Accessing an autism assessment can sometimes feel overwhelming. At Mind & Health Psychology, we offer structured, evidence-based autism assessments for children, adolescents, and adults, conducted in our Newcastle Office and Sydney (Chatswood) Office Our assessments are consistent with current clinical guidelines and suitable for NDIS documentation where relevant. This article outlines why autism diagnosis is often delayed, our process, the tools we use, and our commitment to neuro-affirming practice.

*Why is an Autism Diagnosis often Delayed?

1. Early Misdiagnoses & Diagnostic “Tunnel Vision”

Many young children are diagnosed first with ADHD or sensory processing issues—conditions that often overlap with autism—with 30–40% of autistic children also having ADHD .
These initial diagnoses can delay recognition of autism when symptoms become more apparent in social contexts, especially as the child starts school.

2. Hesitation by Clinicians

Clinicians and parents tend to opt for the diagnosis with the best prognosis or the most immediate, treatable condition, preferring to wait and “see how development goes”.
Autism requires a lengthy, specialist assessment (e.g., the ADOS-2 plus parental interviews such as the ADI-R), which isn’t feasible during brief check-ups with general pediatricians.

3. Tunnel Vision & Overlooked Symptoms

Once a diagnosis (e.g. ADHD or sensory issues) is made, clinicians may inadvertently ignore additional signs pointing toward autism—what Dr Amir Miodovnik calls Tunnel Vision’
A study led by Dr Miodovnik found that children initially diagnosed with ADHD experienced autism diagnoses that were delayed by an average of three years, and were nearly 30 times more likely to receive an autism diagnosis after age 6 compared to those diagnosed earlier.

4. Specialist Insight

Dr  Lord notes that children may spend years seeing speech or occupational therapists for sensory issues when what they truly need is social skills-focused support aligned with autism treatment.

5. What Parents Can Do

Obtain a full evaluation by professionals experienced in autism diagnosis.
If you suspect your child may be on the spectrum and still haven’t received clarity, seek a second opinion.
Dr Nash emphasizes: “Empower yourselves as parents. Advocate for your child”.
Author & Expert Contribution

Author: Caroline Miller (Editorial Director, on the Child Mind Insitute Website, June 2025)
Clinical Experts Cited:
- Dr Wendy Nash, MD (Child & Adolescent Psychiatrist) Child Mind Institute.
- Dr Catherine Lord, PhD (Veteran Autism Researcher and Clinician at UCLA) Child Mind Institute.
- Dr Amir Miodovnik (Pediatrician, Centre for Development & Learning) Kennedy Krieger Institute.

What Is Included in an Autism Assessment at Mind & Health Psychology?

We use a comprehensive battery of validated tools. Depending on age and presentation, the assessment may include:

ADOS-2 – Autism Diagnostic Observation Schedule - Second Edition (a semi-structured behavioural observation)
ADI-R – Autism Diagnostic Interview–Revised (with parents or caregivers)
MIGDAS-2 – Monteiro Interview Guidelines for Diagnosing Autism Spectrum -Second Edition.
Cognitive assessment – using the Wechsler scales, Stanford-Binet, Adaptive Measures, and/or other appropriate developmental tools
Clinical behavioural observation and developmental review
Comprehensive and Collaborative: Involving a team-based approach ensures a comprehensive understanding of the individual’s needs across different environments.

Understanding the Tools We Use

ADOS-2 (Autism Diagnostic Observation Schedule – Second Edition)
This semi-structured observational tool assesses social communication and interaction through interactive tasks. It is suitable for individuals aged 12 months through adulthood and is adapted based on language ability.

ADI-R (Autism Diagnostic Interview – Revised)
The ADI-R is a structured clinical interview conducted with caregivers, exploring early development, communication, play, social interaction, and restricted behaviours.

MIGDAS-2
The MIGDAS-2 provides a sensory-based and narrative-driven framework that complements the ADOS-2 and ADI-R. It emphasises authentic communication, sensory interests, and individual differences.

How These Tools Work Together

Using both the ADOS-2 and ADI-R allows for a comprehensive understanding of both present behaviours and developmental history. The MIGDAS-2 adds qualitative insights and supports a more person-centred understanding of autism characteristics. This triangulated approach helps inform diagnostic formulation.

Cognitive and Developmental Assessments

Cognitive testing supports diagnosis by clarifying verbal/non-verbal strengths, reasoning skills, learning profiles, and adaptive functioning. Depending on age and developmental level, we use:

Wechsler Intelligence Scales (for school-aged children and adults)
Stanford-Binet Early Version and Rossetti Infant-Toddler Language Scale (for younger children)

These assessments also allow for observational insight into problem-solving, communication, and task engagement.

A GP appointment is also required as part of the Assessment Process.

About the Lead Psychology Practitioner

Autism assessments at Mind & Health Psychology are conducted by a team.
Stephen O’Malley has completed Doctor of Psychology (Clinical Neuropsychology) coursework to Master’s level, with training in autism, other neurodevelopmental childhood disorders, and neuropsychological assessment. He has over 20 years of professional experience and is a Board Approved Supervisor. Stephen is formally trained and certified in the administration of gold-standard autism assessment measures, including the ADOS-2, ADI-R, and MIGDAS-2, as well as a range of cognitive and language measures in his neuropsychology training.

What Happens After the Assessment?

Following the assessment:

A feedback session is conducted to discuss the findings and provide clarification
Following the evaluation, we offer a follow-up session to review the results, answer questions, and discuss possible next steps. A detailed written report is prepared, outlining the individual’s identified strengths and areas of difference. Our reports are designed to be comprehensive and may assist in applications for supports such as NDIS funding. Whether a report is accepted for funding decisions is determined by the relevant agency and depends on individual circumstances.

Final Considerations

Autism is a form of neurodiversity that presents uniquely across individuals. Our assessments aim to offer a structured and affirming understanding, consistent with best-practice guidelines and the ethical standards of the Psychology Board of Australia.

Our autism assessment approach is child-centred and adult-appropriate, creating a comfortable space for authentic engagement. It focuses on individual strengths to support a holistic and empowering understanding. A collaborative, team-based process ensures comprehensive insight across home, school, and social settings.

Contact

For more information or to enquire about assessment availability, contact: mindandhealthpsychology@gmail.com

All assessments are conducted within the professional scope and ethical guidelines of a Registered Psychologist. Diagnostic decisions are based on comprehensive clinical evaluation. No diagnostic outcome is implied or guaranteed.

Posted on July 27, 2025

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