Adult ADHD and ASD Assessment, Test, Medication and Psychological Therapy

Full ADHD assessment – i.e. no previous diagnosis of ADHD
Full ASD assessment – i.e. no previous diagnosis of ASD
What if I already have a diagnosis or not sure what kind of assessment I need
General Mental Health Assessment

Full ADHD assessment – i.e. no previous diagnosis of ADHD

We employ an evidence based, valid, full psychiatric and psychosocial interview to assess for adult ADHD and any other condition that might mimic ADHD symptoms. A full assessment takes no less than 2 hours to complete (often more). On the day of the assessment, we will invite you and, if possible, an informant to collect collateral history. Prior to the meeting, we will ask you and the informant to complete several rating scales and questionnaires focused on ADHD and other conditions that might co-exist or mimic ADHD symptoms. Rating scales and questionnaires are always used in conjunction with diagnostic information gathered during the psychiatric and psychosocial interview and never used alone to reach a diagnostic conclusion.

Full ASD assessment – i.e. no previous diagnosis of ASD

The full assessment for Autism Spectrum Disorders (ASD) involves a comprehensive psychosocial clinical interview with the patient and an informant (usually a parent), and the use of ASD specific rating scales and questionnaires including the Autistic Quotient scale (AQ); Emotional Quotient scale (EQ); RQ (CAST-revised); AAA; Patient Questionnaire (PQ). In general, the assessment will take around 3 hours.

What if I already have a diagnosis or not sure what kind of assessment I need

If you already have a diagnosis of ADHD or ASD earlier in life, and you wish to have a consultation with our experts – in order to resume treatment for example – feel free to contact us. We will review the diagnosis and, if needed, we will devise a tailored treatment plan. The interview process will be similar to that conducted for a full assessment. If we agree that you would benefit from our treatment management, regular follow-up sessions will be planned and you will also have the opportunity to use our helpline, just in case you need it. If instead you are not sure what kind of assessment you need (if any), simply send us an email and we will be able to discuss your case and offer you advice.

General Mental Health Assessment

Given our clinicians are experienced professionals, and given ADHD and ASD are often co-morbid with several other mental health conditions, the Clinic also offers assessment and treatment for a wide range of general mental health conditions including anxiety, depression, and other mood disorders, substance abuse/misuse, personality disorders, anger outbursts and obsessive compulsive disorder (OCD). The general mental health assessment follows a standardized diagnostic clinical interview with the aid of several rating scales that the patient will need to complete before the clinical interview. Sometimes informants are asked to join the process, which lasts not less than 2 hours.

PHARMACOLOGICAL INTERVENTIONS
PSYCHOLOGICAL INTERVENTIONS

PHARMACOLOGICAL INTERVENTIONS

Medication is the first-line treatment for ADHD, unless the patient prefers psychological treatment. Medication is part of a comprehensive treatment program addressing psychological, behavioural and educational or occupational needs. Our Psychiatrist will be able to provide the most appropriate pharmacological intervention that works for you.

For ASD, pharmacological intervention is not the first choice, psychological therapies are shown to be effective in addressing the core symptoms of ASD. However, if other conditions co-exists (e.g. anxiety, depressive disorder) then medication treatment might be a appropriate.

For other general mental health conditions, such as anxiety, depression and other mood disorders, substance abuse/misuse, personality disorders, anger outbursts and other impulsive based disorders such as OCD, the treatment plan usually combines pharmacological and psychological interventions.

PSYCHOLOGICAL INTERVENTIONS

Evidence-based psychological therapies include all the following; modified versions of CBT, and Integrative approaches are also adapted to treat other general mental health conditions.

Cognitive Behavioural Treatment (CBT) for Adult ADHD

Cognitive-Behavioural Therapies tailored to ADHD symptomatology is an effective treatment for ADHD in adults. A recent study showed that the effect of medication was augmented by CBT but, strikingly, medication did not impact on the capacity to learn the skills taught during CBT. This suggests that CBT can be effective in adults with ADHD, even in patients who cannot tolerate stimulants.

Mindfulness based CBT for Adult ADHD

In recent years, mindfulness based CBT has been showed to improve attention, reduce stress, and improve mood. Studies examining the efficacy of mindfulness based cognitive therapy show improvements in ADHD symptoms and performance on neuropsychological tasks measuring attention and impulsivity. Improvements in anxiety and depressive symptoms were also observed.

Psychoeducation and Social Cognition Training for ASD

This approach has the aim to improve individuals’ ability to grasp social cues and, as a consequence, improve social functioning. Indeed, one problem central to individuals with autism is impaired social cognitive functioning. These social impairments encompass basic emotion recognition (reading specific emotions from human faces), theory of mind deficits (inferring intentions and beliefs in others and themselves) and other social cues (e.g. vocal tone), significantly affecting the lives of people with ASD and their families. The training employed here will focus in enhancing emotion recognition using external cues, role playing, facial emotion and prosody/vocal tone/body language recognition training tasks.

Applied Behaviour Analysis for ASD

This is a series of interventions that will lead to modification of behaviours. The Analysis focuses on an antecedent, which is a verbal or physical stimulus such as a command or request. This may come from the environment or from another person, or be internal to the subject; a resulting behaviour , which is the subject’s response or lack of response to the antecedent; a consequence, which depends on the behaviour. The consequence can include positive reinforcement of the desired behaviour or no reaction for incorrect responses. ABA targets the learning of skills and the reduction of challenging behaviours. Each skill is broken down into small steps, and taught using prompts, which are gradually eliminated as the steps are mastered.

Integrative approach for Adult ADHD and ASD

Research evidence also shows treatment effect when employing an integrative treatment approach based on cognitive behavioural (CBT), systemic paradigms, and attachment theories. Acceptance and Commitment Therapy (ACT) has also shown promising results.

ADHD or ASD focused couple therapy

Couples where one of the members suffers from ADHD (with or without ASD) commonly experience significant problems and conflicts in several domains including: chore-sharing, finance management and planning, sexual intimacy, communications, child-rearing style, anger outbursts, just to name a few. Integrating several techniques from psychoeducation, systemic theory, mindfulness and CBT approaches, we will be able to foster understanding, change and wellbeing. Some examples of what kind of change you should expect:

A self-centred partner finally listens and shows empathy toward his spouse.
The compulsive spender is able to self-regulate his spending habits having in mind his family financial security.
The impulsive parent mindfully responds more calmly to her children’s behaviour.
The “drama couple” finally finds new positive ways to channel creativity and energy.

In sum, adults with ADHD will be able to act more mindfully, with more insight and be able to develop new healthier habits and being more emotionally connected with their loved ones.

ASSESMENT

TREATMENT