Assessments

Assessment and diagnosis should be done in consultation with your healthcare provider and a psychologist, or provided by a psychiatrist. If you suspect you or your child might be autistic or have ADHD, there are a number of options for assessment, diagnosis, and seeking support.

If your child is experiencing difficulties at school, please ask the school team for help. This can include the guidance counsellor, resource teacher, social worker, and/or a school psychologist. They should be able to get to know your child and provide in-school supports to help with any areas of difficulty. If these supports are inadequate, the principal should refer your child to the school psychologist for a thorough assessment.  

MATC’s Attention Deficit Hyperactivity Disorder (ADHD) Service has a provincial mandate to provide assessment and treatment for children and youth ages 6 to 17 years and their families. Parents can refer their children through the WRHA's central intake. Due to underfunding of psychological support services in Manitoba, there is an incredibly long waitlist for these services.  

Additionally, in order to be prescribed medication, the referral must come from a physician. MATC then provides their assessment to your child's doctor and the doctor will discuss treatment options with you and your child. Visit the MATC website for more information. 

MATC's Neurodevelopmental Service (NDS) provides psychiatric support for children ages 5–18 years with complex neurodevelopmental issues. This service also provides assessment, education, consultation and support to families and community caregivers who are involved with autistic school-aged children. 

This service is reserved for established partnership agencies such as Children’s disAbility Services; New Directions for Children, Youth, Adults and Families; and St. Amant Centre. Children must be referred through one of these agencies or by their physician. 

If you have additional health coverage or the resources to pay for a private assessment, this is another (albeit expensive) option. Aside from the expense, there are other downsides to this option if you are seeking assessment and diagnosis for your school-aged child.

Some schools will question a private diagnosis and may be less inclined to follow their recommendations. A private psychologist may only see your child a few times. If your child’s issues are primarily occurring at school, the school team may see your child more often and will be able to see them in the environment in which they are struggling.  

The private psychological offices of Red Ladder wrote a helpful and informative article on this subject. Visit the RED LADDER website.

If more of the challenges are occurring at home or outside of school, or if you are seeking an adult diagnosis, there may be more reason to seek private assessment and support.  

Not all private supports are created equal, even amongst qualified psychologists. The Manitoba Psychological Society has a directory of all private practice psychologists outlining their areas of specialty.

The directory has a search function which allows users to narrow down psychologists based on the age group they support, their areas of expertise, and the types of therapies and services they offer. 

An important note: I very strongly recommend avoiding practitioners who primarily practice Applied Behavioural Analysis (ABA) therapies. While there is much controversy and varying opinions on this subject, my philosophy is to provide supports to children that nurture and honour their full authentic self, not try to change or "fix" them.

While all children need guidance and support, adults should not attempt to “train” neurodivergence out of their child. It is my professional opinion that many, if not all, ABA practices seek to do this. neurodivergent children should not be forced to conform to a society that is created for neurotypical people. 

A family doctor or pediatrician can diagnose ADHD or autism and offer treatment options and referrals. Whether your doctor will do this, and is well-qualified to do this, depends on that particular doctor's training and professional experience. If they are not well-qualified to provide a diagnosis, ask them for a referral. 

If you're an adult now and have struggled for much of your life yet never fully understood why, or if you've received conflicting diagnoses from various professionals yet none quite seemed to fit, you might consider pursuing self-diagnosis. 

Self-diagnosis is beneficial if you wish to better understand yourself, learn about neurodiverse brains, and figure out what strategies might best work for you. 

Self-diagnosis will not help if you wish to pursue medication, health coverage, or legally protected accommodations. This is never something to be done lightly, but it's important to acknowledge the very real barriers in place for receiving a formal diagnosis, including systemic racism, lack of resources, financial constraints, gender bias, to name but a few. 

Firstly, this is just a general guide. Each individual's situation will vary, depending on the circumstances, your geographic region, and the professional who is completing the assessment. It will also be different for adults compared to children. The primary goals will also influence the process: whether you're seeking formal diagnosis, or simply wanting to explore medication and treatment options. 

Your child's school or doctor, or your own clinician, will send you home with questionnaires to fill out. For children, the most common is the SNAP-IV, and for adults, the WEISS symptom record. CADDRA has a very helpful webpage which provides copies of forms used for ADHD assessment and diagnosis. 

There are a number of diagnostic tools used to assess for Autism, and which ones used will depend on region. and clinician training. Until recently, the most common assessment tool was the Autism Diagnostic Observation Schedule (ADOS). This has since been revised to the Autism Diagnostic Interview-Revised (ADI-R). For children there is also the Childhood Autism Rating Scale (CARS) 2. 

Unfortunately, there are a significant number of clinicians whose knowledge and training about ADHD and Autism is out of date. This is especially true for adults, women, and other marginalized groups. Women, trans, non-binary, and people of colour are all less likely to receive accurate diagnosis because of the system racism inherent in the diagnostic processes and because of clinician bias.

After you have filled out your forms and returned them to the doctor, there are two routes which can be taken. If the primary goal is to seek out medication and treatment options, the doctor may discuss these with you at this point. If the primary goal is a full psychological assessment and formal diagnosis, then there will be extensive interviews. For children, this will usually include observation in the classroom if the assessment is being done by the school division's psychologist. 

For school psychologists, the wait times will vary by division. Here in Manitoba, the wait times are between 6 months and one year. The process depends on the level of challenges presented at school, as well as the amount of backlog due to delays during the covid pandemic. For private psychologists, the wait times here in Manitoba are similar, and will depend on the clinician. 

Adults who wish to do a self-assessment using an online questionnaire can take the RAADS-R just for fun. It's not a scientific or formal diagnostic process, but it can be illuminating (it was for me!). 

Often coercive and manipulative, using rewards and punishment to "shape" a child to behave how the adults want them to. 

• Often focused on goals set by adults.
• Don't support children to reach their own goals. 
• The primary objective is usually compliance.
• Often psychologically harmful.

A form of "training" the neurodivergence out of a child, rather than showing a child unconditional positive regard and acceptance.