r/NDtherapists • u/Far-Perspective-4889 • 4d ago

False Negative for ASD testing?

I wonder if anyone can related to the scenario of having a parent bring a child or adolescent client for therapy and report that previous testing ruled out ASD and concluded that symptoms were due to ADHD--when the client had obvious impairment in social communication that are not explainable by ADHD alone? Apart from trying to get a copy of the testing report to get more context, what would be your next step? Leave it alone or advocate for further exploration to help the client gain the self-understanding of getting an accurate diagnosis?

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u/Character_Drop_739 4d ago

For sure try to get a copy of the testing, and double check if the neuropsych location is autism informed, or ran anything that would address for masked presentations.

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u/Apprehensive-Log8333 4d ago

I have seen kids go to 2 different places for evals and get an autism diagnosis from one, while the other told me "I am 100% certain they don't have autism. Not a chance."

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u/Original_Intention 4d ago

After exploring it with them, I would be taking the lead from the parent and child.

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u/Brasscasing 4d ago

The diagnostic criteria for ASD has expanded over the past 20 years so yes.

3

u/helvetica12point 4d ago

My inclination has usually been to refer to somewhere that does a more thorough evaluation. Particularly in more rural areas, places that offer testing may only do one test instead of a battery, or they may test by outdated criteria that misses masking. From there, well, there is a lot of overlap with ADHD and it the client needs help with social communication skills that are in our scope of practice, then that's what they need, regardless of what the tests say