ASSESSMENTS

For people aged under 25 years, referral from a Paediatrician or a Child & Adolescent Psychiatrist for an Autism Spectrum Assessment under Medicare will make 4+4 rebates available for assessments by psychologists and other allied health clinicians. 

The referring paediatrician/psychiatrist requests and coordinates the multidisciplinary ASD assessment. They determine what assessments have been completed to-date, conduct or request relevant medical or laboratory tests, and specify what multidisciplinary (eg speech pathology, occupational therapy and/or psychology) assessments are still required for formulation of a reliable diagnosis [or no diagnosis]. They then write the referral under the relevant Medicare item(s).Medicare rebates apply to the direct observation and/or assessment of the person. Rebates for max 4+4 Autism Spectrum assessment items can be claimed under the age of 25 years. 

Our clinicians offer the following Autism Spectrum assessment services:

• initial consultation [Medicare rebate 1 of 4]
• Autism Diagnostic Observation Schedule (ADOS2) or MIGDAS [Medicare rebate 2 of 4]
• diagnostic parent interview (ADI-R or 3Di) to gather diagnostic information about developmental history and current function [parent(s) only] [no Medicare rebate]
• comprehensive [extended] assessment report, or short summary report if preferred [no Medicare rebate]
• feedback consultation [Medicare rebate 3 of 4].

Medicare rebates do not apply to autism spectrum assessments above the age of 25 years. 

Referral from a Psychiatrist for an Autism Spectrum assessment is preferred.
We offer the following Autism Spectrum assessment services:

• initial consultation
• Autism Diagnostic Observation Schedule (ADOS2) or MIGDAS
• diagnostic parent* interview (ADI-R or 3Di) to gather diagnostic information about developmental history and current function
• comprehensive [extended] assessment report, or short summary report if preferred
• feedback consultation.

      *If the parent of an adult is not available, their spouse or another close relative or friend, who knows the person well and/or has known the person since childhood, may attend the diagnostic interview. 

ADHD can be assessed and diagnosed by a paediatrician or psychiatrist, with or without input from a psychologist or mental health nurse practitioner.

The multidisciplinary team of professionals who are often involved in this process may include:

• GP: to screen, diagnose and treat any related health issues, and to refer to a paediatrician, psychiatrist and/or psychologist for assessment/diagnosis and/or treatment/support
• Paediatrician / Psychiatrist: to assess, diagnose and provide a treatment/management plan including prescription of medication, when appropriate, and regular reviews
• Psychologist: to assess, diagnose, and provide therapy/support.

It is recommended that you first meet with your GP and discuss the referral pathways that are most appropriate for you or your child.

Some specialists [ie paediatricians and psychiatrists] prefer to conduct their own assessments, while others will request, accept, and incorporate assessments conducted by psychologists.

Medicare rebates for ADHD assessments are available for pediatricians, psychiatrists, but not for psychologists. This can make ADHD assessments by psychiatrists more affordable.

Following assessment and diagnosis, a GP referral & Mental Health Plan, or a psychiatrist referral, will make Medicare rebates available for psychology and social work services under the Better Access to Mental Health Services initiative.

When potential reading difficulties are identified early, it is easier to respond to the problem. Early screening and support can lead to improved learning and reduced emotional distress. Slow learners and potentially dyslexic children can be identified from the age of 5-6 years, in time to arrange for additional reading support in primary and/or secondary school.
The Dyslexia Screening Test (DST) is designed to identify children and adolescents/teenagers who may be 'at risk' of reading difficulties.
Alternatively, including in later years (K-Y12+), specific subtests from the WIAT can be administered and used to obtain a Dyslexia Index Score indicative of 'risk'.

Prior to the formal assessment of specific learning difficulties, it is important that the person has received a period of additional and targeted academic support and intervention. 

  *Reading Recovery does not count as evidence-based explicit instruction for reading difficulties.
Following such a period of targeted teaching and support, the formal assessment process has 2 components:
(1) a cognitive assessment (WISC or WAIS) to exclude intellectual disability and to identify the person's pattern of cognitive strengths and weaknesses. If a cognitive assessment was completed in the recent past, it may not be necessary to re-administer it - please mention this during the intake process.
(2) an achievement test (WIAT) to identify strengths and weaknesses in the academic/learning domains of reading, writing, and mathematics.
These assessments require two separate appointments, usually on the same day, with a long lunch break in between. Alternatively, the two assessments can be scheduled on different days, if preferred.
The assessment results are used to establish if there are significant and 'unexpected' differences between the person's cognitive abilities versus their academic/learning achievements. These are usually specific areas: it can be a single area or there can be multiple areas of specific learning difficulties in reading, writing, and/or mathematics.
If a diagnosis of a Specific Learning Disorder is required, we then also take developmental history, obtain school/teacher reports, consider the results of other standardised tests (eg NAPLAN, On Demand, Edutest, etc) and consult current diagnostic criteria (eg DSM or ICD).
Finally we write a comprehensive assessment report [4-6 weeks] that presents the results, addresses diagnostic criteria if needed, and makes recommendations.
These assessments and the comprehensive report are time-consuming, and therefore expensive - and not subsidised by Medicare. Some schools and/or support-agencies are able and happy to pay for these assessments as a third party.
We conduct these assessments locally, in our Shepparton clinic. 

SPELD Victoria in Melbourne also conduct these assessments, using a similar process.