Psychological assessment across development

Common reasons for referral

• Clarifying whether ADHD or autism is present
• Understanding a child’s cognitive strengths and weaknesses
• Investigating academic underperformance or uneven learning profiles
• Assessing for learning disorders, including dyslexia where indicated
• Clarifying mental health diagnoses to guide treatment
• Supporting school, workplace or broader care planning

How assessment is approached

Assessment is guided by the specific referral question rather than using the same battery for every person. Depending on the concern, assessment may include clinical interview, psychometric testing, diagnostic interviews, behavioural questionnaires, observational assessment, and review of background information from parents, schools or other treating professionals where relevant.

Recommendations are based on the presenting concerns, age, history and the type of clarity being sought.

When this is useful

ADHD assessment may be useful where there are concerns regarding inattention, impulsivity, hyperactivity, executive functioning, emotional regulation, organisation, follow-through, or chronic difficulties with everyday functioning across settings.

What it typically involves

ADHD assessment draws on a combination of psychometric measures, diagnostic interviewing, developmental and functional history, and review of behavioural patterns across relevant settings. This helps determine whether the presentation is consistent with ADHD, and whether there are other factors that may be contributing to the difficulties observed.

The aim is not simply to identify symptoms in isolation, but to understand how attentional and executive functioning difficulties are affecting day-to-day life.

When this is useful

Autism assessment may be appropriate where there are concerns regarding social communication, sensory sensitivities, restricted or repetitive patterns of behaviour, rigidity, difficulty managing change, longstanding relational differences, or broader neurodevelopmental concerns.

What it typically involves

Assessment may include the MIGDAS-2 as part of an observational assessment process across the lifespan, alongside developmental history, questionnaires and other relevant tools. The specific approach varies depending on age and presentation, with greater reliance on caregiver input in childhood and more detailed diagnostic interviewing in adulthood.

The focus is on careful, developmentally informed assessment rather than relying on a single measure in isolation.

When this is useful

Cognitive assessment is useful when there is a need to better understand overall intellectual functioning, a profile of cognitive strengths and weaknesses, and how these may be contributing to learning, problem solving, attention, processing, or broader day-to-day functioning.

Measures used

Cognitive assessment is conducted using the WISC-V for children and the WAIS-IV for older adolescents and adults, depending on age. These assessments provide detailed information regarding areas such as verbal reasoning, visual reasoning, working memory, processing speed, and broader cognitive functioning.

This type of assessment is often helpful when trying to understand why a person may be struggling relative to expectations, or where a more nuanced cognitive profile is needed for planning and support.

When this is useful

Academic assessment can be helpful where there are concerns about a child or young person’s progress in reading, writing or mathematics, including when there is a question of whether performance is significantly below expectation for age, grade, or broader cognitive ability.

What it can show

Academic assessment using the WIAT-III helps identify a young person’s academic strengths and weaknesses and provides information regarding the grade-level development of different reading, writing and mathematics skills.

When combined with cognitive assessment, this process can also assist in assessing for specific learning disorders such as dyslexia, where relevant to the referral question.

This can be particularly helpful for school planning, support applications, and understanding why a student may be finding parts of learning more difficult than expected.

When this is useful

Mental health assessment may be appropriate where there is a need to clarify whether a presentation meets criteria for a disorder described in the DSM-5-TR, or where diagnostic clarity is needed to guide treatment, care planning, or communication with other providers.

Scope and limitations

Mental health assessment may include clinical interviewing, standardised measures, review of symptom patterns, history and functional impact, and diagnostic formulation. Examples may include clarification of anxiety disorders, depressive disorders, trauma-related presentations, and other emotional or behavioural difficulties.

For more highly specialised or medically complex diagnoses, multidisciplinary input is often appropriate. This may involve a psychiatrist, GP, neurologist, or referral to a more specialised clinician where that is likely to provide the most accurate and useful assessment outcome.

Assessment recommendations are guided by the limits of scope, the referral question, and what is most clinically appropriate.