ASSESSMENTS

For a people aged <25 years, referral from a Paediatrician or a Child & Adolescent Psychiatrist for an Autism Spectrum Assessment under Medicare will make max 4+4 rebates available. 

The referring paediatrician/psychiatrist 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 allied health (eg speech pathology, occupational therapy and/or psychology) assessments are still required for 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. 

We offer the following Autism Spectrum assessment services under Medicare:

• initial consultation
• Autism Diagnostic Observation Schedule (ADOS2) 
• feedback consultation.

Additional assessment services are also available as part of a comprehensive multidisciplinary Autism Spectrum assessment but not covered by Medicare:

• diagnostic parent interview (ADI-R or 3Di) to gather diagnostic information about developmental history and current function [parent(s) only]
• developmental or cognitive assessment, depending on the child's/adolescent's language and cognitive abilities to: (i) exclude or identify global developmental delay or intellectual disability (ii) establish cognitive profile including strengths and weaknesses
• achievement test to identify specific learning difficulties/disorders (including reading/dyslexia, writing/dysgraphia and maths/dyscalculia)
• multidisciplinary assessment report(s).

 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 (ie K-12), a small number of subtests from the WIAT can be administered and used to obtain a Dyslexia Index Score indicative of 'risk'.

 Prior to formally assessing for specific learning difficulties, it is essential that the person has received a period of additional academic support targeting those difficulties.
*It is important to note that Reading Recovery does not count as evidence-based explicit instruction for reading difficulties.
Following such a period of additional support, the formal assessment process has 2 components:
(1) a cognitive assessment (WISC or WAIS) to exclude intellectual disability and to identify strengths and weaknesses in the person's cognitive profile; if a cognitive assessment was completed in the past it may not be necessary to re-administer it - please discuss with the assessing psychologist
(2) an achievement test (WIAT) to identify strengths and weaknesses in academic/learning domains: eg reading, spelling, maths.
The assessments require two separate appointments, usually on the same day, with a long lunch break in between.
The assessment results are used to establish if there are significant and 'unexpected' differences between the person's cognitive abilities versus their learning achievements. These are usually very specific areas: it can be a single area or there can be multiple areas of specific learning difficulties.
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 that serves as evidence of these learning difficulties.
This is a time consuming and therefore expensive process that is not subsidised by Medicare.
Some schools and/or agencies are able and happy to fund these assessments as a third party because the assessment results inform their service provision, including additional, individualised and targeted support.
We conduct these assessments locally, in our Shepparton clinic. Further afield, in Melbourne, SPELD Victoria also conduct these assessments, using a similar process.