Autism Evaluations, which one is the best?

Most of my clients are not well informed on the types of autism evaluation tools that exist. I get a lot of questions on this topic! The Monteiro Interview Guidelines for Diagnosing Autism Spectrum, Second Edition or the MIGDAS-2 is the only autism evaluation tool that I use and trust, and it is the most current.

Historically, autism has been collectively known as a disease of deficits. The Diagnostic and Statical Manual (DSM) describes autism with terms like "restricted", "apparent indifference", "inflexible", and of course "deficits" is repeatedly used to describe autistics in relationships, with communication and with emotions (APA, 2013).

This language represents how we've understood and defined autism and autistic people in the U.S.:

1. through the lens of allistic (non-autistic people).

2. how autistics appear to allistic.

3. how the autistic is simply not being allistic enough.

Autism assessments have been designed with these tenants in mind and have produced very limited, discriminatory and unhelpful feedback.

CONCLUSION: Autism has been know as a disorder of behavior, what the body of the autistic body does, is not doing, is doing wrong and how the autistic body appears.

This behavior-centric paradigm has produced assessments like the Autism Diagnostic Observation Schedule, Second Edition) ADOS-2, a commonly used assessment based on standardized behavioral observation.

The MIGDAS-2 has changed this paradigm. It does not consider the autistic in terms of allistic's standards of what the autistic's body is doing or not doing. The MIGDAS-2 is build with the autistic's self-expression, authenticity, strengths and sensory needs in mind. This produces evaluations with generative dialogue that encourage the client's interests and valued ways of being to guide the evaluation.

Some essential characteristics of the MIGDAS-2 autism evaluation tool:

1. Describes how the person experiences the world, verses how they do not (deficit).

   
   

2. Unique words such as, "interests", "preferences", "tends towards". This is a strengths-based framework.

   
   

3. Sensory objects are used during the assessment. This is fun!

   
   

4. "The Descriptive Triangle" is a framework for the evaluation and includes three areas within "Differences in Development": Language and Communication, Sensory Use and Interests, Social Relationships and Emotional Responses.

   
   

5. Diagnostic Feedback of the MIGDAS-2 autism evaluation includes some of the following: recommendations for self-advocacy, a deeper understanding of the self (and/or loved one), unique language to describe the person evaluated, communication supports, sensory/self-regulation supports.

   
   

6. Designed for online! The MIGDAS-2 evaluation was designed to be just as useful online as in-person for children, adolescents and adults. This tool is accessible and cares about clients being as comfortable as possible.

I hope this blog post helps to more deeply understand the underlying goals and beliefs associated with the ADOS-2 and the MIGDAS-2, and to help you choose which evaluation is best for you or your adolescent.

Autism Assessments are expensive, are they worth it? See my post on this topic here:

https://www.kristinabravo.org/post/autism-evaluations-are-expensive-is-it-worth-it

**If you'd like a discuss this some more, contact me for a free consult:

my contact form is on this site is HERE

email: kristina-bravo@outlook.com

phone: 737-825-5005

*And for more information on the structure and what to expect with MIGDAS-2 evaluations with me go to the Autism Evaluations page HERE

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). http://doi.org.10.1176/appi.books.9780890425596

Monteiro, M, J., & Stegall, S. (2021). Monteiro interview guidelines for diagnosing the autism spectrum disorders (2nd ed.). Western Psychological Services.