A Neuroaffirming Approach to Adult Autism Assessment
For many adults, seeking an autism diagnosis is not about "fixing" a problem—it’s about finding the missing piece of a lifelong puzzle. Traditional diagnostic models have historically focused on what an individual cannot do, often leaving high-masking adults or those with complex presentations feeling misunderstood.
Modern psychological assessment has evolved to move beyond these deficit-based checklists. By utilizing the MIGDAS-2 (Monteiro Interview Guidelines for Diagnosing the Autism Spectrum) in a telehealth setting, we can now provide a diagnostic experience that is both clinically rigorous and deeply affirming of your unique "brain style."
What is the MIGDAS-2?
The MIGDAS-2 is a qualitative, sensory-based interview process. Unlike standardized tests that force you to perform tasks in a sterile office, the MIGDAS-2 is designed to "reveal the autism story." It shifts the focus from "what is wrong" to "how do you experience the world?"
The process explores three key areas:
Sensory Use and Interests: Your unique relationship with your environment and the passions that drive you.
Language and Communication: How you process information and share your internal world with others.
Social Relationships and Emotional Responses: Your patterns of connection and how you navigate the social landscape.
The Power of Tele-Assessment for Autism
There is a strong clinical rationale for conducting autism assessments via telehealth. For many neurodivergent individuals, traveling to an unfamiliar clinic, navigating a waiting room, and dealing with the sensory "assault" of fluorescent lights or strange smells can trigger high levels of anxiety or masking.
By conducting the assessment in your own home, you are in a safe, controlled environment. This comfort allows for naturalistic observation, where your true behaviors and sensory needs are more visible to the psychologist. It removes the "performance" of being in an office, leading to a more accurate and authentic diagnostic profile.
Navigating the "Comorbidity" Overlap
It is rare for autism to exist in a vacuum. Most adults seeking an assessment also experience symptoms of ADHD and Anxiety. These conditions often overlap and "mask" one another:
ADHD: You might have the social drive of ADHD but the social exhaustion of autism.
Anxiety: What looks like generalized anxiety might actually be a nervous system response to sensory overload or social "unpredictability."
A comprehensive telehealth assessment doesn't just look for autism; it uses a battery of behavioral rating scales and clinical deep-dives to untangle these threads. By identifying the interplay between these conditions, your psychologist can provide a "roadmap" that addresses your brain as a whole, rather than treating symptoms in isolation.
The Pillars of a Comprehensive Evaluation
A thorough adult autism assessment via telehealth includes:
The MIGDAS-2 Interview: A conversational, strength-based session to explore your internal experience.
Standardized Rating Scales: Validated tools to quantify your experiences and compare them to clinical norms.
Collateral Feedback: Interviews or surveys with a partner, parent, or close friend to understand how your patterns manifest across your lifespan.
Differential Analysis: A dedicated effort to distinguish (or combine) diagnoses like ADHD, OCD, or social anxiety.
An assessment is an investment in self-understanding. It provides the language you need to advocate for yourself at work, improve your relationships, and—most importantly—stop judging yourself by neurotypical standards. By using neuroaffirming tools like the MIGDAS-2, we ensure that your diagnosis isn't just a label, but a supportive framework for your future.
