Dr Max Buchanan

Autism Assessments for Adults in Somerset & The South West

Dr Max Buchanan

Clinical Psychologist – CPsychol, DClin.Psy, BSc(Hons), PGDipPBS, DipOpenPsych, DipCAT

Based in Somerset and practising in Taunton, I am a registered and chartered clinical psychologist with over 30 years experience of working in health and social care supporting people with diverse abilities.

I specialise in the diagnostic assessment of autism in adults, providing NICE approved diagnostic assessments (e.g. ADOS-2 and ADI-R) that consider the needs of the whole person. I also offer ADHD assessments and joint Autism and ADHD assessments where indicated.

I am a Cognitive Analytic Therapist, EMDR trained and I spent many years as a Positive Behaviour Support practitioner. I draw on my knowledge and interests in Autism, ADHD, complex trauma, embodied work (e.g. Polyvagal Theory) and Acceptance and Commitment Therapy approaches to inform my work.

Autism Diagnostic Assessments

I offer diagnostic assessments for adults with probable Autism Spectrum Disorder in Somerset and the South West. I have extensive experience of completing diagnostic assessments both in the UK and Canada (NHS and Canadian Provincial equivalent), and I also have experience in recognising the female presentation of autism which is slowly becoming better understood. I bring a strengths-based approach to diagnostic assessment and believe strongly in collaboration as essential to the process.

I recognise that choosing to engage in an Autism assessment is a big step so I ensure that time is spent building rapport and creating an environment of warmth and curiosity. This means that the sessions can be completed as comfortably and as sensitively as possible.

Autism diagnostic assessments are completed within the framework of the NICE Guidance for Autism: recognition, referral, diagnosis and management of adults on the autism spectrum (NICE CG142, 2012; last updated 2021) and the national framework to deliver improved outcomes in all-age autism assessment pathways (NHS England; 2023).

Autism Strengths Word Tree — Word tree from Russell et al, 2019. The larger the word the more people with autism reported this strength in this small study.

What People Say

Deciding to have an autism assessment is a big investment, emotionally, mentally, and physically. As a 49-year-old woman, with CPTSD (complex trauma), I wanted to understand further the difficulties that I face daily and find the motivation to move forward with my life.

Max is an awesome communicator, both online and in person. He responded to all my questions via email and a zoom call, easily and readily. I was able to book my two-half day face-to-face in-person assessment slots quickly, with an interview slot for my husband. I was very wary of the validity of online assessments.

It takes real skill to connect with a very anxious and isolated individual; that immediate rapport and instinctive trust was key to the ease of the process. I really felt safe. Throughout, Max educates you on various autistic traits, giving you a toolkit to take away. His final report is phenomenal; I will be spending months processing the assessment, his suggestions and further research.

Lastly, I found that the process has made me feel more complete. I always knew that there were big gaps in ‘me,’ that something vital was missing. I know that it is a long road ahead but, I have found the beginning of the Quirk. And to Max and his colleague, Diane, I will be forever grateful.

Q (Devon)

We have been through assessments with Dr Max Buchanan for 2 of our grown up children. This has been a process of self-exploration for our children and us as parents. The next step in our journey of understanding what lies beneath our family dynamics, as well as individual tendencies, behaviours and traits. We are SO grateful to have had this process guided by someone with such humanity, making it a much more gentle process for us all. Max ensures clarity and holds a compassionate and professional space. So grateful. Thank you.

MG (North Somerset)

Max was kind, patient and extremely helpful in providing insight into our son’s differences and difficulties when taking us through the process of an autism assessment (then ADHD Assessment). Max helped our son (who was quite anxious about attending any kind of assessment) feel at ease and relaxed. The Assessment is rigorous and detailed, but never felt imposing or stressful. We are incredibly grateful to have gone through this process and believe it’s the new starting point into our future living with an Autistic Son.

C and M (Devon)

Having already waited for a year on the NHS waiting list for my young adult son’s ADHD assessment, I decided to explore a private alternative. I found Dr Max Buchanan, who provided a remarkably relaxed and accessible process. Initially, we were asked to fill out preliminary background questions as forms, which helped set the tone for the assessment. However, there was no pressure to complete them before the assessment day. The assessment was conducted in a friendly and relaxed environment. With my son’s permission, I remained present throughout the majority of the half-day consultation. Dr Buchanan managed to elicit open and comfortable communication from both my son and me, allowing us to discuss challenging topics without inhibition. I wholeheartedly recommend Dr. Buchanan to anyone seeking to explore suspected ADHD and/or Autism.

DH (Taunton)

In December my husband learned that he was Autistic! He was 76 years old. He had a history of mental ill health which started as a teenager. He has been seen by psychiatrists and many counsellors of all persuasions. Finally, he was referred for an autism assessment.

It was an illuminating exercise for both of us. Dr Buchanan is clearly very experienced and able to explain things and keep everything very positive.

There was plenty of follow up with Dr Buchanan on our session. We had a supportive online meeting with him after Christmas. He completed a comprehensive written report, a copy of which was sent to my husband’s G.P. with his permission.

Of course, we wish this had happened when he was a lot younger but are glad and grateful to have some certainty now.

Thank you, Dr Buchanan

MR (Somerset)

Thank you Max, I really valued your time and explanations discussed in our appointments. Already it has helped me make sense of why I react as I do and have spent so much of my life feeling different to colleagues and peers.

I am so grateful for your patience and support over the past couple of months. It has been by far the best investment in myself. For the first time in decades, I feel positive about the future.

S (Burnham-on-Sea)

Availability

I offer my autism assessment services privately to address local need in a timely manner, whilst also continuing to work for the NHS.

Autism assessments are available on Saturdays and some evenings for convenience. If you would like to find out more, please contact me.

Deciding Whether an Autism Assesment is Right for You

Autism is a way of being, it is about being different not less, a variation of the ‘norm’. Autistic people experience a range of strengths and challenges in daily life.

Autism is a neurodevelopmental condition, the core challenges of which are persistent difficulties in social interaction and communication and the presence of restricted and repetitive behaviours and cognitions, resistance to change or restricted interests and sensory differences.

The way that autism is expressed in individual people differs at different stages of life, in response to life situation or stressors, and with the presence of coexisting conditions.

The diagnostic criteria for ASD (DSM-5) are focused on challenges and deficits. It is an Autism Spectrum Disorder after all so would have a significant impact on daily life for the diagnosis to be agreed.

However, it is very important to recognise that traits associated with autism may be strengths in particular contexts and settings, indeed, each of the diagnostic criteria can be positively reframed. The assessment process will therefore be balanced and include a focus on your own strengths and abilities.

Autism traits can be experienced as either advantageous or disadvantageous dependent upon context. It may not be helpful to try to separate autism strengths from autism weaknesses as there is no boundary between them i.e. hypersensitivity can be an advantage in experiencing art or nature but problematic in some social contexts.

Examples of characteristics from clinical conversations include:

Ability to hyperfocus (“zooming in”, “unwavering focus”, “tenacious”)
Attention to Detail (“spotting things others miss”)
Good or exceptional memory (particularly related to areas of special interest)
Creativity
More accepting of difference in others than “neurotypical” people
Conversation flowing when discussing topic of interest
Ability to quickly ‘read’ the atmosphere in a room
Non-conformist, thinking beyond limits – not restricted to socially constructed ideas as to what is possible
Compassionate
Empathetic
Strong sense of justice

Perseverant
Open, fair, loyal
Dedication to a particular area of interest – deep study – above and beyond
Sensory engagement and interaction with the world
Logical decision making where emotions may interfere
Feeling connected and safe when social engagement comes without threat
Willingness to practice and perfect
Interested primarily in significant contributions to conversation
Seeking sincere, positive, genuine friends
Fascination with word-based humour, such as puns
Conversation free of hidden meaning or agenda

Reference: Russell, G., Kapp, S. K., Elliott, D., Elphick, C., Gwernan-Jones, R., & Owens, C. (2019). Mapping the Autistic Advantage from the Accounts of Adults Diagnosed with Autism: A Qualitative Study. Autism in Adulthood, 1(2), 124-133.

There are a number of ways that can happen. You may have recognised possible autism yourself from discussions with important others or may have come across examples of lived experience of autism via cultural means such as film, books, TV, radio or social media and wondered about your own traits. You may notice traits from the information you have read on this page.

There are screening tools that might help with your understanding. Though simplistic, and not a substitute for full assessment, they can be helpful as one aspect of fact finding. One example is given below:

Adult Autism Screening Questions (AQ-10)

If you are thinking about taking part in a ASD diagnostic assessment, it can be helpful to consider the extent to which you agree with the following 10 statements below.

1) I notice small sounds when others do not

2) I concentrate more on the small details, rather than the whole picture

3) I find it difficult to do more than one thing at once

4) If there is an interruption, I can’t switch back to what I was doing very quickly

5) I find it difficult to ‘read between the lines’ when someone is talking to me

6) I don’t know how to tell if someone listening to me is getting bored

7) When I’m reading a story I find it difficult to work out the characters’ intentions

8) I like to collect information about categories of things (e.g. types of car, types of bird, types of train, types of plant, etc.)

9) I find it difficult to work out what someone is thinking or feeling just by looking at their face

10) I find it difficult to work out people’s intentions

Scoring: Score 1 point for each item you agreed with. If you agreed with 6 or more of the above statements, research suggests that you might consider being referred for a diagnostic assessment, particularly if you have had these experiences since childhood.

This test is recommended in ‘Autism: recognition, referral, diagnosis and management of adults on the autism spectrum’ (NICE clinical guideline CG142). www.nice.org.uk/CG142.

Key reference: Allison C, Auyeung B, and Baron-Cohen S, (2012) Journal of the American Academy of Child and Adolescent Psychiatry 51(2):202-12.

Of course, this screen is limited 10 questions and is indicative only.

The ASD Diagnostic Assessment typically comprises of:

Clinical interview with referred person (approx. 2-3 hours; face-to-face whenever possible). Covering topics relating to your background history and development and then becoming ASD specific relating to the quality of your social functioning, social communication, interests, routines, repetitive behaviour, and sensory differences across the course of your life.
A neurodevelopmental history assessment (approx. 1-2 hours) completed with you and, where possible, with someone who knew you well when you were a child. This includes gathering information related to developmental milestones, learning and education, past and present history of concerns, previous assessment and reports, prenatal and perinatal history, medical and psychiatric history, family history of mental health and developmental disorders, psychosocial stressors and significant life events.
Developmental History Interview (approx.1.5 – 3 hours typically via video call or telephone). This is with someone who knows you. An extensive interview covering your early development, play and schooling, as well as differences in social interaction and communication, and restricted and repetitive patterns of behaviour and interests associated with the autism spectrum. Ideally this is completed with someone who knew you well when you were a child because signs of autism should be observable in early development. I recognise that not all adults have someone they can contact from their early years so in these situations I would instead hope to speak to someone who knows you well more recently and would also ensure you are asked detailed questions about your own development.
Clinical Observation (approx. 2 hours face-to-face). A semi-structured, standardised assessment of communication, social interaction, imaginative use of materials, and restricted and repetitive behaviours for individuals referred because of possible Autism Spectrum Disorder (ASD). This includes some gentle tabletop activities and conversations and may be observed by an additional trained clinician, either in person, by video link or recording.
Supplementary assessment and materials as necessary or beneficial to the completion of assessment. Sometimes further screening or assessment tools are indicated as part of the overall assessment. I understand that ASD and ADHD can go hand in hand so I can screen or assess for ADHD concurrently if indicated and requested. This would only be completed with your permission. Written reports such as school reports or other assessment reports can also be helpful to the process.
Feedback & written report explaining the outcome and reasons for meeting or not meeting ASD diagnostic criteria. The report also contains recommendations.

I use DSM-5 (diagnostic and Statistical manual – 5th Edition) criteria when carrying out an Autism assessment. It can be helpful to look at these criteria to see if you recognise traits:

DSM-5 DIAGNOSTIC CRITERIA Autism Spectrum Disorder 299.00 (F84.0)

A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text):

Deficits in social-emotional reciprocity, ranging, for example, from abnormal social approach and failure of normal back-and-forth conversation; to reduced sharing of interests, emotions, or affect; to failure to initiate or respond to social interactions.
Deficits in nonverbal communicative behaviors used for social interaction, ranging, for example, from poorly integrated verbal and nonverbal communication; to abnormalities in eye contact and body language or deficits in understanding and use of gestures; to a total lack of facial expressions and nonverbal communication.
Deficits in developing, maintaining, and understanding relationships, ranging, for example, from difficulties adjusting behavior to suit various social contexts; to difficulties in sharing imaginative play or in making friends; to absence of interest in peers.

B. Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text):

Stereotyped or repetitive motor movements, use of objects, or speech (e.g., simple motor stereotypies, lining up toys or flipping objects, echolalia, idiosyncratic phrases).
Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior (e.g., extreme distress at small changes, difficulties with transitions, rigid thinking patterns, greeting rituals, need to take same route or eat food every day).
Highly restricted, fixated interests that are abnormal in intensity or focus (e.g., strong attachment to or preoccupation with unusual objects, excessively circumscribed or perseverative interest).
Hyper or hypo reactivity to sensory input or unusual interests in sensory aspects of the environment (e.g. apparent indifference to pain/temperature, adverse response to specific sounds or textures, excessive smelling or touching of objects, visual fascination with lights or movement).

C. Symptoms must be present in the early developmental period (but may not become fully manifest until social demands exceed limited capacities, or may be masked by learned strategies in later life).

D. Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning. (Note: Although there is no common measure for ‘clinically significant functional impairment’, it typically applies to pervasive/disabling difficulties within areas such as work, housing/home management, relationships, education, self-care, and employment).

E. These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. Intellectual disability and autism spectrum disorder frequently co-occur; to make comorbid diagnoses of autism spectrum disorder and intellectual disability, social communication should be below that expected for general developmental level.

Autism Assessments for Adults in Somerset & The South West

Dr Max Buchanan