they find comforting or to fidget and stim with, if they would like to. There will be at least one break about half-way through the three-hour clinical interview, and clients can request as many additional breaks as they need. If a client experiences extreme fatigue day-to-day, please email info@thetealspace.com.au to discuss options for multiple shorter clinical interview sessions. The clinical interview is informed by semi-structured interview schedules (e.g. MIGDAS-2 or DIVA-5), and includes questions from Bianca’s clinical, research and lived experience.
Young Person Assessments
The initial clinical interview for a young person assessment is booked for 90 minutes with parents/carers (face-to-face in Canberra or telehealth across Australia). This session is informed by semi-structured interview schedules (e.g. MIGDAS-2 or Young DIVA-5); however, the questions are more conversational and seek to understand the family member’s observations of the young person’s strengths and challenges.
-
Adult Assessments
Dr Bianca Calabria speaks to a family member for one-hour as part of the assessment process. This is important for the assessment process because it provides information from another person about you when you were younger and now. The family member session is conducted via telehealth (video or phone session). This session is informed by semi-structured interview schedules (e.g. MIGDAS-2 or DIVA-2); however, the questions are more conversational and do not specifically use “Autism” or “ADHD” and instead seek to understand the family member’s observations of the client’s strengths and challenges during childhood and currently.
If we cannot speak with a family member, we can speak to someone else who knew you when you were younger (e.g. a close childhood friend).
Young Person Assessments
The seond session for a young person assessment is booked for two and a half hours with the young person/client (face-to-face in Canberra or telehealth across Australia). The session will continue as long as the client can, and if they become overwhelmed the session will end and the remaining time re-booked. Clients can choose to sit in one of two armchairs, on the lounge or on the floor, if the clinical interview is conducted in person. Movement around the room during the clinical interview is welcomed by Bianca. Fidget toys are available in the room, and clients can bring in items that they find comforting or to fidget and stim with, if they would like to. There will be at least one break about half-way through the three-hour clinical interview, and clients can request as many additional breaks as they need. If a client experiences extreme fatigue day-to-day, please email info@thetealspace.com.au to discuss options for multiple shorter clinical interview sessions. The clinical interview is informed by semi-structured interview schedules (e.g. MIGDAS-2 or DIVA-2), and includes questions from Bianca’s clinical, research and lived experience.
-
Adult Assessments
After your clinical interviews are finished, you will receive an email with links to complete measures/questionnaires.
Young Person Assessments
After the clinical interviews are finished, emails with links to complete measures/questionnaires. will be sent to parents/carers, a teacher, and possibly the young person (depending on their age).
Measures/Questionnaires
No measure/questionnaire is perfect, and they all assume that we act similarly across contexts, when this is not usually anyone’s experience. Answers should best reflect your experience in the world. No one response or result from the measures/questionnaires is used for diagnostic purposes, and instead, we integrate all information gained during the assessment process to develop a clinical formulation and recommendations to support improvements in quality of life for the client.
-
The assessment process is strengthened by inclusion of school reports or other medical/wellbeing reports. These reports provide evidence of what you were like in these settings when you were younger. If you do not have access to any reports, we can speak to a family member to ask questions about what you were like when you were younger and what school is/was like for you.
-
Dr Bianca Calabria conducts a one-hour feedback session via telehealth (video is preferred) to communicate the outcome of the assessment, to discuss recommendations following the assessment and to provide clients the opportunity to ask questions. Adult clients can attend the feedback session alone or they can invite others to be with them. For young people, parents/carers can be present for all or part of the feedback session.
-
In the week following your feedback session, you will be emailed (via encrypted email) a letter stating the outcome of your assessment and recommendations. For young people assessments, parents/carers will be emailed the letter. If you were referred by a medical practitioner, a letter will also be faxed to them.
The comprehensive report will then be finalised and we aim to send it (via encrypted email) four to six weeks after the feedback session.
-
If Autism and ADHD assessments are being conducted concurrently for a client, they will have three sessions. For adults there are two 3-hour sessions and one 1-hour session with a family member/partner. For young people assessments, there will be one 90-minute session with a family member and two 2.5 hour sessions with the young person. Measures/questionnaires will be completed for both Autism and ADHD. The combined assessment will include a one-hour feedback session and one comprehensive report with supporting letter.
Information about our Diagnostic Assessments for Autism and ADHD
-
Clinical psychologists can conduct Autism and ADHD assessments. Current tertiary training programs teach limited and sometimes outdated information about Autism and ADHD. Clinical psychologists who conduct Autism and ADHD assessments may have completed additional training after their university courses to ensure that they are working with current understandings and research.
-
Please note that psychiatrists can conduct Autism and/or ADHD assessments, and neurologists can conduct ADHD assessments. Their processes are informed by discipline-specific guidelines that can differ from clinical psychologist guidelines. They set their fees for assessments and Medicare rebates may apply; usually a letter stating relevant diagnoses is provided.
***Please note that psychiatrists have their own processes that can include conducting their own assessment, including clinical interview and completion of measures/questionnaires.
Assessments conducted by Dr Bianca Calabria (clinical psychologist) include a comprehensive report that outlines strengths and challenges that can be used to determine and advocate for reasonable and appropriate accommodations and adjustments in education and workplace settings. If a person has a diagnosis of ADHD from a clinical psychologist, then they can seek a medication review from a psychiatrist; psychiatrists have processes they follow before medication is recommended, irrespective of information provided in a clinical psychologist’s assessment. It is important to communicate to psychiatrists if you have a diagnosis of ADHD from a clinical psychologist and provide them with your comprehensive report.
-
Multidisciplinary teams can also conduct Autism and/or ADHD assessments.
-
Australia has national guidelines for Autism and for ADHD assessment:
Australia's First National Guideline for the Assessment and Diagnosis of Autism Spectrum Disorders | Autism CRC
Australian Evidence-Based ADHD Clinical Guideline (aadpa.com.au)Dr Bianca Calabria also aligns her practice with international guidelines, for example:
Download Guidelines | CADDRA -
If you are not an Australian citizen and you are planning to apply for Australian citizenship, having a diagnosis of Autism could be detrimental. The Department of Home Affairs website states that they “cannot approve your application [for Australian citizenship] in certain circumstances” and includes “having a permanent or enduring physical or mental incapacity” as one such circumstance (Become an Australian citizen (by conferral) Permanent residents or eligible New Zealand citizens (homeaffairs.gov.au)). Autism is defined as a disability by Australia’s National Disability Insurance Scheme (List A: Conditions that are likely to meet the disability requirements | NDIS).
Please note, this is not legal advice. If you are applying for Australian citizenship, please seek independent legal advice.
Cognitive (IQ) Assessment Process
1
You book your initial session online.
We email you a quote for your assessment; you need to accept this to proceed.
2
We will send parents/carers of young person clients an email with a link to book the family member/carer session for the assessment (e.g., booked before initial session).
3
We will send parents/carers of young person clients an email with links to forms for completion. Forms must be completed before your initial session.
4
We email three invoices over six-weeks, starting the week before your initial session. See fees for more details.
5
Parents/carers complete the initial one-hour clinical interview online.
6
The young person completes a three-hour assessment interview face-to-face.
7
We email parents/carers a link to book a feedback session.
8
Feedback session is completed online.
9
We send a comprehensive assessment report (via encrypted email) four to six weeks after the feedback session.
10
What to Expect
The cognitive (IQ) assessments conducted at The Teal Psychology Space Pty Ltd are informed by the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V).
-
The initial clinical interview for a WISC-V assessment is with a parent/carer, to discuss the reason for the assessment and to collect background information. The initial clinical interview is one-hour (face-to-face in Canberra or telehealth).
-
The WISC-V is a standardised assessments that will be conducted as specified.
The session will continue as long as the client can, and if they become overwhelmed the session will end and the remaining time re-booked. Clients sit in a chair opposite the assessor who will be seated across a desk. Movement around the room during the assessment is welcomed by Bianca. Fidget toys are available in the room, and clients can bring in items that they find comforting or to fidget and stim with, if they would like to. There will be at least one break about half-way through the three-hour clinical assessment, and clients can request as many additional breaks as they need. If a client experiences extreme fatigue day-to-day, please email info@thetealspace.com.au to discuss options for multiple shorter assessment sessions.
-
Dr Bianca Calabria conducts a one-hour feedback session via telehealth (video is preferred) to communicate the outcome of the assessment, to discuss recommendations following the assessment and to provide clients and parents/carers the opportunity to ask questions.
Neurodivergent-Affirming Assessments
and Practice
The word Neurodiversity was coined by Judy Singer, in her 1998 sociology honours thesis, to describe unique brains and specifically to recognise that autistic brains differed from non-autistic brains. You can find her work in Judy Singer’s book NeuroDiversity: The Birth of an Idea (published in 2016).
The word Neurodivergent has since been used to describe any brain that has developed or changed so that differs or divergences from most other brains in a society. Commonly, and at The Teal Psychology Space, the word neurodivergent is used to describe people who are Autistic and who have ADHD. People who are Autistic and those who have ADHD have divergent brains, bodies and experiences of the world, compared to the majority of people.
The Teal Psychology Space is a neurodivergent-affirming practice. Reframing Autism reviewed the latest research and developed six questions to ask a mental health provider to determine whether they are neurodivergent-affirming (see Guidelines for selecting a neurodiversity-affirming mental healthcare provider | Reframing Autism). Reframing Autism’s questions refer to Autism only because that is their focus. The questions, and The Teal Psychology Space’s responses in relation to Autism and ADHD are below:
-
Autism and ADHD are special interests of Bianca’s and she engages with learning opportunities as often as she can (this is usually daily!). Bianca seeks out training and learning opportunities that are developed and presented by neurodivergent people. These have included Reframing Autism, the Canadian ADHD Resource Alliance (CADDRA), and InTune Pathways/Families.
Bianca is constantly and consistently learning from newly published and existing peer reviewed research papers, webinars, online training courses, podcasts, books, online forums, face-to-face discussions, and her lived experience. Bianca has regular peer and clinical supervision with neurodivergent psychologists. She has also completed formal training in current diagnostic assessment measures and clinical interview schedules (e.g. MIGDAS-2 and ADOS-2) and is a member of the Canadian ADHD Resource Alliance (CADDRA | The Canadian ADHD Resource Alliance).
We are passionate about neurodivergent people understanding themselves and learning to un-mask when they feel safe to, so that their wellbeing is ultimately improved. Bianca aims to un-mask in her practice and hopes that this is validating for her neurodivergent clients.
-
The Teal Psychology Space is located at Lantern Psychology. The room where appointments take place has natural light with a beautiful tree out the window.
We understand that our clients can have sensory sensitivities (and Bianca does too!) and so lights can be dimmed, movement in the room is welcomed, fidget toys are available (and clients can bring their own if they would like to). Clients can choose to sit on the lounge, on one of the two arm chairs, or on the floor.
Neurodivergent social approaches are understood (e.g. eye contact may be limited, speaking before the other person has stopped talking is not necessarily a sign of rudeness and can be a fluid way that neurodivergent people communicate).
We love talking about special interests! These are the passions and interests that are special to each person who is Autistic or who has ADHD. We welcome special interest items in session!
The pace of the session is matched to the client’s needs and preferences (e.g., some clients speak quickly and constantly, others need time to think before responding, and both can be relevant for one person).
Multiple breaks can be taken for any reason and even without a reason.
Friendly reminders are provided as needed and without judgement. We understand that each person’s situation is unique, and we aim to work effectively and flexibly to suit each individual.
We aim to provide detailed information about what to expect and we encourage feedback if our processes or communications could be improved (and we implement changes to address feedback).
Appointments can be made online using booking links. We have face-to-face and telehealth sessions available.
-
Autism and ADHD are part of each neurodivergent individual. There are huge strengths to being Autistic and having ADHD. Neurodivergent brains and bodies are exceptional and in the right environment they can achieve things that are impossible for most others. The world we live in was not built for neurodivergent people and so we can have difficulties and challenges daily. If the world was different, then our difficulties and challenges could be minimised. We can’t change the world, but we can work out supports and accommodations, that will be unique for each neurodivergent person. Once supports and accommodations are in place so that difficulties and challenges are minimised, neurodivergent brains have the opportunity the thrive. Each and every DSM-5-TR diagnostic criteria is deficit defined; however, these criteria are also all strengths when we have the opportunity and capacity to show and share them.
-
Clients are the experts on themselves, and we integrate this information with clinical experience and research evidence to collaboratively work towards client goals. We are aware that functional capacity is variable and can change day-to-day or hour-to-hour, and this is incorporated into each session. Clients all have unique sensory profiles and these are also considered in the therapy context. Our mental healthcare approach is holistic and understands the contributors to mental health that are outside of the client’s control.
For example, a recent research paper in the Lancet found that interpersonal discrimination likely contributes substantially to psychological distress among Aboriginal and Torres Strait Islander adults in Australia. When Indigenous Australians are compared with non-Indigenous Australians, psychological distress is much higher for Indigenous Australians (i.e., there is a gap in psychological distress). The Lancet research found that almost half of the gap in psychological distress could be explained by everyday racial discrimination.
That means that almost half of the “extra” psychological distress experienced by Indigenous Australians is likely because of their everyday experience of racism.
The research paper can be found here: Population-level contribution of interpersonal discrimination to psychological distress among Australian Aboriginal and Torres Strait Islander adults, and to Indigenous–non-Indigenous inequities: cross-sectional analysis of a community-controlled First Nations cohort study - The Lancet.
-
We used strengths-based approaches. This means that while working on supporting clients with challenges we are also highlighting and valuing their strengths. The DSM-5-TR criteria for Autism and for ADHD are all deficit focused; however, each characteristic relevant to criteria is also a strength. We learn from clients about their passions and interests and integrate these into our therapeutic approaches. We support clients to manage and process challenges in their lives so that their strengths can flourish.
-
Progress can be viewed through common measures (e.g. questionnaires) and other uniquely defined ways for each client. We ask each client “what would success look like for you?” and “what are you working towards” so we can track how it’s going along the way.
We work with client goals and collaboratively decide on practical and achievable steps. We communicate these steps using methods suited to each client (e.g. written, visual, verbal, memes).
The Teal Psychology Space is all about breaking down the barriers that stop neurodivergent people getting appropriate mental healthcare:
We have current knowledge about Autism and ADHD from research, clinical experience and the lived experience of neurodivergent people. We are always learning from others and from each other.
1
We understand social differences and their strengths. Neurodivergent people do not have deficit social approaches, they have a different way of communicating that is often not a problem when communicating with other neurodivergent people.
2
We are informed by current research that is conducted by neurodivergent people and that uses identity-first language. We understand neurodivergent presentations that are not aligned with stereotypes (e.g. masked Autistic presentation that is commonly referred to as the female presentation of Autism).
3
Our communication style is direct, open and collaborative.
4
We understand and value information and research that describes experiences commonly described by neurodivergent people. For example, Pathological Demand Avoidance (i.e. Persistent Drive for Autonomy) and Rejection Sensitive Dysphoria. We aim to understand how these impact on clients day-to-day and help them to understand their related thoughts, feelings (emotions and bodily experiences) and behaviours.
5
Our room aims be accommodate sensory needs. For example, have dimers on lights, natural light through tinted windows, fidget toys available, encourage movement.
6
We welcome and encourage all forms of communication, both verbal and non-verbal. Sometimes words are not available to describe neurodivergent peoples’ experiences, and other times neurodivergent people are non-verbal (this can be consistently or periodically). We use assistive technology when/if client’s are non-verbal.
7
We aim to accommodate communication differences (e.g. using subtitles in videos).
8
We provide detailed and clear steps that outline our processes and requirements. We encourage clients to ask as many questions as they have. Friendly reminders are sent, without judgement, to clients who have not completed required administrative processes.
9
Our team understands the complex health and wellbeing service systems (e.g. public health services, private practitioners, across disciplines) and make recommendations for referral to other services if needed. We endeavor to support referrals by providing contact details of other practitioners and if needed (and consent provided by the client) providing referring information to that practitioner.
10
Copyright 2024 The Teal Psychology Space Pty Ltd