Neurodiversity-Affirming Psychological Assessment: What It Is and Why It Matters

What Does Neurodiversity Mean?

Neurodiversity is a relatively new term, coined by sociologist Judy Singer in the late 1990s, to highlight that some neurological differences are best seen as natural variations of human cognition, not problems to be cured (Singer, 1998). Just as we recognize diversity in race, gender, or sexuality, neurodiversity reminds us that differences in how brains experience the world are a normal part of being human.

In practical terms, neurodiversity usually refers to lifelong neurodevelopmental differences such as autism, ADHD, dyslexia, dyscalculia, and sometimes intellectual disability or Tourette’s syndrome. There is ongoing discussion in the field about where neurodiverse presentations end and other types of mental health conditions begin, and how best to understand the overlap between them. The boundaries aren’t always clear, and our understanding continues to evolve as research and lived experience shape the conversation.

Of course, when terms are used too broadly or without context, they can start to lose their meaning. As psychologist Ed Perin joked, phrases like “trauma-informed therapy” can start to sound as generic as “tooth-informed dentistry.” The same confusion can happen with “neurodiversity-affirming” assessment. This post aims to bring some clarity by describing what neurodiversity-affirming assessment actually means, how it differs from traditional practices, and what you can expect from the assessment process.

Why Does Neurodiversity Matter for Assessment?

A neurodiversity-affirming approach means we don’t automatically view differences in thinking or learning as flaws. Instead, it recognizes that while most people experience the world in “neurotypical” ways, some do not—and that’s perfectly okay. Rather than focusing solely on changing what’s “between the ears,” this perspective considers how environments can be adapted to better fit neurodiverse brains.

While traditional models of psychological assessment have often focused on identifying deficits and gathering information to change individuals so they fit more easily into existing environments, there’s a growing recognition that we can—and should—think bigger. As B.F. Skinner, a pioneer in the science of behavior, reminded us, “Any science of behavior is, at bottom, a philosophy of human possibility. It must consider the possibility of a better world.”

Neurodiversity-affirming assessment takes that idea to heart, shifting the focus from changing people to reimagining environments where every mind can thrive.

This marks a shift from the traditional medical model, which tends to locate problems within the individual and focus primarily on reducing symptoms. Neurodiversity-affirming assessment broadens the conversation, exploring where and when a person thrives, what situations are most challenging and why, and how settings—whether at home, school, work, or in relationships—can be adjusted to support each unique mind. It also considers how to help build skills and strategies that encourage both authenticity and adaptation.

As Wright (2022) describes, many struggles are less about “deficits” and more about a mismatch between a person’s brain and their environment.

How Is Neurodiversity-Affirming Assessment Different?

A neurodiversity-affirming assessment looks and feels quite different from the traditional information gathering model of psychological assessment and incorporates elements of collaborative/therapeutic assessment models. Rather than a one-way process focused on deficits and diagnoses, it’s built on partnership, curiosity, and respect for lived experience. Here are some of the key ways that neurodiversity-affirming psychological assessment stands apart from traditional assessment models:

Collaboration and Partnership
Neurodiversity-affirming assessment is built on partnership. Psychologists contribute expertise in psychological testing—including comprehensive psychological and neuropsychological testing—while clients and families bring expertise on their own experiences. The process involves co-creating the questions that matter most, focusing on what the client wants to understand, not just what the tests measure.

Psychologist Filippo Aschieri (2012) described this as a process of blending narratives from both the client, who ‘writes with personal meaning,’ and the psychologist, who ‘writes with numbers,’ to collaboratively ‘write stories with four hands.’

Stephen Finn expands on this idea, describing psychological tests as powerful “empathy magnifiers”—tools that allow us to better understand and appreciate the lived experiences of others. In this way, testing becomes more than a diagnostic step; it helps individuals and families begin to reframe their self-narratives with greater compassion, insight, and agency.

Context Matters
Rather than viewing challenges in isolation, neurodiversity-affirming assessment takes a deliberate, context-driven approach, as described by Wright (2022). This means we look closely at the environments and situations in which a person lives, learns, works, and connects—recognizing that strengths and struggles often emerge in response to specific contexts, not in a vacuum. The assessment process explores where someone feels energized and authentic, where they encounter barriers, and what kinds of spaces or relationships help them thrive versus those that create stress or overwhelm.

For example, an ADHD brain may find long lectures draining but thrive in short bursts of hands-on learning (Wright, n.d.). An autistic person may be overwhelmed by open office environments but excel in focused, quiet work. Deliberate context-driven assessment asks not just “What are the challenges?” but “When and where do these challenges arise?” and “What patterns can we see when environments are adjusted to better fit the individual’s neurotype?”

Strengths and Challenges: Two Sides of the Coin
This approach highlights both strengths and difficulties, viewing them as interconnected rather than opposing forces. For example, a child who is easily distracted may also be remarkably observant, able to spot details others overlook, or become deeply absorbed in a favorite interest. Sensory overwhelm might accompany heightened sensitivity or unique abilities, such as perfect pitch.

When it comes to ADHD, traditional environments—like classrooms that rely on extended focus and quiet, independent work—can be particularly difficult. Challenges with attention, impulse control, organization, and emotion regulation often arise in these settings (Wright, n.d.; Climie & Mastoras, 2015). Yet, a neurodiversity-affirming approach recognizes that these difficulties are often context-dependent. The same ADHD brain that struggles with long lectures may thrive when learning happens in short bursts, through hands-on projects, collaboration, or creative expression. Research shows that ADHD is frequently associated with energetic exuberance, adventurousness, creative and divergent thinking, and the ability to hyperfocus on areas of passion. Many individuals with ADHD also demonstrate remarkable resilience, bouncing back from setbacks and adapting in the face of adversity (Sedgwick et al., 2019; Chan et al., 2022).

By identifying both the obstacles and the unique strengths each person brings, neurodiversity-affirming assessment offers practical, individualized recommendations—not just for building skills, but for creating environments where people truly flourish.

Language Matters
Language plays a powerful role in shaping how we understand ourselves and each other. In neurodiversity-affirming assessment, careful attention is given to words and phrasing—not only in conversation, but also in written reports and recommendations. Rather than relying narrowly on clinical labels or deficit-focused descriptions, this approach uses language that respects and dignifies each individual’s experience. For example, many people in the neurodivergent community prefer identity-first language, such as “autistic person,” which can reflect pride and belonging, rather than “person with autism,” which some feel separates them from an integral part of who they are (Wright, n.d.).

Importantly, neurodiversity-affirming assessors don’t assume one preference fits all. Reports emphasize lived experience, personal strengths, and individual traits—not just symptoms or challenges—so that the language itself supports a sense of agency and self-worth. In this way, assessment becomes not only a tool for understanding, but also a means of affirming identity and fostering respect. As described by Constance Fischer, the assessment process can help individuals take the first step toward crafting more accurate and compassionate self-narratives—stories about themselves that honor both their challenges and their unique capacities. This shift in narrative can be transformative, opening the door to greater self-acceptance and growth.

Concrete, Practical Recommendations
Feedback from neurodiversity-affirming assessment is designed to be understandable and actionable. Recommendations are tailored to the individual’s real-life contexts—offering specific strategies to reduce stress and burnout, improve relationships, and foster success in environments that fit their brain. This might include ideas for modifying workspaces or classrooms, building on personal strengths, or developing routines that support well-being. The ultimate goal is to provide meaningful tools and insights that empower individuals and families to make positive, sustainable changes in daily life.

Real-World Scenarios

To see how neurodiversity-affirming assessment works in practice, consider how it can reshape the experience for people like Sam, Jamie, and Alex.

Take Sam, a 15-year-old referred for autism assessment. In a traditional model, Sam might complete a battery of tests and receive a report listing impairments and stating whether he “meets criteria” for autism. He and his family may come away from the experience with a list of problems and areas of difficulty, feeling as though Sam was defined largely by what he can’t do. This can feel discouraging and limiting.

In contrast, a neurodiversity-affirming approach invites Sam and his family to share their experiences. Sam feels drained at school but comes alive at home when coding or drawing. He struggles with group work but has deep friendships online. Importantly, the assessment doesn’t simply look at a list of challenges—it also explores Sam’s passions and talents, helping his family understand why certain environments are exhausting and how to create more spaces where he can thrive.

This broader perspective is just as important for Jamie, age 7, who has ADHD. Jamie finds it hard to sit still and focus during long lessons, but she’s bursting with energy, creative ideas, and can hyperfocus on building elaborate structures with her blocks. Rather than simply recommending behavior charts or medication, a neurodiversity-affirming assessment encourages her teachers and parents to create learning environments with more movement, shorter tasks, and opportunities for Jamie to shine—recognizing her cognitive dynamism and creativity as strengths.

The same principle applies to adults like Alex, who has dyslexia. Alex struggles with rote memorization and written tests, but excels at finding hidden connections between ideas and telling compelling stories. Instead of focusing solely on improving his weaknesses, the assessment highlights how Alex’s workplace can better utilize his strengths in narrative reasoning and problem-solving, supporting him in roles where these abilities matter most.

In each case, neurodiversity-affirming assessment moves beyond labels and deficits, offering practical recommendations that help individuals flourish in environments that fit their brains. The ultimate aim is to help clients navigate life with less struggle and more joy, honoring both their individuality and potential for growth.

For Referring Clinicians: Assessment as a Collaborative Tool

The connection you have with your client is the foundation for their growth and healing. If you’re considering referring a client for autism, ADHD, or learning difference assessment, you may have some reservations—perhaps you’ve seen psychological testing that feels cold or impersonal, focused only on collecting data, or reducing a person to a set of scores with little room for their story or strengths. These are valid concerns, and they reflect real experiences that many clinicians and clients have had with traditional assessment models.

Neurodiversity-affirming assessment is designed to be different. Rather than viewing assessment as a separate, one-off event, this approach invites clinicians into a shared process of discovery. The goal is not just diagnosis, but genuine understanding and growth. Your insights, questions, and ongoing perspective help ensure the assessment is relevant and responsive to your client’s unique goals. The process is built on partnership, respect, and a focus on lived experience—not just test results.

Collaboration can take many forms—from shaping referral questions, to sharing observations, to integrating assessment findings into therapy, school planning, or everyday life. Reports are written for real people, not just professionals, with clear language and practical recommendations that you and your client can use together.

Assessment helps refine and extend the map for your client’s journey, but the clinician-client relationship remains the essential harbor—anchoring the process and guiding next steps. In this way, neurodiversity-affirming assessment serves as a resource for deeper understanding, ongoing care, and truly meaningful support.

Neurodiversity-Affirming Psychological Assessment in Central Indiana

Our practice offers neurodiversity-affirming psychological testing and assessment for children, teens, and adults with questions related to autism, ADHD, and learning differences across Carmel, Indiana, and surrounding areas—including Fishers, Westfield, Noblesville, Zionsville, and the north side of Indianapolis. Whether you’re a parent seeking support for your child, a teen curious about your experiences, or an adult with questions about your own neurodiversity or learning profile, we’d be glad to work alongside you.

If you’d like to learn more or schedule a consultation, contact us today.

References

Angoff, L. (2024). 2 Sides of the Coin – Neurodiversity-Affirming Reframes. www.ExplainingBrains.com

Aschieri, F. (2012). Epistemological and ethical challenges in standardized testing and collaborative assessment. Journal of Humanistic Psychology, 52(3), 350-368.

Chan, E. S. M., Groves, N. B., Marsh, C. L., Miller, C. E., Richmond, K. P., & Kofler, M. J. (2022). Are There Resilient Children with ADHD? Journal of Attention Disorders, 26(5), 643–655. https://doi.org/10.1177/10870547211025629

Climie, E. A., & Mastoras, S. M. (2015). ADHD in schools: Adopting a strengths-based perspective. Canadian Psychology / Psychologie canadienne, 56(3), 295–300. https://doi.org/10.1037/cap0000030

Kannangara, C., Carson, J., Puttaraju, S., & Allen, R. (2018). Not all those who wander are lost: Examining the character strengths of dyslexia. Global Journal of Intellectual & Developmental Disabilities, 4(5). https://doi.org/10.19080/GJIDD.2018.04.555648

Meilleur, A.-A., Jelenic, P., & Mottron, L. (2015). Prevalence of clinically and empirically defined talents and strengths in autism. Journal of Autism and Developmental Disorders, 45(6), 1354–1367. https://doi.org/10.1007/s10803-014-2296-2

Milton, D. E. (2012). On the ontological status of autism: The ‘double empathy problem’. Disability & Society, 27(6), 883–887.

Sedgwick, J. A., Merwood, A., & Asherson, P. (2019). The positive aspects of attention deficit hyperactivity disorder: A qualitative investigation of successful adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11, 241–253.

Singer, J. (1998). Odd people in: The birth of community amongst people on the autistic spectrum: A personal exploration of a new social movement based on neurological diversity. Honours Thesis, University of Technology Sydney.

Woods, S. E. O., Brook, A., & Angoff, L. (2025). Principles of Neurodiversity-Affirming Collaborative Assessment. Neurodiversity, 3. https://doi.org/10.1177/27546330251342069 (Original work published 2025)

Wright, A. J. (n.d.). Neurodiversity and neuro-affirming care [White paper]. Parallel Learning.

Wright, A. J. (2022). Deliberate context-driven conceptualization in psychological assessment. Journal of Personality Assessment, 104(5), 700–709.

Are Personality Disorders Really Just Interpersonal Disorders by Another Name?

Understanding the Origins of 'Disordered Personalities'

The fascination with human personality and its potential to cause difficulties is not a modern phenomenon. Early thinkers like Confucius and Theophrastus explored the idea of human nature, each in their own way categorizing personalities into types—some virtuous, others less so. Ancient Chinese and Greek philosophers recognized that certain traits could lead to social and personal struggles, often framing these within a context of moral failings or social dysfunction.

Interestingly, the term "character"—the root of our modern understanding of personality—comes from the Greek word "kharakter," which referred to a tool used to stamp or engrave, much like a coin or seal. This metaphor suggests that early thinkers viewed personality traits as something "inscribed in the fabric of a person"—permanent, fixed, and deeply ingrained.

This view of personality as an enduring, almost indelible part of a person continued into the 18th and 19th centuries. Figures like Philippe Pinel and Emil Kraepelin began to formalize the concept of "personality disorders" in psychiatric nosology. Kraepelin’s "psychopathic personalities" were described as inborn defects, further cementing the idea that certain traits could be permanently pathological. These early formulations of personality disorders were often tied to explanations for criminality or moral failings, portraying individuals with these traits as "defective" in ways that couldn’t be changed.

Fast forward to today, and the term "personality disorder" persists in our psychiatric classification systems, as seen in the DSM-5-TR, which includes ten specific types of personality disorders. However, as our understanding of mental health has grown more nuanced, so too has our awareness of the limitations and potential harms of this label.

Reframing Personality Disorders as Interpersonal Disorders 

The term "personality disorder" can feel heavy and stigmatizing, implying something fundamentally wrong or "disordered" about someone's personality—the core of who they are.

This perspective has been around for thousands of years, but is it accurate?

A growing number of psychologists, including Dr. Aidan Wright and his colleagues, believe it’s time to change how we think and talk about these issues. In their 2022 article in American Psychologist, they argued that the label "personality disorder" is misleading and, at times, harmful.

Instead, they proposed adopting the term "interpersonal disorders"—a shift that more accurately reflects the challenges these individuals face and reduces the stigma associated with locating the source of one’s difficulty in their personality.

Why Interpersonal Disorders Make Sense

Wright et al. (2022) highlight several reasons why focusing on "interpersonal disorders" is beneficial.

First, personality isn’t inherently the problem. Everyone has personality traits—some healthy and adaptive, some less so. Research shows that even people with mood disorders, anxiety, and other psychological conditions often score high on scales measuring "maladaptive" personality traits. These traits aren't unique to what we currently call personality disorders. In fact, they’re widespread across various forms of mental health struggles.

As Zavlis and Fonagy (2024) argued, if we relied solely on traits, we would be forced to conclude that either all forms of psychopathology were personality disorders, or there is no such thing as a personality disorder. Traits alone don’t meaningfully distinguish people diagnosed with personality disorders from other common mental disorders.

Research by Hopwood and Bleidorn (2018) also suggests that personality traits are less stable than previously thought and can change in response to significant life events or interventions. Interestingly, they also found that maladaptive traits in individuals without personality disorders exhibit more stability than expected, indicating that these traits can persist across different mental health conditions.

So, if neither the presence of maladaptive traits nor their stability distinguishes PDs from other mental disorders, what does?

Wright et al. (2022) emphasize that what distinguishes individuals with these struggles isn’t just their traits, but the specific problems these traits cause in relationships. People who meet criteria for a personality disorder generally experience considerable difficulty forming or maintaining healthy connections with others. They may face frequent misunderstandings or conflicts in their personal or professional lives and feel unstable in their identity or direction. As Hopwood (2024) explains, these struggles are less about the traits themselves and more about how these traits affect interpersonal dynamics and self-understanding.

Finally, the language we use matters. The label "personality disorder" carries a weight that can feel like a judgment of who someone is. Historically, this seems to have been the intent. But this framing is also prone to making people feel ashamed, broken, or unchangeable. By shifting the focus to "interpersonal disorders," the emphasis moves from "What’s wrong with you?" to "What’s causing this pattern of challenges you face in your relationships and self-understanding?" Besides reducing shame, this shift widens the avenues toward healing and likely lessens prognostic pessimism among clients and clinicians alike.

A Kinder Approach to Diagnosis

Wright and colleagues propose this change not only because it’s more scientifically accurate – although that’s the driver of their argument – but also because it’s kinder. It aligns with what clinicians see in therapy every day: people who are not "broken" or inscribed with inherent flaws, but struggling with interpersonal difficulties that are often deeply rooted in pain, trauma, or unmet needs.

This reframing also offers clinicians clearer guidance. When someone is diagnosed with an "interpersonal disorder," it signals the therapist to pay attention to potential relational difficulties in the treatment process, such as challenges in forming a therapeutic alliance, vulnerability to feelings of rejection or abandonment, a tendency to oscillate between feelings of admiration and disillusionment, and the risk for behaviors like self-harm or impulsivity when relational tensions arise. By focusing on these challenges, therapy becomes a space to untangle the knots of interpersonal pain.

Understanding as a First Step

Addressing interpersonal challenges starts with gaining a clearer understanding of yourself and your life. At our Carmel, Indiana-based practice, we specialize in collaborative therapeutic assessment, a collaborative process where we work together to explore puzzling, troubling, or stuck aspects of your experience. This collaborative process aims to provide you with clarity and direction, allowing us to co-create a more accurate and compassionate understanding of your personal experiences.

Through this process, you gain more than just self-awareness; you develop actionable steps toward recovery and lasting change. We provide a supportive environment where you can explore relational challenges and begin to develop new ways of connecting with yourself and others.

Curious about how therapeutic assessment can help? Reach out to us by phone at 317-960-4899 or email us at contact@SycamoreCAPS.com to schedule a consultation.

References

Hopwood, C. J., & Bleidorn, W. (2018). Stability and change in personality and personality disorders. Current Opinion in Psychology, 21, 6-10. https://doi.org/10.1016/j.copsyc.2017.08.034

Wright, A. G. C., Hopwood, C. J., & Zanarini, M. C. (2022). It’s time to replace the personality disorders with the interpersonal disorders. American Psychologist, 77(1), 111-123. https://doi.org/10.1037/amp0001087

Zavlis, O., & Fonagy, P. (2024). Either all mental disorders are personality disorders or there are no personality disorders: A reply to García and colleagues (2024). Pre-print. https://osf.io/preprints/psyarxiv/4xpdg

Writing Stories with Four Hands in Psychological Assessment

Therapy without assessment is often likened to a ship without a rudder, while assessment without therapy is compared to a ship without a harbor. These metaphors contain some truth, but they don’t always fit every situation. Therapy can certainly progress in many cases without extensive psychological testing, and the assessment process itself can sometimes be therapeutic, even eliminating the need for further therapy. However, this analogy points to a deeper difference in how therapists and assessment psychologists often approach their work—particularly in how they understand and define truth.

At the heart of this distinction is the difference between positivist and post-positivist approaches to understanding human experience. Many traditional forms of psychological assessment operate from a positivist epistemology, which assumes that there is an objective reality that can be measured and understood through scientific inquiry. In this framework, tests are designed to reveal these objective truths about a person’s inner life—whether about personality, cognition, or emotional functioning.

In contrast, many therapists, particularly those with humanistic, narrative, or psychodynamic orientations, may operate from more post-positivist or constructivist traditions, which emphasize that all knowledge is filtered through subjective experience. In this view, truth is not a fixed reality to be measured, but something co-constructed and shaped by personal narratives, cultural contexts, and interpersonal relationships.

The Traditional View of Psychological Assessment

Traditional psychological assessment tends to adopt a positivist approach, where the goal is to gather information and measure internal psychological states as objectively as possible. This model assumes that by using standardized tests, psychologists can access and quantify the “truth” of a person’s inner life. While there is great value in this objective data, it can be incomplete if removed from the client’s lived experiences and personal context.

As Wright (2024) observed, psychological assessment has historically centered its validity inquiry on the tests themselves, often leading to decontextualized interpretations of data. This epistemological focus on objective, measurable truth can strip away the client’s subjectivity, making the process feel almost dehumanizing. By prioritizing test scores over personal narratives, assessment may come across as cold or impersonal, contributing to a perception that it is disconnected from the lived realities of clients.

The assumption that objective truth can be cleanly separated from subjective experience reflects a pure positivism that some now see as limited. While objective data is certainly useful, post-positivist perspectives remind us that test data can only be meaningfully understood as one part of a larger picture. When assessment is done without consideration for clients’ personal experiences, it risks being perceived as impersonal or even paternalistic. Put differently, test data provide a map of the territory; clinicians shouldn’t confuse it for the territory itself.

Writing Stories with Four Hands

Collaborative Therapeutic Assessment (CTA) provides a framework that blends both positivist and post-positivist perspectives, acknowledging the importance of objective data while centering the client’s subjective reality. CTA begins with the premise that while psychologists are experts in tests and data, clients are the experts on their own lives. By working together, they can co-create a richer, more accurate understanding of the client’s story—one that integrates both lived experience and psychometric evidence.

Filippo Aschieri (2012) described this process as “writing stories with four hands.” In this model, clients bring their personal narratives, which are often clouded by self-criticism, shame, or incomplete understanding, while psychologists contribute insights derived from objective testing. Through collaboration, the assessor and client co-edit these stories, creating a new narrative that reflects both the subjective world of the client and the objective insights from psychological testing.

This process aligns with the post-positivist emphasis on epistemological pluralism, which recognizes that truth is best understood by integrating multiple perspectives. In CTA, this is referred to as epistemological triangulation—the blending of narratives from both the client, who ‘writes with personal meaning,’ and the psychologist, who ‘writes with numbers,’ to collaboratively ‘write stories with four hands.’

Relevant to this process is the concept of ‘life validity,’ a term coined by Fischer and Finn (2014) to emphasize the importance of contextualizing test results within the client’s personal life story and current circumstances. This stands in contrast to decontextualized score interpretations, which may ignore the broader emotional, relational, and cultural dimensions of the client's life. By focusing on life validity, CTA moves beyond a strictly positivist approach, ensuring that the data resonates meaningfully within the client's lived reality.

The Benefits of Collaborative Therapeutic Assessment

By integrating both positivist and post-positivist perspectives, CTA offers clients a more holistic understanding of themselves. It not only provides them with objective data but also helps them use that data to reshape personal narratives in ways that are compassionate and empowering.

This process can be particularly powerful for clients who have struggled with negative or self-limiting beliefs. Through CTA, they can begin to reframe their understanding of themselves, incorporating the insights from psychological testing into a broader, more compassionate story of who they are.

Research shows that CTA is effective in improving clients' self-understanding and emotional well-being. It also aligns with the therapeutic goals of many practitioners who believe that assessment can—and should—be more than just information-gathering; it can also serve as a transformative experience that promotes healing.

Conclusion

Psychological assessment, when done collaboratively and contextually, doesn’t have to be cold or detached. By blending the objective rigor of tests with the rich subjective narratives of clients’ lives, Collaborative Therapeutic Assessment offers a way to “write stories with four hands.” This approach honors both positivist and post-positivist epistemologies, recognizing that truth is not one-dimensional but emerges from the intersection of data and experience.

Whether you're a therapist in Carmel, Indianapolis, or the broader Central Indiana area considering referring a client for assessment, or a prospective client yourself, know that our goal is not just to collect data, but to help co-create a meaningful, accurate, and supportive understanding of your life. Together, we’ll write your story—using both numbers and narratives—to guide you toward greater understanding and self-compassion.

References

Aschieri, F. (2012). Epistemological and ethical challenges in standardized testing and collaborative assessment. Journal of Humanistic Psychology, 52(3), 350-368.

Fischer, C. T., & Finn, S. E. (2014). Developing the life meanings of psychological test data: Collaborative and therapeutic approaches. In R. P. Archer & S. R. Smith (Eds.), Personality Assessment, 2nd Edition (pp. 401-431). Routledge.

Wright, A. J. (2024). Queering psychological assessment. Professional Psychology: Research and Practice. Advance online publication. https://dx.doi.org/10.1037/pro0000594.

Suggestion for Further Reading

Fantini, F., Aschieri, F., David, R. M., Martin, H., & Finn, S. E. (2022). Therapeutic Assessment with Adults: Using Psychological Testing to Help Clients Change. Routledge.

Sensory Seeking and Avoidance: What Parents and Caregivers Should Know

What is sensory seeking and sensory avoidance in children?

Alex’s parents watch as their child turns upside-down on the couch. When Alex gets tired, his parents often find him in an inverted state: head down, feet or bottom in the air. What many parents don’t realize is that this position sends a strong sensation to the inner ear. What’s more, many children with neurodevelopmental challenges, including ADHD and Autism, find this sensation highly soothing. 

Sensory seeking and sensory avoidance can show up across all 5 senses - sight, sound, touch, smell, and taste - as well as vestibular - the inner ear system that helps us know if we’re right side up or makes us feel dizzy after too much spinning. The behavior that children use to satisfy their sensory needs can be hilarious, sweet, inconvenient/irritating, or downright dangerous. There’s a reason that most kids like to roll down hills, snuggle when sick, and get sucked into videos with bright colors and catchy music. Everyone has sensory needs!

When is sensory seeking or avoidance a problem? 

Sensory behaviors become a concern when they start to interfere with daily life. For example, if your child’s need for sensory input gets in the way of school, friendships, or safety, it’s worth paying attention. For example, children that seek sensory input to the extreme may engage in repetitive movements that distract them and others from their surroundings, increasing learning and behavioral challenges. Sensory seeking can also lead to dangerous behavior, like darting away on a busy street, putting dirty or harmful objects in their mouth, or self-injury. Children who are high in impulsivity and sensory-seeking, like in some forms of ADHD or when Autism and ADHD combine, are especially vulnerable. 

Sensory avoidance can show up in many different ways. Aversions to certain food textures can lead to food refusal and nutritional concern. Extreme sound sensitivities can cause meltdowns at unexpected loud noises. Recent research shows that high levels of sensory seeking and avoidance are more common in youth with ADHD and/or Autism than in kids without these diagnoses.

How can parents help? 

If you suspect your child has strong sensory reactions, one way to help is to start by making some observations. Write down the behavior, the situation, and what happened before and after. This will help you see any patterns to the behavior. Also note - is this sensory-related behavior causing problems? Is it injuring my child or someone else? Is it getting in the way of the child’s social life or education? If you decide to consult with a provider, this will be important!

How can psychological assessment help? 

If you feel like a child’s sensory seeking or avoidance behaviors are creating challenges at home, in school, or other parts of their life, a psychological evaluation might offer some clarity. In this kind of assessment, we partner closely with families to explore the unique ways a child thinks, feels, and behaves. We may look at how they solve problems, communicate socially, and manage their attention and impulses. Our goal is to help you understand whether these sensory experiences are a part of a diagnosable condition, and, if so, how to best support your child moving forward.

Every child’s development is unique, and there’s a wide range of what’s considered ‘normal’ behavior. But as a parent, caregiver, or provider, you know the child in your care the best, and that gut feeling when something seems off is worth listening to. If you’re noticing sensory behaviors along with things like trouble focusing, impulsivity, or difficulty connecting with others, a psychological assessment can help shed light on what’s happening and offer guidance on the next steps.

Disclaimer: This blog is intended for informational and educational purposes only and should not be considered therapy or any form of treatment. Our psychological testing and assessment practice, based in Carmel, proudly serves clients from Indianapolis, the surrounding suburbs, and throughout Central Indiana. If you’re in the area and have questions, or would like to consult with an experienced child psychologist or discuss any specific psychological concern, please contact us!

On Being Seen: Why Collaborative Psychological Assessment Matters

In a world of rushed, surface-level interactions, being truly seen and understood is a rare commodity. It’s not just about kind gestures or validation of the parts of yourself you’re proud of, but about a genuine understanding—where someone sees all of you, warts and all. Your strengths, your compassion, but also your secrets, fears, regrets—everything—and accepts you because of it, not despite it. It’s in these moments of shared humanity that we truly feel seen, and the acceptance from another allows us to embrace ourselves more fully. 

The Need to Be Seen

From the moment we’re born, we start looking for connection. It’s not just about talking or listening—it’s about really connecting with someone. Finn talks about this as a fundamental human drive, right up there with our need to form attachments. And when you think about it, it makes perfect sense. We want to be seen and known, not just by others but by ourselves too.

This need is strikingly evident in the work of Harvard developmental psychologist Ed Tronick, who developed the ‘still face paradigm.’ In unsettling experiments, parents were coached to keep their faces completely still in front of their infant children—no smiles, no gestures, no acknowledgment at all. Almost invariably, the infants quickly became distressed, with many bursting into tears. It’s as if, without the mirroring and validation from their parents, these babies felt they’d ceased to exist, and that’s terrifying for them. This shows how deeply ingrained our need to be seen is. And while it’s easy to observe this in young children, the truth is that this need never really goes away—it just goes underground for most of us.

More Than Just a Diagnosis

Getting a diagnosis can be important. It provides a framework to understand what someone is going through and can begin to guide treatment. But most people we see in our practice are looking for something more than just a label. They want to understand themselves better, make sense of their experiences, and feel validated in their struggles.

This is where collaborative psychological assessment, the kind Finn developed, comes in. It’s not just about diagnosing someone; it’s about going on a journey together. In this process, the client is at the center. We start by exploring their questions—what they want to learn about themselves. Then, we work together to chart a path that helps them make sense of the results in the context of their life.

This collaborative approach can be transformative. It helps people build a more accurate, compassionate story about who they are, which can lead to real change. Research shows that this kind of assessment not only helps reduce symptoms but also boosts self-esteem and cuts down on shame. It’s about more than just answers; it’s about a new way of seeing oneself.

Quiet Motivations

Here’s the thing: a lot of times, people don’t even realize they’re seeking to be seen and understood. Often, there are unconscious aspects to their motivations for seeking assessment. And when they find it—when they begin to feel understood—it’s like a light bulb goes off. They’re more engaged, more open, and more motivated to dive into the process.

That’s what makes collaborative assessment so powerful. It’s not just about checking off a box with a diagnosis. It’s about meeting a fundamental human need—to be seen, to be known, and to be understood.

The Case for Comprehensive, Collaborative Psychological Assessment

We all know that insurance companies often push for quick, diagnostic-only assessments. And sure, there’s a place for that. But people are more than just a diagnosis. They’re complex, with stories and experiences that deserve to be fully understood. That’s why we’re such big advocates for comprehensive, collaborative assessment. It offers something deeper, something that goes beyond just putting a label on someone.

Because at the end of the day, the need to be seen and known is as fundamental as it gets.

And honestly, who wouldn’t want that?

So, if you’re ready to meet our team of psychologists, make the decision to call and schedule your collaborative assessment at our Carmel, Indiana-based psychological testing and assessment practice, or just want to learn more about our psychological testing services, remember that asking, 'When can I be seen?' may mean more than we initially realize.

Comprehensive ADHD Evaluation: Why Quick Screenings Might Miss the Mark

Understanding the Challenges of ADHD Diagnosis

In our Carmel, Indiana-based psychological testing and assessment practice, we often meet individuals who have been diagnosed with ADHD based on a quick checklist or a brief conversation with a provider. Despite following prescribed treatments, many find themselves still struggling, frustrated by a lack of progress. When they come to us for comprehensive ADHD testing for children, adolescents, and adults, they’re not just seeking a diagnosis—they’re seeking clarity. Unfortunately, we frequently discover that their initial diagnosis missed the mark, leading to years of unnecessary suffering that could have been avoided with a more thorough evaluation.

The Complexity of ADHD and Symptom Overlap

ADHD is commonly associated with difficulty concentrating, being easily distracted, and impulsivity. However, these symptoms aren’t unique to ADHD; they appear in a variety of psychiatric conditions. For instance, difficulty concentrating is a symptom in 17 different psychiatric diagnoses in the DSM-5-TR (Forbes et al., 2024). In fact, 36.8% of the 628 distinct psychiatric symptoms in the DSM-5-TR overlap across multiple diagnoses. This significant overlap complicates the diagnostic process and increases the risk of misdiagnosis.

What’s more, ADHD isn’t near the top of the diagnostic hierarchy for difficulties with concentration, which means that meaningful differential diagnosis requires consideration of other conditions before arriving at a diagnosis of ADHD.

Consider a child struggling to focus in school. They might have ADHD, or they could be experiencing anxiety, depression, or simply boredom due to being academically gifted. Similarly, an adult feeling overwhelmed and struggling to keep up at work might have ADHD—or they could be dealing with anxiety, depression, or another condition that shares similar symptoms.

The Limitations of Quick ADHD Screenings

Because online tools and quick symptom checklists are so widely available, many people turn to them for answers about ADHD.  While these can be a helpful starting point, they have significant limitations. Screening tools that focus solely on one condition often overlook other potential causes of similar symptoms, leading to misdiagnosis and ineffective treatments. For example, anxiety and depression can impair concentration, mimicking ADHD. If these cognitive symptoms are misattributed to ADHD, individuals may miss out on the appropriate care, such as targeted therapy or mood support, and may also receive inappropriate care or medication, potentially worsening their condition.

The Importance of Comprehensive Psychological Assessments

The question 'Do I have ADHD?' is common, but it’s only part of the picture. In collaboration with the client, an experienced clinician will work to reframe the question, exploring together why concentration and focus are challenging. By broadening the perspective in this way, we can jointly explore a wide range of diagnostic possibilities, ensuring that the treatment plan addresses the underlying issues effectively.

So, why does it matter to broaden the question beyond just 'Do I have ADHD?' Reframing the issue this way is key because if the answer is yes, we can confidently move forward with the right diagnosis and treatment plan. But if the answer is no, you’re still left struggling with concentration and productivity. Simply knowing that you don’t have ADHD isn’t likely to help you perform better at school or work. Understanding the true underlying issue—whether it’s anxiety, depression, or something else—ensures that you’re not left without a roadmap toward recovery and support. A comprehensive assessment provides a clearer understanding, guiding the development of a personalized treatment plan that gives you the best chance to overcome your challenges.

The Bottom Line

Psychiatric symptom overlap makes accurate diagnosis challenging, particularly with conditions like ADHD. A quick screening might suggest ADHD, but without a comprehensive psychological assessment, there’s a significant risk of missing the real issue. If you or someone you know is struggling with symptoms that might suggest ADHD, consider seeking a thorough evaluation. It’s the most reliable way to ensure the right diagnosis and treatment, paving the way for real progress and relief.

Learn more about our comprehensive ADHD testing services in Central Indiana.