Assessment and Treatment for Adults with Autism Spectrum Disorder
In addition to services for children and adolescents, I have extensive experience working with young and older adults with Autism Spectrum Disorder (ASD), including what was previously diagnosed as Asperger's Disorder or Asperger Syndrome. Over the past twenty years, an increasing part of my practice has focused on young adults and their families, addressing social, academic, and workplace issues that accompany an ASD diagnosis at this stage of life. This work often includes coaching, modelling and practicing skills, completing workplace evaluations, developing intervention plans, and providing family consultations. I also see couples where one or both partners have, or suspect they may have, ASD, and I complete comprehensive diagnostic evaluations for adult ASD.
My goal is to help individuals learn, practice, and master skills that they may, or may not, choose to use. The important thing is that these issues, different for all individuals, are issues they need to be able to make choices about. Not become overwhelmed by.
Assessments are often used to determine eligibility for disability tax credits, disability support programs, or accommodations and support services in school, university, or the workplace. A comprehensive assessment for Autism Spectrum Disorder costs approximately $3,200.
If you have previously received a different diagnosis from another provider, I will need those records before proceeding. They can usually be obtained by asking your medical provider directly. In most cases, I will also ask that you see a medical doctor to rule out other plausible causes for your symptoms and concerns.
While a referral is not required, a brief description of your reasons for requesting an assessment is helpful before we meet.
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Services
- Diagnostic assessments for Autism Spectrum Disorder, ADHD, and related conditions
- Forensic assessments involving legal or workplace matters, billed individually. Any assessment intended for legal purposes must be arranged through your legal representative, as special forms and procedures are required for evaluations used in court
- Workplace consultations and site-based education programs
- Social coaching for adults and young adults with ASD in workplace, college, and community settings
- Family consultations
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Frequently Asked Questions
What is your background for working with adults with ASD?
My background with adults grows directly out of more than thirty-five years working with children and adolescents. Understanding adult ASD requires familiarity with the full developmental picture of autism spectrum disorder, and that is where my work began. I have worked as a special education teacher, a school psychologist, a school district behaviour specialist for autism, and a provincial consultant for autism and related disorders throughout British Columbia (POPARD).
What are the aims of therapy for adults with ASD?
The work varies by person, but the broad aims are consistent. I try to help clients develop cognitive and behavioural skills that were not learned earlier, build compensatory strategies for difficulties that are not likely to change, and work toward genuine self-acceptance. Where anxiety, depression, or other co-morbid conditions are present, we address those directly. The overall goal is practical: to help you find ways to make life easier, reach your goals, and develop the choices you want to have.
Do you work with ADHD and executive dysfunction?
ADHD is now frequently diagnosed alongside autism spectrum disorder, and much of my work with children, adolescents, and adults involves both. Executive function refers to the set of cognitive processes required to plan and carry out activities. This includes task initiation and follow-through, working memory, sustained attention, performance monitoring, impulse control, goal-directed persistence, and the ability to regulate emotions. Deficits in executive functioning can significantly affect performance in school, work, and social settings.
With these clients, I typically begin by clarifying the diagnosis through assessment, then develop an individualized plan addressing school, home, or work as relevant. This may include individual behavioural therapy, school or workplace consultation, referral to medical professionals, and psychoeducation. Much of my work in this area draws on the research and treatment programs developed by Dr. Russell Barkley. Additional information is available on the ADHD page.
What does the assessment process involve?
A comprehensive assessment has three components. The first is an extensive clinical interview with you, covering your history, your current concerns, and the specific questions you want the assessment to address. The second is a face-to-face evaluation using standardized instruments designed to identify symptom patterns associated with autism spectrum disorder. The third, and equally important, is a detailed interview with someone who knows you well, such as a family member or partner. This collateral interview is essential for understanding your developmental history and getting an accurate picture of how your symptoms present in daily life. Adults with ASD have often developed strategies that partially mask their difficulties in structured settings, and the perspective of someone who knows you outside those settings is a necessary part of an accurate evaluation.
Where the clinical picture warrants it, additional neuropsychological and language testing is carried out. All patients are also assessed for ADHD, as the two conditions have a high rate of co-occurrence and distinguishing between them, or identifying both, has direct implications for treatment.
The face-to-face portion of the assessment typically takes three to five hours, depending on which tests are required. In addition, you will be asked to complete a number of self-report forms, which can be done at home, online, or in the office. The process concludes with the scoring and analysis of all test results and the preparation of a comprehensive written report. That report is reviewed with you in a dedicated feedback session and is written to serve practical purposes: it can be used as the basis for accommodations in school or the workplace, and for establishing eligibility for relevant provincial and federal benefit programs.
What about anxiety, depression, or family issues?
As part of the autism and ADHD assessment process, adolescents and adults are evaluated for depression, anxiety, and behaviour problems that may have environmental or interpersonal origins. Anxiety and depression are frequent co-morbid conditions for adults with ASD and often need to be addressed as part of treatment. Depending on the presentation, this may involve cognitive-based therapy, counselling, or more traditional supportive therapy.
How do I make an appointment?
Contact me by email at drjimroche@gmail.com. If you are writing about an autism assessment, please put "Autism Assessment" in the subject line.
I usually begin with an initial session to gather a developmental history, discuss your current concerns, and determine the best course from there. An assessment may or may not be the right next step, and you should fully understand your options before proceeding.
When I have openings, appointments are generally available within ten to fourteen days. I return emails and calls on Wednesdays and Thursdays. If you do not hear from me within ten days, it means I have no openings in the near term. You are welcome to try again after that point.
Please include a brief description of your concerns and your contact information, including a phone number. Do not include detailed personal information in this initial email. If I need to leave a phone message, it will identify me as a doctor and briefly state the reason for the call. If you would prefer I not leave a message, please note that in your email.
Fees for initial and ongoing sessions are $260 per hour, payable by cash, cheque, or eTransfer.
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All services are provided in accordance with applicable professional and jurisdictional requirements.