Most of the adults who come to us for an autism evaluation have been thinking about it for a long time. A few months for some, a few years for many, a few decades for more than you’d expect. By the time they’re scheduling an intake, they’re rarely asking is something there. They’re asking what is it, what does it mean, and what do I do with that.
This post is for those readers. Here’s what an adult autism evaluation at Encore actually involves, what it can and can’t tell you, and what the written report is designed to do once it’s in your hands.
Why adult autism evaluation is its own thing
A lot of the testing for autism in this country was built around children: the observational tools, the rating scales, the developmental questions. Most providers are set up to evaluate kids, and a lot of adults who go looking for an evaluation hear some version of “we don’t do that here.”
That’s the gap we work in. We’ve made adult autism evaluation a core part of the practice, in person in Michigan and virtually in 40 other PSYPACT-participating states. We see late-diagnosed adults, high-masking adults, adults who’ve been told for years it was “just anxiety,” and adults whose own child’s recent diagnosis is what finally made them look at themselves.
It’s a different evaluation than a child evaluation. The questions are different, the rating scales are different, and the conversation is different. That’s the point.
What the evaluation includes
A typical adult autism evaluation at Encore looks like this:
- A 50-minute intaketo understand what brings you in, what you’ve already considered, and what you want the evaluation to address. This is also where we map out the rest of the schedule.
- Clinical interviewing covering developmental history (as best as you and your family can recall), social and communication history, sensory experience, special interests and routines, work and relationship patterns, and your mental-health history.
- Validated rating scalesfor you, and, when it’s helpful and you’re comfortable, for a partner, parent, or close friend who’s known you a long time. Adult autism evaluation often benefits from a second perspective.
- Structured observationusing adult-appropriate measures of social communication and interaction. This is one of the parts that’s distinct from a child evaluation.
- Cognitive and executive-function testingwhen relevant, particularly when ADHD is also in the picture (we’ll get to that).
- A written report with diagnostic conclusions and a detailed recommendations section.
- A feedback session to walk through the report together, in person or virtually.
Total time, intake to feedback session: most evaluations complete in 4–6 weeks. A 48-hour expedited turnaround is available as a paid add-on when a deadline requires it.
What the evaluation doesn’t do
A few things adult autism evaluation is not:
- It is not a single questionnaire.Self-screeners and online quizzes can be a useful starting point, but they’re not diagnostic. A full evaluation triangulates a self-report measure, a clinical interview, an observational measure, and history, because no single measure is enough on its own.
- It is not a label-stamping exercise. A diagnosis is one part of the report. The recommendations section, what to do with this information at work, in relationships, in therapy, with family, is usually the longer and more useful part.
- It is not pass/fail.There’s no “qualifying” for autism. The question we’re sorting out is what’s the most accurate way to describe what’s going on, and what does that mean for you.
- It is not the end of the conversation.Most of our adult autism clients come back, sometimes a few months later to talk through a workplace accommodation, sometimes years later for an ADHD update, sometimes for a child’s evaluation.
“But I’ve been functioning fine”: what high-masking looks like
A lot of adults who reach out to us open with some version of “I’m probably fine, but…” Most of those adults have been functioning at a level that has cost them something: exhaustion, burnout, relationship strain, a sense that the social world takes more energy from them than from the people around them. That’s the high-masking presentation, and it’s one of the reasons adult autism gets missed for so long.
Masking isn’t the same as not being autistic. The evaluation looks at both: what’s observable now and what you’ve been doing under the surface to make the observable thing possible.
When autism and ADHD show up together
For many adults who come in asking about autism, ADHD is also in the picture, sometimes already diagnosed, sometimes suspected, sometimes neither of the two. About a third of the time, an adult autism evaluation expands into an autism-plus-ADHD evaluation. We’ll talk about that during the intake; the scope of the evaluation can be adjusted to include the ADHD piece when it’s warranted.
If you’re not sure which question is yours, that’s a fine question to bring to the intake. We’ll help you figure out what to scope.
What the report does in the world
The most useful piece of an evaluation isn’t the diagnostic letter. It’s the recommendations.
For our adult autism clients, the recommendations section tends to cover:
- Workplace accommodations under the ADA (specific to your job and your profile)
- University and graduate-school accommodations
- Therapy referrals matched to what the evaluation found
- Coping and self-management strategies grounded in your specific strengths and the areas you’re working on
- Family and relationship conversations: language to help the people around you understand what the evaluation found
- Follow-up evaluation timing (e.g., if an ADHD update would be useful at the 2–3-year mark)
We write recommendations to be carried out of the report and used At work, at school, in therapy, in conversations. A diagnosis is just words. The roadmap is what makes those words do something.
In person or virtually
Adult autism evaluations can be completed in person at our Bloomfield Hills office or virtually under PSYPACT for residents of 40 states. We see clients regularly from North Carolina, Connecticut, Nevada, Illinois, and Tennessee, states with longer waits for adult autism testing locally, and from many more.
A virtual evaluation isn’t a watered-down version of an in-person one. The instruments are adult-appropriate, the report is the same, and the feedback session is the same. The only structural difference is the screen.
Where to start
If you’ve been carrying this question and you want a clearer answer, the next step is an intake. Forty-five to fifty minutes, by phone or video. We’ll talk about what brings you in, what scope makes sense, what the timeline looks like, and what it will cost.
You don’t need a referral to come to us. You don’t need to have already tried therapy. You don’t need to have it figured out beforehand. The intake is where we figure out together what the evaluation should be.
