Combined Assessment:

Autism and A.D.H.D.

  • Autism and A.D.H.D. can co-occur—a neurotype often referred to as “AuDHD.” At All Kinds of Minds Assessments, Clinical Psychologist-led combined A.D.H.D. identification is available for autistic children and adolescents (from age six up to their 18th birthday) where co-occurring A.D.H.D. traits are associated with low-to-moderate support needs. These may include differences in attention, emotional regulation, organisation, impulsivity, or a high need for movement.

    Low-to-moderate support needs are considered flexibly and collaboratively with parents to determine whether a Psychology-led assessment is suitable. Traits may be present across home, school, or other settings, but do not typically cause significant disruption to learning, relationships, or daily life. In many cases, increased understanding, informed parenting strategies, and appropriate school accommodations are sufficient to meet the young person’s needs.

    If moderate-to-high support needs become apparent—particularly where psychiatric input, a medication consultation, or multidisciplinary support is needed—a combined A.D.H.D. assessment will not proceed. Instead, a written recommendation for a G.P.-led referral to C.A.M.H.S. will be provided. This ensures access to the most appropriate service or professional, where indicated, and reflects ethical practice.

Clarification

  • Both Clinical Psychologists and Psychiatrists diagnose A.D.H.D. as part of their professional practice (see link), but there are important differences between these roles that parents should be aware of.

    • A private Combined A.D.H.D. assessment with a Clinical Psychologist is suitable for autistic children and adolescents who present with low-to-moderate A.D.H.D.-related support needs. These may include needs relating to attention, focus, organisation, emotional regulation, impulsivity, or a high need for movement, where current support structures are in place or can be easily introduced through increased understanding and accommodations.

    • For autistic children and adolescents whose experiences reflect moderate-to-high A.D.H.D.-related support needs—particularly where these needs are more persistent across settings or may warrant a psychopharmacological consultation—parents will be advised of indicators and encouraged to seek a G.P.-led referral to the Child and Adolescent Mental Health Service (C.A.M.H.S.) for multidisciplinary assessment and support.

    • It is important to note that Clinical Psychologists do not prescribe medication. Where a medication consultation is considered necessary, an A.D.H.D. assessment with a Psychiatrist, either privately or through C.A.M.H.S., is recommended.

    • Private Psychiatrists in Ireland offer A.D.H.D. assessments and psychopharmacological consultations. Further information is available via the A.D.H.D. Ireland Directory. These services are fully independent, and the link is provided for informational purposes only. Families are encouraged to carry out their own research and due diligence when considering private Psychiatric services.

    • The All Kinds of Minds Practice considers Clinical Psychologist-led Combined A.D.H.D. assessments for autistic children and adolescents on a case-by-case basis. This ensures that the assessment process is a good fit for the young person’s needs and the type of support being sought.

  • Co-occurring A.D.H.D. often presents differently in autistic children and adolescents, with traits varying in intensity, consistency, and impact across daily life. While diagnostic specifiers such as Mild, Moderate, or Severe are used, these are not rigid categories but serve as a guide to understanding the level of support a young person may require. In forming a clinical view, diagnosticians consider both the number and intensity of traits, as well as how these traits affect learning in neuro-normative school environments, relationships, self-regulation, and emotional well-being.

    Co-Occurring A.D.H.D. with Low Support Needs

    At the All Kinds of Minds Practice, a Combined A.D.H.D. assessment may be appropriate for autistic children and adolescents who present with low support needs in areas such as attention, emotion and impulse regulation, or activity levels. These needs are typically situational rather than pervasive and may become more noticeable in specific environments—particularly structured or fast-paced settings like school.

    Young people in this group may experience some difficulty with organisation, time management, or following through on tasks, but often develop their own compensatory strategies. Support needs tend not to interfere significantly with relationships, learning, or family routines. In these cases, a clearer understanding of the young person's neurotype, informed parental support, and appropriate educational accommodations are often sufficient to meet their needs. Medication is typically not considered necessary or indicated.

    Co-Occurring A.D.H.D. with Moderate Support Needs

    Autistic children and adolescents with moderate support needs related to A.D.H.D. often experience traits that are more consistent across home, school, and social contexts. These may include difficulties with sustaining focus, managing emotional responses, regulating impulses, or maintaining task-related persistence. These needs may affect a young person’s academic progress, relationships, and daily responsibilities, especially in neuro-normative learning environments.

    They may, for example, misplace items frequently, need repeated prompts to complete tasks, or feel overwhelmed by unstructured or time-sensitive situations. Emotional regulation may be more variable, and managing peer interactions or expectations can lead to frustration. These young people often benefit from a combination of structured accommodations, informed parental support, and educational accommodations.

    Autistic children and adolescents with moderate support needs related to co-occurring A.D.H.D. may be considered for a combined assessment at the All Kinds of Minds Practice on a case-by-case basis, in close consultation with parents. Together, we consider the support structures already in place, the type of input being sought, and whether psychopharmacological or multidisciplinary involvement is likely to be needed. If it becomes clear that further support is required—particularly where a psychopharmacological consultation is being considered—parents will be advised of the relevant indicators and encouraged to seek a G.P.-led referral to the Child and Adolescent Mental Health Service (C.A.M.H.S.) or explore private psychiatric options as appropriate.

    Co-Occurring A.D.H.D. with High Support Needs

    When A.D.H.D.-related traits are persistent, intense, and consistently impact functioning across all areas of life, a higher level of support is typically required. These young people may struggle with attention, impulse control, emotional regulation, and social understanding in ways that significantly impact participation in learning, peer relationships, and family life.

    They may have difficulty planning and organising daily activities, regulating frustration, or understanding social boundaries, and they often require substantial, ongoing support to navigate daily demands. In such cases, a Psychology-led assessment is not sufficient on its own. A comprehensive, multidisciplinary approach is essential, and medication is often considered as part of a broader support plan through consultation with a Psychiatrist.

    If high support needs are identified during the autism assessment process, parents will be advised to seek a G.P.-led referral to C.A.M.H.S. to ensure access to the appropriate level of assessment and ongoing support.

Combined Process

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  • To begin the process, please complete and submit the Screening Form.

    This form gathers relevant information about:

    • Legal guardianship and consent

    • Assessment readiness

    • Mental health needs that may affect your child or adolescent’s ability to engage meaningfully in the process

    • Risk factors 

    After reviewing the form, the Clinical Psychologist will contact you by email.

    If it is determined that All Kinds of Minds Assessments is an appropriate service for your child or young person at this time, you will be asked to complete and return both the Consent Form and the Intake Form. These must be submitted before your child or adolescent can be added to the waitlist.

    If the information provided in any of the forms submitted indicates that the service is not suitable—for example, if it does not align with the Terms of Service—you will be informed, and the decision will be explained. In such cases, all submitted forms will be deleted in line with G.D.P.R. requirements.

    This process helps ensure that referrals are clinically appropriate, and that the service is responsive to the needs of each child or adolescent before proceeding.

    Once all forms are submitted and All Kinds of Minds Assessments is considered appropriate, the child or young person will be added to the waitlist.

  • When your child or adolescent reaches the top of the waitlist, the Clinical Psychologist will contact you by email.

    You will receive a booking link that allows you to choose a date and time for your Parent Consultation Appointment.

    After booking, you will be asked to complete a set of standardised, parent-rated assessments. These may include:

    • Social Responsiveness Scale, Second Edition (S.R.S.-2)

    • Sensory Processing Measure, Second Edition (S.P.M.-2)

    • Conners Comprehensive Behavior Rating Scales (Conners C.B.R.S.) or the Conners-4

    These tools are designed to capture  information about your child or adolescent’s experiences, including social communication, sensory processing, attention, emotional regulation, and mental health. If your child is old enough, they may also be invited to complete age-appropriate, self-rated assessments to share their own perspective.

    All assessments must be completed before the Parent Consultation Appointment, as the results will be reviewed in detail during that session.

    You can complete the assessments online using a smartphone, tablet, or computer. All responses are protected by end-to-end encryption and are accessible only to the Clinical Psychologist.

  • The Parent Consultation is attended by parent(s) or caregiver(s) only. Your child or adolescent does not attend this appointment.

    This session explores your child’s development, current experiences, and possible neurodivergent traits. We will discuss:

    • Social communication preferences

    • Sensory processing differences

    • Patterns of attention and focus (including movement and regulation needs)

    • Executive functioning, emotional regulation, and learning

    • Cognitive processing style

    • Significant relationships and formative experiences

    We will also review the standardised assessments you and (if applicable) your child completed in advance.

    These tools compare your child or adolescent’s traits and behaviours to those of age-matched peers in the general population. This allows us to identify patterns that may be consistent with autism or other neurodevelopmental profiles.

    In combination with intake information, developmental history, and any prior reports, these results help determine whether a full autism assessment is currently indicated.

    While the Parent Consultation does not provide a diagnosis, it offers a clinically grounded decision point. If further assessment is not indicated at this time, we explore why this is and discuss alternative ways of understanding and supporting the child or adolescent.

    This step helps ensure that in-depth assessment is pursued only when there is clear evidence of autistic traits, acknowledging the time and resources involved in private assessments.

  • If further assessment is indicated following the Parent Consultation, the next step involves gathering information from your child’s teacher using standardised, norm-referenced assessments. These are typically the same assessments completed by parents or caregivers, adapted for use in the school setting.

    Teacher-rated assessments offer important insight into how the child or adolescent is coping in structured, group-based environments—contexts where social communication, sensory processing, attention, and behavioural flexibility may be challenged differently than at home.

    According to D.S.M.-5 diagnostic criteria, a formal autism diagnosis requires that traits be evident across more than one setting—or identified by more than one adult who knows the child well. For children aged 12 and under, particularly those still in primary school, this typically means that traits must be observable both at home and at school—or reported consistently by both a parent and a teacher. As such, teacher-rated input is an essential part of the assessment process at this stage.

    Some autistic children and adolescents may mask or compensate in school environments. As a result, traits may be less visible to teachers, particularly in children who are highly verbal, reserved, compliant, or strongly motivated to fit in socially. Where traits are not observed at school, this is explored further, taking into account possible contributing factors such as anxiety, above average cognitive ability, contextual, and relational dynamics.

    However, for children aged 12 and under, if no traits are evident at school, families are typically advised to defer private assessment until school-based differences become more apparent, or the child’s insight develops sufficiently to contribute reliable self-report data as a second source of information.

    For older children and adolescents—typically from around 13 years of age, depending on developmental profile—self-reported information becomes a developmentally appropriate source of insight. In some cases, a young person’s own account may provide the additional evidence needed to support diagnosis, particularly when traits are not clearly observable in post-secondary school environments.

  • The Autism Diagnostic Observation Schedule, Second Edition (A.D.O.S.-2), is a semi-structured, standardised assessment that is often used to explore social communication and behaviours associated with autism through direct interaction. It is carried out in person and includes play-based tasks for younger children and more structured or conversational activities for older adolescents. While not used in isolation to confirm or rule out autism, the A.D.O.S.-2 provides important observational evidence that informs the overall diagnostic formulation.

    In most cases, the assessment is co-facilitated by two clinicians—the All Kinds of Minds Clinical Psychologist and a Speech and Language Therapist. The Clinical Psychologist leads the session while the Speech and Language Therapist observes and takes detailed notes. Both clinicians contribute to scoring and case discussion after the session.

    For older adolescents, however, the A.D.O.S.-2 can be conducted independently by the Clinical Psychologist if preferred. This format can support greater comfort and engagement for the adolescent, while still preserving the validity and reliability of the tool.

    A diagnosis requires consistent evidence across multiple settings, and structured clinical observation is very important. If traits consistent with autism are observed during the A.D.O.S.-2, the assessment will proceed to the next stage, which is the Autism Diagnostic Interview—Revised (A.D.I.-R.).

    However, if no or minimal autistic traits are identified during the A.D.O.S.-2, this will be discussed with parents before further assessment is considered. In a private assessment context, where continuing represents a significant undertaking for families, the decision to proceed should be both collaborative and carefully considered.

  • During this appointment, parent(s) or caregiver(s) will complete the Autism Diagnostic Interview–Revised (A.D.I.-R.), a structured, evidence-based clinical interview designed to explore developmental patterns relevant to autism. The interview focuses primarily on early childhood and draws on parental insight to build a detailed understanding of how the child’s social communication, sensory processing, and behavioural style have developed over time.

    The A.D.I.-R. places particular emphasis on traits that were evident early in life. This is important because diagnostic frameworks such as the D.S.M.-5 require evidence that autistic traits emerged during early development—even if they only became more noticeable, or were understood differently, as the child matured. Clarifying these early patterns helps to differentiate autism from later-developing anxiety, trauma-related responses, or compensatory behaviours.

  • If indicators of possible co-occurring A.D.H.D. are identified, this will be discussed in consultation with parents or caregivers. For children and adolescents with low to moderate support needs, a combined A.D.H.D. assessment can be carried out as part of the current process. In many cases, developing a clearer understanding of the young person’s neurodevelopmental profile—along with appropriate educational accommodations—may be sufficient to meet their current needs without requiring referral to Child and Adolescent Mental Health Services (C.A.M.H.S.).

    However, where moderate to significant challenges are reported or observed—particularly where daily functioning or emotional regulation is impacted across environments—families will be advised to seek a G.P.-led referral to C.A.M.H.S. for further multidisciplinary assessment and support.

    Note: The threshold for what constitutes moderate need remains flexible and is considered on a case-by-case basis. This determination is guided not only by the frequency or significance of observed needs, but by the extent to which traits impact the child or adolescent’s ability to cope, learn, participate, relate to others, and maintain wellbeing across different neuro-normative environments.

  • A cognitive assessment is completed as part of a Combined Autism and A.D.H.D. Assessment Process. This assessment takes place in-person with the child or young person. The Wechsler Intelligence Scale for Children, Fifth Edition (W.I.S.C.-V U.K.) or the Wechsler Adult Intelligence Scale, Fourth Edition (W.A.I.S.-IV U.K.) will be administered. The purpose is to gain a detailed understanding of the child or adolescent’s cognitive profile, including verbal comprehension, visual-spatial ability, fluid reasoning, working memory, and processing speed.

  • Feedback Appointment Structure

    The structure of the feedback appointment depends on the age and developmental stage of the child or young person:

    • Children aged 6–12: Feedback is typically provided to parents or caregivers only.

    • Adolescents aged 13–15: A separate feedback session for the young person can be arranged depending on their developmental readiness and stage of self-understanding, as well as personal and parental preferences.

    • Young people aged 16–18: Feedback is offered directly to the young person. With their informed consent, a separate session can also be arranged for parents or caregivers if requested.

    What to Expect

    The feedback appointment provides an opportunity to review all findings from the assessment process in a structured, supportive, and developmentally sensitive way.

    If the child or young person meets criteria for autism and/or A.D.H.D., the discussion will focus on understanding what this means for them, with emphasis on their distinct strengths, identity, support needs, and lived experiences. Practical strategies and recommendations for navigating neuro-normative environments will also be discussed.

    If diagnostic criteria for a neurodevelopmental difference (i.e., autism and/or A.D.H.D.) are not met, this will be clearly explained. An alternative formulation will be offered that reflects the young person’s individual profile, and recommendations will be tailored accordingly.

    There will be time to reflect on the findings, ask questions, and consider next steps. Regardless of the outcome, the goal is to ensure clarity, affirm strengths, and identify meaningful ways to support the child or adolescent across contexts.

  • The written report is a key outcome of the assessment process and reflects the time, expertise, and clinical reasoning involved in reaching a clear, evidence-based formulation.

    This comprehensive document includes:

    • Scoring and interpretation of all standardised assessment data

    • Integration of developmental history, observations, and informant reports

    • A clear formulation that captures the child or adolescent’s neurodevelopmental profile

    If the child or young person meets D.S.M.-5 criteria for autism and/or A.D.H.D., the report will include a formal diagnosis. If diagnostic criteria are not met, the report will provide an alternative, evidence-informed formulation that reflects their strengths, differences, and support needs.

    Where appropriate, the report will also outline educational accommodations and supports. These recommendations are tailored to the child or young person’s profile and may be used to guide school planning and access relevant supports. All reports are prepared using U.K.-normed tools and are accepted by the Health Service Executive (H.S.E.).

Multidisciplinary

  • For younger children and adolescents, the Autism Diagnostic Observation Schedule, Second Edition (A.D.O.S.-2) is administered collaboratively with Tina Usborne, an experienced Speech and Language Therapist (C.O.R.U. No. 016775) working in a private capacity. After each assessment, both clinicians jointly score the A.D.O.S.-2 and contextualise the results by integrating all pertinent information.

    Tina Usborne is a Trinity College Dublin graduate with more than 35 -years of experience in hospital and school settings in the Ireland and the United States. She also works publicly as a Senior Speech and Language Therapist with the H.S.E. Primary Care Speech and Language Service. Multidisciplinary A.D.O.S.‑2 assessments are scheduled on Sundays, a day that is typically convenient for families.

Assessment Fees

  • Combined Autism and A.D.H.D. Assessment

    AAt the All Kinds of Minds Practice, Clinical Psychologist-led combined A.D.H.D. identification is available for autistic children and adolescents (from age 6 at the point of referral up to their 18th birthday) where there are indicators of co-occurring A.D.H.D.-related traits associated with low-to-moderatesupport needs in areas such as attention, focus, organisation, emotional regulation, impulsivity, or a high need for movement.

    Fees

    • €200 is required to book the initial Parent Consultation Appointment.
    • If proceeding, the autism assessment fee is €2,200.
    • If low-to-moderate co-occurring A.D.H.D. needs are identified and parents wish to explore further, a combined assessment is available for an additional €500.
    • The total fee for a combined Autism and A.D.H.D. assessment is €2,900.

Payment Options

  • Pay-Per-Appointment: You may choose to pay per appointment, with the total assessment fee divided across the number of sessions required. Payment is made at the time of booking each appointment.

    Monthly Instalment Plan: A monthly instalment plan is available via Stripe to support accessibility for families. Under this option, an agreed amount is automatically deducted each month until the full fee is paid. The Psychological Report is issued once the final payment has been received. If you are interested in this option, please indicate this when contacted.

    Insurance Reimbursement: Many insurance providers offer partial reimbursement for private psychological assessments carried out by psychologists who hold Chartered Membership with the Psychological Society of Ireland. The Clinical Psychologist at All Kinds of Minds holds Chartered Membership, as well as Full Membership of the Clinical Division. It is the responsibility of each client to contact their insurer and explore any applicable reimbursement options.

    Tax Relief: Clients may also be eligible to claim tax deductions on the cost of these assessments. It is the responsibility of each client to explore any tax deduction options.

A.D.H.D. F.A.Q

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  • Attention-Deficit/Hyperactivity Disorder (A.D.H.D.) is a neurodevelopmental difference that is an inherent part of an individual's identity and many prefer to be called "A.D.H.D. individuals" or "ADHDers" to affirm their identity. ADHDers have unique ways of thinking, processing information, and engaging with the world.

    A.D.H.D. tends to run in families. Additionally, brain function differences might be associated with A.D.H.D. Unfortunately, it is still crucial to note that A.D.H.D. is not caused by parenting practices (e.g., permissive parenting).

    Prevalence rates of A.D.H.D. vary by region and population but it is estimated 9.8% of people have been identified as A.D.H.D. A.D.H.D. is a common and naturally occurring difference that transcends racial, ethnic, and socio-economic backgrounds. It is a unique way of experiencing the world that comes with strengths and challenges.

  • Inattention: “ADHDers” often have difficulty sustaining attention and following through on tasks. They may struggle to stay organised, and they may be easily distracted.

    Hyperactivity: Some “ADHDers” experience hyperactive behaviour—this can include restlessness, fidgeting, and difficulty remaining still or seated.

    Impulsivity: Impulsivity is another common indicator. “ADHDers” may act before thinking about potential consequences, have trouble knowing when it is their turn to talk in conversations, or have difficulty waiting their turn in activities.

    Difficulties Across Multiple Settings: indicators of A.D.H.D. should be present across multiple settings—such as at home and in school or work. This differentiates A.D.H.D. from situational presentations.

    Difficulties Present From Early Childhood: Indicators of A.D.H.D. should have been present since early childhood. It is a neuro-developmental difference that becomes apparent in early childhood.

    Difficulties with Daily Activities: To receive a formal diagnosis of A.D.H.D., these traits must have a significant impact on the child’s daily functioning.

  • Here are some strengths associated with A.D.H.D., backed by research:

    Creativity: ADHDers often display high levels of creativity, which can lead to innovative thinking and problem-solving (Kyaga et al., 2013).

    Hyperfocus: While also considered a challenge, hyperfocus, or the ability to intensely concentrate on a task or interest, can be a positive quality as well. Research has discussed hyperfocus in A.D.H.D., as seen in "A.D.H.D. and Hyperfocus: The Flip Side of the Same Coin?" by Tucha et al. (2015).

    Enthusiasm and Passion: ADHDers often approach their interests with enthusiasm and passion, which can lead to dedication and success in areas that align with their passions. This positive trait has been discussed in various publications on A.D.H.D. and personal strengths.

    Quick Thinking: ADHDers tend to think quickly and adapt to changing situations, which can be advantageous in dynamic and fast-paced environments. Research has explored the cognitive flexibility and quick thinking associated with A.D.H.D. (Alderson et al., 2008).

    High Energy Levels: The surplus of energy in A.D.H.D. can lead to increased productivity and motivation in tasks and activities.

    Empathy: Some research suggests that ADHDers may have heightened empathy and sensitivity to the emotions of others. While more research is needed in this area, some studies have explored the social and emotional aspects of A.D.H.D., such as "Emotion Recognition in Adults with Attention-Deficit/Hyperactivity Disorder" by Corbett et al. (2009).

    It is, of course, important to remember that the strengths associated with A.D.H.D. vary among individuals. ADHDers also experience challenges as a neuro-minority group.

  • It is important to recognise that “ADHDers” have unique experiences regardless of gender. However, research has shown that there can be differences in how AD.H.D. presents in cisgender girls compared to cisgender boys. These differences reflect the diverse ways A.D.H.D. can manifest.

    Underdiagnosis and Misdiagnosis: Research has highlighted that cisgender A.D.H.D. girls are often underdiagnosed or misdiagnosed compared to cisgender boys. This may be due to differences in presentation and the tendency for girls to display less overtly disruptive behaviors, which can lead to their challenges being overlooked or attributed to other things (Quinn, P. O. , 2008).

    Inattentive Type: Cisgender A.D.H.D. girls are more likely to exhibit the predominantly inattentive presentation of A.D.H.D. or A.D.H.D.-P.I., which is characterised by difficulties with focus, organisation, and attention to detail—rather than the hyperactive-impulsive presentation often associated with cisgender boys (Rucklidge, J. J., 2010).

    Social Coping Strategies: Some research suggests that cisgender A.D.H.D. girls may develop compensatory social coping strategies to “mask” their difficulties, making it less apparent that they are struggling with inattention and impulsivity (Hinshaw, S. P., 2002).

    Internalising Symptoms: Cisgender A.D.H.D. girls may be more likely to experience internalising difficulties, such as anxiety and depression, which can complicate the presentation and diagnosis (Owens, J. S., et. al., 2007).

    Academic Struggles: Cisgender A.D.H.D. girls may face challenges in academics, but these difficulties may manifest differently, such as in disorganisation, inconsistent performance, and difficulty staying on task (Gaub, M., & Carlson, C. L., 1997).

  • Rejection sensitivity dysphoria (R.S.D.) is a concept that refers to the heightened emotional response individuals may experience when they perceive or anticipate rejection, criticism, or disapproval from others.

    ADHDers often have unique neurocognitive profiles that make them highly sensitive to social interactions and cues. While it is important to note that not all ADHDers experience rejection sensitivity, some may be more prone to it due to social and systemic adversity related to being neurodivergent.

    Rejection sensitivity in ADHDers means that they may be acutely attuned to social dynamics and are more likely to interpret ambiguous or neutral social cues as rejection or criticism. This heightened sensitivity can lead to emotional distress and anxiety in social situations.

    Recognising rejection sensitivity in ADHDers may include creating safe and inclusive environments, providing consistent co-regulation, modelling and teaching emotional regulation skills, and promoting self-acceptance.

  • A.D.H.D. can sometimes be mistaken for or co-occur with other neurodivergent and mental health presentations. Here are some common differential presentations for A.D.H.D.:

    Adverse Childhood Experiences (ACEs): ACEs, which include traumatic experiences in early life, such as abuse, neglect, and household dysfunction, can have profound effects on a child's development. The difficulties associated with high ACEs or trauma can, in some cases, closely resemble difficulties associated with A.D.H.D., leading to potential misdiagnoses or misunderstandings.

    Key Differences: The onset of trauma symptoms arise after exposure to traumatic or adverse events and can be triggered by reminders of the trauma. Indicators of A.D.H.D. appear in the early developmental period and are not reactions to specific events. While both can involve inattention, in trauma, this might manifest as dissociation or avoidance—while in A.D.H.D., it is more about difficulty sustaining attention due to neurological differences. Lastly, trauma responses often involve intense emotional reactions tied to memories or reminders of traumatic events. Whereas emotional dysregulation in A.D.H.D. is not typically linked to specific traumatic memories. References: Ford, J. D., et. al. (2000) and Steinberg, A. M., et. al. (2004).

    Anxiety Presentations: Anxiety presentations, such as generalised anxiety disorder or social anxiety disorder, can sometimes share similarities with A.D.H.D., such as restlessness or difficulty concentrating.

    Sensory Processing Differences: Some individuals may have sensory processing differences that resemble A.D.H.D. traits. However, these differences do not include the hallmark symptoms of inattention and hyperactivity associated with A.D.H.D (Dunn, W., 2014). Additionally, some A.D.H.D. individuals can have sensory processing differences.

    Specific Learning Differences: Specific Learning Differences, such as dyslexia or dyscalculia, can also have an impact on attention and academic performance. They should be considered and ruled-out when considering A.D.H.D. (Shaywitz, S. E., & Shaywitz, B. A., 2008).

    Mood Presentations: Difficulties related to mood presentations, like depression or bipolar disorder, share similarities with A.D.H.D., such as difficulty concentrating and impulsivity (Source: N.I.M.H.).

    Executive Functioning Challenges: Executive functioning difficulties, which are often present with A.D.H.D., may also occur in other neurodivergent presentations (Gioia, G. A., Isquith, P. K., Guy, S. C., & Kenworthy, L., 2000).

    Specifically, autism and A.D.H.D., can share overlapping traits and characteristics, such as:

    Executive Functioning Challenges: Both autistic individuals and ADHDers may experience difficulties with executive functions, which include skills like planning, organising, initiating tasks, and maintaining attention. These challenges can impact daily life and academic or work performance (Zalewska, A., 2019). Executive functioning difficulties in ADHDers arise primarily from difficulties related to inhibitory control, working memory, task initiation, and attention regulation. Organisational difficulties, leading to challenges in structuring tasks or activities and often resulting in misplaced items or last-minute rushes, can occur. There can also be difficulty with time management, estimating how long a task will take, or perceiving the passage of time accurately.

    Executive functioning challenges in autism are diverse, affecting processes such as cognitive flexibility, planning, and initiating actions. They can also be intertwined with social communication differences. Difficulties in switching between tasks or adapting to changes in routine are common. While some autistic individuals may excel at detailed planning, others might struggle with organising tasks, foreseeing consequences, or sequencing actions. Challenges in starting tasks or activities, especially if they are not aligned with personal interests, can occur. Some autistic individuals may have difficulty holding and processing multiple pieces of information simultaneously, especially in dynamic social situations. A preference for routines or familiar environments may be associated with difficulties adapting to unexpected changes. Lastly, autistic individuals might focus on details rather than the overall context or “bigger picture.”

    Sensory Processing Differences: Many autistic individuals and and ADHDers have sensory processing differences—but sensory processing is associated more strongly with autism. Sensory processing difficulties are a core feature of autism and are included in its diagnostic criteria for autism. In A.D.H.D., while these difficulties are prevalent, they are not a central diagnostic feature. Also, the range and depth of sensory sensitivities might be more diverse in autism, encompassing all sensory modalities. Individuals with sensory processing differences can be hypersensitive and then seek to avoid certain sensory inputs, such as sound, light, or textures, and/or hyposensitive (i.e., they may seek out certain stimuli). Sensory sensitivities can influence individuals comfort in and response to various environments (Ben-Sasson, A. et.al., 2007).

    Social Interaction Differences: Social challenges in ADHDers primarily stem from impulsivity, inattention, and hyperactivity. ADHDers might interrupt others, act without thinking, or struggle to wait their turn, leading to unintentional social faux pas amongst neurotypical peers. They might miss social cues because they are distracted or not paying close attention to social interactions. This can make them appear as if they're not listening or are not interested in others. Also, restlessness or fidgeting can be perceived by neurotypical people as disruptive in group settings. There is often a desire to engage socially and make friends, the A.D.H.D. child’s difficulties can make sustained positive interactions more challenging—especially with neurotypical peers. ADHDers often recognise and feel hurt when rejected or left out, but they might not always understand why their actions lead to these outcomes.

    By contrast, social challenges for autistic children are related to inherent differences in understanding and interpreting social information. Autistic children might have difficulty interpreting body language, facial expressions, or tone of voice, and might use fewer non-verbal cues themselves. Predicting and understanding the behaviours, thoughts, or feelings of neurotypical peers can be challenging—and vice versa. (See the double empathy problem.) While some autistic children might be less aware of or concerned about peer perceptions, many recognise their social differences from neurotypical peers. These differences can land do lead to social misunderstandings with neurotypical peers (Johnston, K., et.al., 2015).

    To summarise: The root of social difficulties for ADHDers is more tied to impulsivity, inattention, and hyperactivity—while, for autistic children, it is related to differences in understanding and navigating social interactions with neurotypical peers. The type of social miscues differs: Miscues for ADHDers might involve interrupting or not listening—whereas for autistic children, this might manifest as missing the nuances of a conversation with neurotypical peers or not understanding neurotypical social expectations. Awareness and desire for social connection might differ: ADHDers often actively seek peer connections despite challenges—while autistic children might have variable social motivation.

    Emotional Regulation: Both autistic individuals and ADHDers can struggle with emotional regulation. Individuals may experience difficulties in managing their emotions, leading to emotional meltdowns, burnout, etc. (Yerys, B. E., et. al., 2017). In A.D.H.D. children, emotion regulation difficulties are often linked to impulsivity and the challenges of inhibitory control. ADHDers might have rapid and strong emotional reactions to stimuli, often appearing to act without thinking. They might become frustrated, impatient, or irritated more quickly than others, often due to difficulties with waiting or experiencing setbacks. Emotional reactions can be intense, leading to difficulties regulating strong feelings of disappointment, excitement, or frustration. ifficulty calming down after becoming upset.ADHDers can experience challenges in shifting attention away from a distressing event or stimulus, which can prolong difficult emotional states.

    For autistic children, emotion regulation difficulties are multifaceted, stemming from sensory sensitivities and social communication differences. Over-or-under-responsiveness to sensory input can trigger strong emotional responses. For instance, an unexpected loud noise might result in an intense fear or distress response. Difficulties being understood by neurotypical peers can lead to misinterpretations, potentially resulting in seemingly unexpected emotional responses in the autistic young person. Lastly, difficulties adapting to change or unexpected outcomes can cause anxiety or distress.

    Hyperfocus vs Monotropic Interest Pursuit: A.D.H.D. is characterised by variable attention regulation. While distractibility is common, the opposite can also occur, leading to hyperfocus. Hyperfocus in ADHDers refers to an intense concentration on a specific task or activity, often to the exclusion of everything else. ADHDers might hyperfocus on various activities, from video games to work tasks. The subject of hyperfocus might change frequently. Hyperfocus in ADHDers often occurs when the individual is particularly interested or engaged in an activity; this contrasts with day-to-day tasks that might be difficult to focus on due to inattention. Many ADHDers describe using hyperfocus productively, especially in creative or work-related tasks, though it can also lead to imbalance when other responsibilities are neglected.

    The term "hyperfocus" is less frequently used in the context of autism, but individuals with autism can exhibit intense concentration on specific interests or activities—and this is known as a monotropic approach to interests. Many people with autism have specific topics or activities, that they are passionate about; this can range from academic subjects to hobbies or even specific items or phenomena. Unlike the more variable nature of A.D.H.D. hyperfocus, the topics of intense concentration in autism tend to be more consistent over time. The focus on a passionately held interest or activity is not necessarily driven by external rewards but seems to be intrinsically motivating. Engaging in an interest can be comforting and a way to manage anxiety or overwhelming sensory input. Deep dives into these interests can lead to high levels of expertise or knowledge in specific areas (Tani, P., et. al., 2006).

    Movement: Fidgeting for ADHDers refers to small and often restless movements, especially with the hands and feet. These can include tapping, bouncing, or shifting position frequently. ADHDers may fidget to help maintain attention. Fidgeting can act as a self-regulation mechanism to help them stay engaged in a task or situation. Fidgeting might increase during tasks requiring sustained attention or in situations where the ADHDers needs to stay still for extended periods.

    By contrast, “repetitive behaviours,” often referred to as "stimming" (short for self-stimulatory behaviours), are behaviours or body movements that are done repeatedly. They can include hand-flapping, rocking, spinning, humming, flicking, etc. Like fidgeting in ADHDers, stimming can be a self-regulation mechanism. It can help manage overstimulation or understimulation, and help the autistic individual cope with anxiety or other emotions. Stimming can also provide pleasing sensory input or help modulate overwhelming sensory experiences. Stimming is often more consistent for the autistic individual compared to the variable fidgeting seen in ADHDers. Both fidgeting and stimming can be misinterpreted by neurotypical individuals, and it is important that neurodivergent children should not be deterred from fidgeting or stimming—unless, of course, the behaviour is causing harm.

  • Here are just some notable A.D.H.D. individuals:

    Michael Phelps: The legendary Olympic swimmer, with 23 Olympic gold medals, has spoken openly about his A.D.H.D. diagnosis and how it has influenced his life.

    Will Smith: The actor and rapper Will Smith has discussed his A.D.H.D. diagnosis.

    Justin Timberlake: The musician and actor Justin Timberlake has revealed his A.D.H.D. diagnosis and how it has shaped his creativity.

    Simone Biles: The gymnastics superstar and multiple Olympic gold medalist has shared her A.D.H.D. diagnosis and advocated for mental health awareness in sports.

    Sir Richard Branson: The entrepreneur and founder of the Virgin Group has spoken about his A.D.H.D. diagnosis and how it has contributed to his success.

    Cher: The iconic singer and actress Cher has talked about her A.D.H.D. diagnosis and how it has influenced her life and career.

    David Neeleman: The founder of JetBlue Airways and other successful ventures has shared his A.D.H.D. diagnosis and has advocated for neurodiversity in the workplace.

    Solange Knowles: The singer, songwriter, and actress Solange Knowles has revealed her A.D.H.D. diagnosis.

    These individuals have achieved remarkable success in their respective fields, thus demonstrating that neurodiversity can be a source of strength. Their openness about their experiences has contributed to reducing stigma and increasing understanding of A.D.H.D.

Cognitive Q&A

Young students in a classroom focusing on writing assignments.

  • The Wechsler Intelligence Scale for Children, Fifth Edition (W.I.S.C.-V) will be used for children and adolescent from 6-16 years old.

    The W.I.S.C.-V is a widely used tool to assess intelligence and cognitive abilities in children aged 6 through 16 years. It provides scores that reflect a child's intellectual ability in specific areas, as well as an overall measure of general intellectual ability.

    Here are the primary domains and what they measure:

    Verbal Comprehension Index (V.C.I.): This evaluates a child's verbal concept formation and verbal reasoning through tasks such as defining words or understanding similarities between words.

    Visual Spatial Index (V.S.I.): This assesses a child's ability to evaluate visual details and understand visual spatial relationships. Tasks might involve puzzles or identifying missing pieces in pictures.

    Fluid Reasoning Index (F.R.I.): This measures a child's ability to think on the spot and solve nonverbal problems. It assesses tasks like recognizing patterns or sequences.

    Working Memory Index (W.M.I.): This gauges a child's ability to temporarily retain and manipulate information. Tasks might involve arithmetic problems or repeating a sequence of numbers in reverse.

    Processing Speed Index (P.S.I.): This measures the speed at which a child can process simple or routine visual information, such as matching symbols or coding.

    In addition to these five primary index scores, the W.I.S.C.-V also provides a Full Scale I.Q. (F.S.I.Q.) score that gives an overall measure of a child's intellectual ability.

    The Wechsler Adult Intelligence Scale, Fourth Edition (W.A.I.S.-IV) will be used for adolescents from 16-18 years old.

    The W.A.I.S.-IV is an individually administered assessment designed to measure the cognitive abilities and intelligence of adults, typically aged 16 to 90 years.

    Here are the primary domains and what they measure:

    Verbal Comprehension Index (V.C.I.):

    This assesses verbal concept formation and verbal reasoning. It taps into abilities related to vocabulary knowledge, understanding similarities between different concepts, and comprehension of verbal information.

    Perceptual Reasoning Index (P.R.I.):

    This gauges non-verbal and fluid reasoning, spatial processing, and visual-motor integration. Tasks might include block design, matrix reasoning, and visual puzzles.

    Working Memory Index (W.M.I.):

    This evaluates the capacity to hold and manipulate information temporarily. Components include tasks that test arithmetic skills and sequence repetitions.

    Processing Speed Index (P.S.I.):

    This measures how quickly and accurately a person can process simple or routine visual information. It includes tasks like symbol search and coding.

    If needed, the Adaptive Behaviour Assessment System (A.B.A.S.-3) will be used. This is used alongside a cognitive assessment in the assessment of an intellectual disability (I.Q.).

    The A.B.A.S.-3 measures adaptive abilities and needs. Adaptive behaviour refers to the practical, everyday skills that a person needs to meet the demands of their environment. These skills encompass a broad range of domains related to personal independence and social responsibility.

    Here are the domains and what they measures:

    Conceptual Domain

    Communication: Includes expressive and receptive language skills.

    Functional Academics: Relates to skills like reading, writing, and arithmetic.

    Self-Direction: Measures skills like setting and achieving personal goals, making choices, and following schedules.

    Social Domain

    Leisure: Assesses the ability to engage in recreational activities.

    Social: Focuses on interpersonal skills, understanding social cues, and the ability to engage in friendships and group activities.

    Practical Domain

    Community Use: Evaluates the ability to navigate and use community resources, such as using public transportation or shopping.

    Home or School Living: Assesses daily living skills such as personal care, chores, and following routines.

    Health and Safety: Focuses on skills and behaviors related to personal health, safety, and responding to illnesses or emergencies.

    Self-Care: Involves skills like dressing, grooming, and feeding oneself.

    Work: Assesses job-related skills, maintaining a job environment, and job responsibilities.

    The A.B.A.S.-3 can be used for a variety of purposes, including assessment of intellectual disabilities, etc. It's applicable to individuals across the lifespan, from early childhood to adulthood.

    One of the significant benefits of the A.B.A.S.-3 is its provision for multiple raters.

  • I.Q. Score Classification

    130 and above: Extremely High Range; 2.2% of the population score in this range.

    120 – 129: Very High Range; 6.7% of the population scores in this range.

    110 – 119: High Average Range; 16.1% of the population scores in this range.

    90 – 109: Average Range; 50% of the population scores in this range.

    80-89: Low Average Range; 16.1% of the population scores in this range.

    70 – 79: Very Low Range; 6.7% of the population scores in this range.

    69 and below: Extremely Low Range; 2.2% of the population scores in this range. Individuals who score in this range with commensurate adaptive functioning scores meet criteria for an Intellectual Disability (I.D.).

  • Using the Wechsler Intelligence Scale for Children, Fifth Edition (W.I.S.C.-V) as an example, here are some limitations to be aware of when assessing cognitive ability:

    Culture and language bias: The W.I.S.C.-V is primarily designed for use in Western cultures and may not fully account for the diverse linguistic and cultural backgrounds of children from other regions. This can introduce biases and affect the accuracy of results.

    Narrow focus: The W.I.S.C.-V primarily measures cognitive abilities related to intelligence but may not capture other important aspects of a child's overall development, such as creativity, social skills, or emotional intelligence.

    Test administration and environment: The quality of test administration and the testing environment can significantly impact a child's performance. Factors like illness, fatigue, test anxiety, inattention, distraction, or inadequate instructions may affect the test results—and this can result in an inaccurate assessment of a child's abilities.

    Limited assessment domains: Although the W.I.S.C.-V covers a wide range of cognitive abilities, it may not capture specific talents or skills that fall outside its test domains. For example, artistic or athletic abilities are not adequately measured by this assessment.

    Normative sample and updates: The W.I.S.C.-V normative sample used for comparison and interpretation was collected up until 2014. As a result, it may not fully represent the current population, and new insights or changes in children's intellectual abilities may not be adequately captured.

    All Kinds of Minds will interpret the W.I.S.C.-V or W.A.I.S.-IV results in conjunction with other information, such as observation and bio-psycho-social information, to reach a comprehensive understanding of a child's abilities and challenges.

  • Yes, a cognitive assessment—also know as an I.Q. assessment—is required to determine whether a child is eligible for the Centre for Talented Youth Ireland (C.T.Y.I.). Children that qualify typically score in the 95th percentile or above.

  • Intellectual disability (I.D.) is characterised by differences in intellectual functioning (i.e., reasoning, learning, problem-solving) and in adaptive ability (i.e., a range of everyday social and practical skills).

    The D.S.M.-5 categorises intellectual disability into four categories: mild, moderate, severe, and profound. These categories reflect the degree of difference and difficulty in intellectual and adaptive functioning, and they guide the type of supports that are needed.

    When considering the D.S.M.-5 categories, it is essential to acknowledge the distinctiveness of each person, as these categories do not fully encompass the diversity of experiences and skills present across individuals.

    Mild Intellectual Disability

    Mild Intellectual Disability is usually noticed during the early schooling years, as this is when academic and social demands increase. It may initially be perceived as a specific learning difficulty (e.g., dyslexia).

    Individuals often acquire social and daily skills that enable them to live with a high degree of independence. They may take longer to learn language, self-care, and social skills but can usually achieve these with appropriate guidance and support.

    Individuals may have a rich social life, although they might need extra support in complex social situations. They often form meaningful relationships and contribute actively to their communities.

    Individuals often benefit from supportive education programs and may need guidance in vocational training to help them gain and maintain in employment.

    Parents might notice their child experiences a broad range of emotions and has developed coping strategies, although they may occasionally need support to navigate complex emotional situations.

    Approximately 85% of individuals with an intellectual disability fall within the mild range.

    Moderate Intellectual Disability

    Moderate I.D. are typically identified during the preschool years, as developmental milestones and social interactions present challenges.

    For moderate I.D., more noticeable delays in learning and intellectual development are present, with children acquiring basic communication skills and requiring more guidance in daily activities.

    Individuals with moderate I.D. may need support in learning basic literacy and numeracy skills, along with developing self-care and independent living skills. Progress in these areas can be made with patience and persistent encouragement.

    Individuals may enjoy social interactions and can form strong family and friendship bonds, although they will need support to navigate some social nuances and expectations.

    They typically require more regular support in daily life and may need a more structured environment. With ongoing support, individuals can participate in community life and engage in activities that are personally meaningful.

    For those with moderate I.D., emotional expression may be more pronounced, and understanding nuanced social cues can be challenging. Parents may observe that their child expresses emotions vividly and might require guidance in identifying and managing feelings, especially in social contexts.

    Approximately 10 percent of individuals with a intellectual disability are classified within the moderate range.

    Severe Intellectual Disability

    Severe I.D. often becomes apparent during the infant or toddler years due to significant delays in developmental milestones and the need for assistance with basic life functions.

    Individuals with severe I.D. will need more significant support in developing self-care skills. They may learn some routines and basic tasks, especially if taught from a very young age and with consistent support.

    They may have a clear preference for familiar people and environments and can experience joy and satisfaction in their social relationships, even if they communicate and interact in non-traditional ways.

    They generally require consistent support from family or caregivers in most aspects of daily living, but with this support, they can participate in community life and engage in activities that are meaningful to them.

    Individuals with severe I.D. might show considerable difficulties in communicating their emotional needs and experiences. They may have a basic understanding of emotion but struggle with regulation, requiring close support and patience from caregivers to ensure they feel understood and supported.

    Approximately 3 to 4 percent of individuals diagnosed with intellectual disability are categorised as having severe intellectual disability.

    Profound Intellectual Disability

    Profound Intellectual Disability is typically recognised in the first year of life, as infants may present with considerable delays in developmental milestones and may require support for physical functions as there may also be coexisting motor and sensory disabilities.

    Profound I.D. involves extensive support for learning and daily life, with children showing considerable developmental delays and requiring intensive assistance.

    Individuals with profound ID will need a high level of assistance with all aspects of daily life, including self-care. They may communicate their preferences and feelings in unique ways and often respond positively to familiar people and routines.

    Individuals can experience and express affection and respond to social interaction, although they may do so in ways that are not based on typical social cues.

    Individuals require close and constant support. The focus is on ensuring that the individual can engage in life experiences in a manner that is respectful, dignified, and tailored to their forms of interaction and communication.

    Emotional expression may be primarily through non-verbal cues, and understanding complex emotions can be significantly challenging. Parents are often deeply attuned to their child's unique ways of expressing needs and emotions, providing continuous support.

    Approximately 1 to 2 percent of those with intellectual disabilities are in this profound category.

  • If a child or young person requires an assessment of autism and has a confirmed or queried Moderate, Severe, or Profound Intellectual Disability (I.D.), the Children’s Disability Network Team (C.D.N.T.) is best suited to carry out the assessment and provide support. The All Kinds of Minds Practice does not provide autism assessments for these levels of I.D.

Understanding A.D.H.D…

Video by the Amazing Things Project