Last week, I explored AuDHD — the experience of living with both ADHD and autism as an adult — and why so many people are only now finding language for what they’ve carried for years. This week, I want to turn toward the practical: what actually happens in an assessment?
If you’ve been carrying questions about ADHD, autism, or AuDHD, you may wonder what an assessment involves and whether it’s right for you. For many adults, even considering an assessment brings mixed emotions: relief at the possibility of answers, fear of what a diagnosis might mean, or uncertainty about whether they will be believed.
At Healing Paths Psychology, I currently provide in-person adult ADHD assessments for new clients in Calgary. Because I include objective testing — not just interviews or questionnaires — these assessments must be completed face-to-face. For those exploring autism or AuDHD, I provide counselling support and referrals to trusted colleagues who specialize in autism assessments.
Why Consider an Assessment?
Adults seek assessments for many reasons:
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A lifetime of feeling “different” without clear answers.
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Burnout from years of masking or overcompensating.
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Noticing familiar patterns after a child or partner is diagnosed.
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Struggles with transitions at work, school, or in relationships that feel harder than expected.
An assessment can serve many purposes. Sometimes it’s about finding out if ADHD is part of your story. Other times, it’s about understanding your strengths and challenges in more detail, planning interventions that can help, or supporting accommodations for school, work, or daily life. In some cases, it can also help with predicting how your needs might change over time.
In short: it’s not just about getting a label. Done well, an assessment creates a clearer picture of how your brain works — and a plan that makes sense for you.
As I mentioned in last week’s blog, research suggests that between 30–80% of individuals with ADHD also meet criteria for autism. This overlap is one reason many adults seek clarity through assessment.
The Historical Context
Understanding why so many adults are only now seeking assessments requires a look at history.
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Male-centered bias: ADHD and autism were long considered “male conditions.” Men were four times more likely to be diagnosed, leaving women and gender-diverse people under-recognized.
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DSM-IV (before 2013): ADHD and autism were considered mutually exclusive. You could not receive both diagnoses. Many adults were given one “acceptable” label, often ADHD, while their autistic traits were missed. Once the door was opened to consider AuDHD, it became apparent how many adults had been overlooked.
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Autism and intellectual disability: Until the 1990s, autism could not be diagnosed without also having an intellectual disability. This history may help explain why autism still carries greater stigma in society than ADHD.
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Cultural bias: Every assessment tool is shaped by the culture in which it was developed, which means cultural bias is always present. A good assessor will take into account your cultural context and ensure that anxiety, fear, or confusion are not misinterpreted as symptoms.
What’s Involved in an Adult Neurodiversity Assessment?
Every assessment varies slightly, but most share common steps.
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Background information
Collecting relevant history, including school, work, and medical records when available. -
Clinical interview
A detailed conversation exploring your developmental history, strengths, challenges, relationships, and coping strategies. This may include discussion of masking behaviours or burnout. -
Questionnaires and rating scales
Standardized tools to identify ADHD traits and screen for related concerns such as anxiety, depression, or trauma. -
Collateral information
When possible, input from family members, partners, or old school reports can provide additional context. -
Observation
Psychologists also notice how you engage during the process — your communication style, sensory responses, and problem-solving strategies. -
Objective testing
In my practice, ADHD assessments include structured, in-person tasks that measure attention, impulse control, and working memory. These provide objective data to support the rest of the assessment. -
Interpretation and recommendations
The psychologist synthesizes all of this information to provide clarity and recommendations. -
Written report and debrief
You receive a written summary and have a debrief session to discuss results, ask questions, and talk about next steps.
Importantly, a thorough assessment must also consider differential diagnosis. ADHD-like symptoms can overlap with depression, anxiety, dissociation, personality disorders, or even the effects of medication, substance use, or trauma. A skilled assessor disentangles these layers.
What Assessments Can — and Cannot — Do
What an assessment can do:
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Provide clarity about ADHD, autism, or AuDHD.
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Validate lived experiences and struggles.
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Support accommodations at work or school.
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Highlight both strengths and challenges.
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Guide next steps for therapy or community resources.
What an assessment cannot do:
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Define your whole identity.
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Erase years of misunderstanding or stigma.
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Guarantee immediate change.
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Always capture internal experiences such as sensory overload or rejection-sensitive dysphoria, which are often under-measured by current tools.
Assessment is a map — it shows where you are and what terrain you’re navigating. But it is not the journey itself.
Unique Considerations in Adult Assessment
No two assessments look alike. Some important factors include:
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Visibility of traits: Many adults, especially women, have learned to mask or camouflage their struggles. They may appear outwardly successful while carrying significant internal challenges.
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Identity and equity: Neurodivergent people are more likely to hold other marginalized identities (e.g., queer, racialized, lower socioeconomic status). Yet most research has historically focused on white males, leaving others underserved and under-diagnosed.
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Life stage: Hormonal shifts such as perimenopause, menopause, or postpartum changes often bring ADHD traits into sharper focus, leading some to seek assessment later in life.
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Safety and trauma: Women with ADHD or autism are at significantly higher risk of gender-based violence and sexual assault. Earlier recognition could have been protective.
To protect fairness and objectivity, psychologists also avoid conducting assessments for clients they already have a therapeutic relationship with — especially if results may affect employment or legal rights.
After the Assessment: What to Expect Next
Once testing is complete, you should expect:
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Results discussion: A collaborative meeting where findings are explained and questions answered.
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Written report: A document summarizing the process, results, and recommendations.
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Timeline: Feedback should be provided in a reasonable time frame.
Your Rights as a Test-Taker
The following rights are outlined by the College of Alberta Psychologists:
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To be treated with courtesy and respect.
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To be informed of your rights and responsibilities.
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To have appropriate, validated measures used.
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To understand the process, timeline, and expectations in advance.
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To know if tests are optional and the consequences of non-completion.
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To receive written and/or oral feedback.
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To have your confidentiality protected by law.
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To raise concerns and be heard.
Your Responsibilities as a Test-Taker
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Ask questions if you are uncertain.
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Inform the examiner about any accommodations you may need.
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Be honest in responses and effort.
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Share if conditions (new medication, fatigue, needing glasses) may have affected results.
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Clarify confidentiality if you have concerns.
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Raise issues in a timely way.
When both rights and responsibilities are honored, assessments are more accurate and supportive.
How Counselling Can Support the Process
Receiving an assessment is only the beginning. Many adults describe feeling both relieved and unsettled after a diagnosis. Counselling can help you process and integrate the results.
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Internal Family Systems (IFS): Creates space to hear parts of yourself that may carry shame, grief, or exhaustion from years of masking or misunderstanding.
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Safe and Sound Protocol (SSP): Gently supports nervous system regulation, particularly for those who have experienced relational trauma connected to being dismissed or excluded.
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Dialectical Behavior Therapy (DBT) with a Neurodiversity Lens: Draws on practical skills adapted for ADHD and autistic adults, such as managing sensory needs, building distress tolerance, and regulating emotions without denying authenticity.
Together, these approaches support not only coping, but also self-compassion and a positive neurodivergent identity.
Closing
Seeking an assessment is a courageous act. For many, it provides long-awaited language for experiences that never quite fit. A diagnosis can open doors to support, accommodations, and community — while also sparking a journey of re-authoring identity and healing.
At Healing Paths Psychology, I currently provide in-person adult ADHD assessments in Calgary. For those exploring autism or AuDHD, I collaborate with colleagues who specialize in autism assessments, while offering counselling support to help integrate and navigate the process.
If you are wondering whether ADHD, autism, or AuDHD may be part of your story, you don’t have to figure it out alone.
