Assessment Services

Given the types of questions we need to ask based on the WPATH Standards of Care, we would recommend reflecting on your history of gender incongruence and key events/times in your gender affirmation journey. 

Likewise, we would recommend learning as much as possible about your selected gender affirmation surgery, including what is done in the surgery and medical risks. It is also important to reflect on what the specific and personal benefits, risks and outcomes might be after the surgery is completed, including psychological, social, financial, employment, fertility, physical or any others you might think of.

There are some great resources on TransHub to guide your learning.

While there are some rebates available for medical services related to the gender incongruence and gender affirmation, there are NO Medicare rebates available for psychological surgery readiness assessment and fees will need to be paid privately.

As per the WPATH Standards of Care, having a psychological or health condition at the time of assessment or surgery is not an exclusion criteria for surgery. 

The guideline outlines that if a significant medical or psychological condition is present, it must be reasonably well controlled and not influence your capacity to make legal decisions. This means that if a condition is identified during the surgery readiness assessment and we are concerned it is not well controlled and/or affecting your judgement, we may pause the assessment and recommend engagement with the appropriate treatment providers. 

We do this so you have the best chance of completing your surgery without major complications associated with the co-occurring conditions, as the recovery and post-surgery adjustment process is challenging.

Once the psychological or medical conditions have been managed (not necessarily resolved) and controlled, we can recommence the WPATH surgery readiness assessment.

Usually its diagnoses that need some sort of evidence to access or be eligible for specialised supports, or medication, that will generally require a formal assessment. 

Neurodevelopmental conditions like Autism, ADHD, Intellectual Disability, Specific Learning Disorders (dyslexia, dysgraphia, dyscalculia) typically need formal assessments to be eligible for in-school supports, specialised schools or classrooms, NDIS funding, Centrelink payments and/or occupational accessibility adjustments in some professional industries.

Sometimes psychological diagnoses may also require formal assessment for legal or forensic purposes, and these are typically conducted by Psychologists working in the legal or forensic industry. Diagnostic assessment for legal and forensic purposes is outside the scope of services Eccentric Minds is able to provide currently.

Eccentric Minds is currently offering assessment for diagnosis of Autism and ADHD based on the combination of assessment tools we have available. If there are suspected symptoms of Intellectual Developmental Disorder or Specific Learning Disorders, we strongly recommend seeking a cognitive and educational assessment to identify these needs and appropriate recommendations with an alternative clinic.

Receiving a diagnosis of or assessing for Autism and/or ADHD is not necessarily dependent on someone's age. It is dependent on a few things, including:

• The presence of clear and observable behaviours or experiences that impact your day to day functioning
• Assessment tools developed and validated for your age, language or culture to understand your behaviours or experiences
• Having had opportunities to meet certain developmental milestones, regardless of whether the milestone was met or not. E.g. It is difficult to comment on how kids engages with their peers if they have not had opportunities to meet, play or be around others of a similar age group.

Currently, Eccentric Minds is able to offer developmental assessment of Autism and ADHD for people aged 6+ based on the combination of assessment tools we have available and because usually by this age there are sources of information from day-cares, preschools, schools and parent's of other kids available to support diagnosis.

The assessment process will vary person to person depending on the complexity of their presentation and history. Overall what you will need to bring or prepare is:

• Yourself or the person being assessed
• Confirmation from a doctor that potential medical causes of symptom or experiences have been assess and/or ruled out. See a summary of these for Autism here and ADHD here
• Any pre-school, school, medical, speech pathology, occupational therapy or psychology reports from below the age of 10-12, but also any across your lifetime too
• Teachers, support persons or other caregivers to complete questionnaires or attend some of the sessions to provide information

Sometimes finding old reports from childhood can be challenging for adults, so please let us know if this is not possible and we can discuss alternatives

The minimum requirement for telehealth diagnostic assessment would be through telehealth – video conference as visual observations are typically required to make valid neurodevelopmental diagnoses. 

If it was determined that telehealth – video was not appropriate or accessible to complete the assessment, Eccentric Minds can offer a private room booking in Newtown 2042 or West Ryde 2114.

In-person assessment is needed for children below 12 years old, and some teens depending on their verbal abilities. However most adults can generally complete the assessment all online.

As with most things in life, there are risk and benefits to diagnostic assessment. Below are some of the potential risks, how we manage these risks, and potential benefits for you to consider in combination with your personal circumstances.

Potential risks:

• No Diagnosis -  Current diagnostic systems typically assume individual experiences fit neatly into specific criteria, and the reality is that sometimes presentations or experiences cannot be explained in such a way or reach thresholds for clinical diagnosis. Sometimes this can produce feelings of invalidation or financial loss if a diagnosis is eagerly sought. 
• Unexpected Diagnosis -  Sometimes experiences are not as they seem on the surface, how we learnt about them, or how we have seen them on social media. The presence of some diagnoses increase the likelihood of related diagnoses also being present, particularly in developmental conditions. 
• Misdiagnosis -  Sometimes clinicians get it wrong, even with the best of intentions. This can be influenced by information available about testing for diagnoses at the time of assessment, limited resources and learning, information provided by clients, or changes in diagnostic criteria that later invalidate diagnoses made or assessment completed. 
• Change in Identity and Perception -  Depending on whether diagnoses were expected or desired, you may experience a negative shift in how you see yourself and others, and how others perceive or behave towards you.  
• Financial Stress -  Unfortunately, diagnostic assessment can be costly and requires fees for service to maintain resources, quality of service and training.
• Fatigue or Distress -  As diagnostic assessment requires thorough investigation of historical and current experiences, multiple sessions are required for interviews and testing, in addition to questionnaires you or others may need to complete outside of sessions within a 3-month period. Some may find this process fatiguing and/or distressing depending on competing life priorities, personal energy or motivation, and psychological wellness. 

At Eccentric Minds, we aim to minimise risks by:

• Maintaining up-to-date professional development and supervision for assessment and diagnostic procedures
• Being informed by Australian recommendations for Autism and ADHD diagnosis and assessment
• Screening for potential diagnoses and discussing these before formal testing occurs
• Seeking information from multiple sources to triangulate symptoms for specific diagnoses while ruling out others (differential diagnoses)
• Providing feedback sessions about the assessment to discuss questions, thoughts and feelings related to diagnoses made
• Offering significantly reduced fees for services compared to fee recommendations by the Australian Psychological Society and Australian Association for Psychologists Inc
• Discussing your energy and emotional needs prior to and during the assessment process, and seeking your feedback in order to make adaptions where possible

Potential benefits:

• Getting Help -  Diagnostic assessment not only aims to clarify the presence of diagnosis but also areas of strength and support, which can help guide you, existing and new health providers to support your individual needs more effectively. 
• Accessibility -  Recommendations will be made to support access to specific services, referral pathways, or modifications for school, higher-education and work environments. 
• Financial Support -  Depending on the diagnosis, individual needs and impairment in daily life activities, a formal diagnostic assessment may increase your eligibility for funding sources like the NDIS, Primary Health Network and Centrelink. 
• Wisdom -  Knowledge is power. The assessment process can promote increased reflection about self, others, the world around us and how you interact with it. It may allow you to understand why you think or behave in a particular way, which may be similar or different to others around you. It may also allow you to set reasonable and realistic goals or boundaries through new understanding of personal strengths and challenges. 
• Validation - Some people have described feeling or being called “different” across their life, struggling to meet particular “typical” life expectations while flourishing in underappreciated areas of life. Sometimes, receiving a diagnosis can provide a simple and concise way of understanding and communicating your strengths while validating challenges that may have been historically dismissed or minimised. 
• Identity -  Depending on whether diagnoses were expected or desired, you may experience a positive shift in how you see yourself and others, and how others perceive or behave towards you. Depending on your experiences, you may develop improved confidence to reach out for help and connection from like minded in individuals or groups. Likewise, you may begin to embrace parts of yourself or experiences that have previously been denied or shamed. 

If you feel the potential benefits outweigh the potential risks for you, it may be appropriate to proceed with formal diagnostic assessment

YES. The reason this is necessary is because after 7 years (or at 25 years old for children) from engagement your file with a psychological service may be closed and responsibility disposed. This is because documentation storage requirements end after this time. The report provided may be the only copy available after this period of time if evidence of formal diagnosis is needed for anything (legal, diversity or funding related) in future. While re-assessment can be completed after that time period, usually health providers will request copies of any previous reports completed as evidence of concerns being present earlier in life, which is required for diagnosis of developmental conditions. 

There are also benefits to having an assessment report or letter, which include:

• Having evidence of conditions and their impact for applications to the NDIS, Centrelink – DSP or Carer payments
• Having recommendations available in writing after the feedback session
• Being able to reflect on what happened during the assessment and have this translated into results or observations noted in the report
• Being able to provide a copy of part or all the report to other health, work or educational providers to the purposes of treatment planning, implementing accessibility adjustments, and educating others in how to support individual needs.

To be accurate and valid, the report or letter must be written and paid for within 3 months of the diagnostic assessment. Some sessions will be recorded with consent to assist the diagnostic process.

NO. NDIS early intervention funding (for those under 7-years-old) can no longer be used to pay for diagnostic assessment of neurodevelopmental conditions or psychosocial disabilities. Likewise, adults with NDIS funding cannot use funds to pay for diagnostic assessment of newly suspected conditions to apply for a ‘change of circumstances review’. NDIS funds can only be used to directly work on goals for the disability named when the NDIS package was initially approved.

As far as we are aware, there are no other insurers that fund developmental diagnostic assessments unfortunately.

For those under 25-years-old and primarily for Autism-related assessment, YES, there are Medicare rebates available with a valid GP or Specialist referral under the Complex Neurodevelopmental Disorders and eligible disabilities plan.

 Unfortunately, this plan does NOT provide rebates for stand-alone ADHD assessments, and Mental Health Care Plans or Chronic Disease Management plans cannot be used as an alternative. 

Eccentric Minds conducts ADHD assessment to make a diagnosis and provide recommendations as a psychological service. In Australia, psychologists are not able to prescribe medication but we can recommend you engage with a specialist doctor such as a psychiatrist or paediatrician (for under 18s), to consider a medication trial or review. Please be aware that not all psychiatrists or paediatricians prescribe medication for ADHD and this is something you should ask before booking an appointment with them.

Depending on the doctor, they may review the report completed by Eccentric Minds and decide to conduct their own assessment or a few tests before considering a medication for ADHD. Ultimately it is up to the doctor whether they prescribe ADHD medication or not, even with a confirmed diagnosis of ADHD.