Earlier this week, I posted about why I sought an assessment for dyspraxia as an adult. Following on from that, this post covers my experience of the assessment process via my university. I’ll also share some tips that helped or would have helped me during the process – some will be aimed at people seeking diagnosis, others will be more relevant to professionals involved in making that diagnosis.
Sounds good. So what were the first steps you took towards getting a diagnosis?
The first thing for me was learning more about dyspraxia. I worry a lot about taking up time or resources unnecessarily, so if I was going to ask for an assessment, I wanted to be reasonably confident that I really needed it. I read a lot from the Dyspraxia Foundation website and the NHS website, among others.
I also watched lots of YouTube videos about what dyspraxia is and what it’s like to be dyspraxic. The Diverse Learners videos about things like eating, brushing your teeth and kitchen gadgets were really helpful in normalising the things that I struggled with as something that other people with dyspraxia also struggled with, which helped me feel more validated in seeking an assessment. I also found videos by the Two Dyspraxics helpful, they are a bit longer and I sometimes found it hard to concentrate but they were interesting.
But probably the biggest thing which helped me to feel more confident to seek an assessment was downloading and completing the Adult DCD Checklist. It was incredibly validating to have my score and to know that I was scoring in the ‘probable DCD’ range. It really helped me to challenge my fear that what I thought was dyspraxia was actually just normal and helped me to re-frame my thoughts from “What if I’m actually just lazy or bad at coping with things I don’t actually find any harder than anyone else?” to “What if I actually do find these things harder than other people and I’m being unfairly hard on myself by beating myself up over that?”
That’s a lot of research! What next?
Well, now I was sure I wanted to get assessed. As I mentioned in my last blog, this is no mean feat as an adult! But fortunately my university was – 2 years after I first enquired about it! – now able to facilitate an assessment. I sent an e-mail to my university Neurodiversity Support Team explaining that I suspected I was dyspraxic, included a copy of my completed DCD checklist to support this, and asked about the process for assessment.
Within a couple of days, I had been sent a form to sign to confirm that I was a UK student (so I’m not sure if international students can get a funded assessment through their universities). I also had to confirm that I’d had an eye test within the past 2 years and agree to wear my glasses during any assessment appointments. Once I e-mailed that back, I was quickly contacted to book a screening appointment.
A screening appointment? What’s that?
The assessment is quite long so I was asked to go to a 30-minute appointment first to check if I have any signs which might indicate that a full assessment would be beneficial.
What happened during your screening appointment?
I had to fill out a couple of questionnaires, including re-completing the DCD checklist. There was a brief spelling and mental arithmetic task, and the tutor also looked at my handwriting. They assessed my working memory (working memory is about information you need to remember temporarily in order to complete the current task or tasks) by asking me to listen to and repeat back sequences of letters, then sequences of numbers. There was a task to copy some shapes, sometimes also being asked to alter them (for example, by drawing the mirror image rather than just copying the shape). And I was asked some questions about why I thought I might be dyspraxic.
At the end of the appointment, the tutor said I was scoring largley normally on the tests and that there was no indication of dyslexia, so she wouldn’t normally recommend any further assessment, but that on this ocassion she’d make an exception because of my DCD Checklist score.
How did you feel about the appointment?
Truthfully, I was a little disapointed. It was all quite fast-paced and it was obvious that it was essentially a screening for dyslexia with a couple of add-ons because of what I’d said about dyspraxia. I had also hoped that my process would be considered as well as outcome – for example, I found drawing a mirror image very challenging, and could only do it by tracing each individual line of the original backwards, then doing the same action in the space where I was supposed to put the mirror image, but this was not considered. Or maybe that’s normal? I don’t know. There also wasn’t any consideration of whether I was using strategies to compensate for difficulties (eg on the working memory tasks, I pictured the letters/numbers, and as the sequences got longer also found myself moving my hands as if writing the sequences down, to try to remember them).
I don’t know if this is something most people would have been disappointed by? As part of my course, I’d just completed training in assessing things like working memory, so perhaps having just learned about the importance of asking about strategies and process made me more sensitive to that!
But, since the outcome was that I would be offered an assessment for dyspraxia, I set aside my disappointment and hoped that the full assessment would be better.
What happened after the end of the screening appointment?
I was sent a brief email confirming that I’d be contacted shortly to arrange an assessment. About a month later, I was offered an assessment appointment. It was another few weeks before the assessment appointment, but the appointment would be at my university and with a specialist tutor who had completed a qualification specifically in assessing for dyspraxia (and was also separately qualified to assess for dyslexia). I was told it would take approximately 3 hours, with the opportunity for a break.
How did you feel at the time?
I was quite nervous, but reassured that the assessor was at least qualified to assess for dyspraxia. Truthfully, I was so busy that I did my best to put it out of my head until a couple of days before the assessment!
Did you do anything else to prepare?
I didn’t plan to. I got a bit anxious again that I was making a fuss about things that are just normal, especially given what had been said at my screening appointment, and I compensated for that by reminding myself of my DCD checklist score and going back over the questions to reassure myself I’d answered fairly and honestly, but that was mostly to manage my anxiety.
One thing I did that was actually helpful was to dig out my old school reports. Seeing teachers commenting that my coordination was bad, all the way back to primary school, was useful. Their comments also reminded me of things I’d forgotten – like how often I mislaid belongings!
What happened on the day of your assessment?
My assessment was in the afternoon, but I headed to uni a bit early to make sure I was there in good time. My assessor met me and took me through to the room where we would be having the assessment. She gave a brief overview of the agenda for the afternoon – which I promptly forgot – and encouraged me to ask for breaks if I needed any in addition to the break we’d take about halfway through. I was given a selection of pens and pencils which I could use if I wanted during the tasks.
I was asked some questions about my childhood, my medical history, whether anyone in my family had any learning difficulties, my education and work history and my hobbies. I was asked about why I suspected dyspraxia and the assessor picked up on things in my answers to ask more in-depth questions. Sometimes she made assumptions about what I meant – for example, when I talked about being tired at school, she made a note of this, but it wasn’t until I would get my report a few weeks later that I learn she’d thought I meant mentally tired, when I’d meant physically tired.
Then I was screened for visual stress by completing a short questionnaire about things like glare from paper/computer screens, andwords/letters being blurry or seeming to move on the page. This indicated I might experience visual stress, so I was helped to try out some coloured overlays to see if any helped and to choose one to use during the rest of the assessment.
Then there were some cognitive tests, assessing things like working memory (now with an additional test involving recalling and imitating sequences of shapes with one hand, such as making a fist or holding you hand flat, palm down), verbal ability and visuo-spatial awareness. The tasks included things like giving definitions for words, or combining combinations of diamond-shaped counters to recreate a given shape. My assessor noticed some things I had not even considered – for example, she commented that I seemed to find it difficult to line up the counters against each other, which was so normal to me that it hadn’t even registered! And unlike in my screening assessment, I was asked about strategies and process. My assessor explained that even though I was just hitting the average range for working memory, the number of strategies I was using to do so suggested I was working hard to compensate for what was likely to actually be a poor working memory.
There was a spelling test and some tests that I associate more with dyslexia than dyspraxia – such as a test of phonological awareness (as I understand it, this is to do with identifying and processing the different sounds that make up language). This involved listening to separated sounds (eg mm, oh, st) and identifying the word that they form (in this case, most).
I was asked to read a passage aloud and then answer some questions about it, and then given a longer passage to read silently before answering multiple-choice questions about the information I’d just read. There was also a rapid-word naming test, which involved reading a list of words as quickly as possible. I think these were intended as assessments for signs of dyslexia, but suspect my performance at least partly reflected dyspraxic-type difficulties – for example, I couldn’t remember much of the passage I’d read aloud because I’d been focused on forming the shapes of the words clearly and pacing my breaths so that I didn’t run out of breath mid-word. I remember thinking it was quite an interesting passage, so it must have made sense to me, but afterwards I could remember almost nothing about it!
There was a break in there at some point, so if you’re thinking it’s a lot of tests – it is, but most were quite short and when I asked for a break a little early, it was happily given.
I was also asked to do some physical tasks – jumping as high as I could on the spot, for example, and walking forwards and backwards in different ways (such as on tiptoes). I was quite anxious about doing this as there were some plastic boxes with things like large Lego-type bricks in them behind me, and I think my assessor was scared I’d fall over them at one point as she shouted ‘stop, stop, stop!’ but I did the exercises as best I could (which is to say, generally quite poorly!).
Finally, there was a 15-minute writing task where I was asked to write as much as I could in the time about my thesis question.
Then I was free! I was really happy the assessment was over as I was pretty tired by that point, but it had been an interesting experience and there were a few times my assessor pointed out things I hadn’t been aware were unusual, such as how tightly I gripped my pen. I was told I’d be contacted within a week or two to arrange a follow-up appointment to discuss the outcome of the assessment.
It was, but also kind of enjoyable. Although lots of the tasks were challenging, I found some really easy, so it also reminded me of my strengths.
So what happened after your assessment?
As they’d said, I was contacted a couple of weeks later to book a follow-up. This should have been with the person who did my assessment, but unfortunately I couldn’t get any more time off placement to attend during my assessor’s working hours. It was therefore arranged with another member of the team.
What happened at the follow-up?
I was given a copy of my assessment report and the ‘key themes’ were explained – I was told that I had been diagnosed with both dyspraxia and dyslexia, and was also advised to seek an assessment for visual stress (unfortunately, that’s another one where you have to pay privately for an assessment). I was also told that my verbal and spelling abilities were excellent, so that was nice! Since there aren’t spelling tests after school, I’d pretty much forgotten I was good at spelling.
There wasn’t time to go through the report in detail, but there was a limited amount of support offered for how I felt emotionally in terms of asking how I felt about it. Most of the follow up was really focused on telling me the routine adjustments the university makes (extra time in centrally-booked exams, of which I had no more to sit; longer loans on library books so long as no-one else has requested that book; and a yellow sticker for lenient marking of spelling and grammar on written work except for my thesis (all of which I had already submitted, by that point! It also seemed odd to effectively say ‘your spelling is great but we’ll take into account that it might not be when marking assignments!’). I was told allowances aren’t made for my thesis as it’s expected that by that point I am able to write to a professional and academic standard (I am still not sure what I make of that).
And then I was on my way, with a copy of my report and a list of recommended reading!
What was helpful about the assessment process, for you?
I liked that the communication from the neurodiversity team was very clear about process and timescales, and the waiting times were shorter than I had expected. I really appreciated that my assessor shared their observations about how I completed tasks as it was quite validating to hear that and also helped me feel less embarrassed.
What was less helpful about the assessment process?
It was unfortunate my follow-up couldn’t be with my assessor, and perhaps if I’d pushed my uni/placement may have permitted me to make up the time later, but I didn’t want to wait the extra time it would take to arrange that before finding out the outcome!
I was really disappointed how much the whole process focused on dyslexia (and really shocked to be told I’d been diagnosed with dyslexia after almost being refused an assessment because the dyslexia screening did not indicate dyslexia, but that’s another story). Thinking back on the assessment, I wish I had shared that the reading out loud tasks were affected by thinking about articulation and pacing my breathing, or asked how performance on those tasks is combined with performance on other tasks to separate out dyslexic and dyspraxic difficulties – but that might be my professional hat speaking!
I also wonder if such a long assessment is helpful – although mine overran, so that probably didn’t help either! In retrospect, although the assessment was long and tiring, I do think that’s preferable over splitting the assessment into two, shorter sessions – at least I didn’t have to make time for it on multiple days, or factor in the additional travel time and cost that more sessions would have involved!
And of course, I wish I’d been able to access an assessment earlier in my course, before I’d submitted everything except my final placement sign-off and my thesis!
Do you have any tips for someone approaching an assessment?
- Spend some time pulling together a list of the reasons you think you are dyspraxic.
- If you still have them, look through school reports or feedback on previous work – I was surprised how much additional evidence I found! Sometimes you may also be asked to bring copies to your assessment if you can.
- Spend some time identifying what strategies you use to compensate for difficulties – I found this a challenge as I’m so used to some of my strategies that I’ve forgotten how much I struggle without them!
- Ask for breaks during the assessment if you need them.
- Ask the assessor if they want you to use your coping strategies during the assessment. Whether they say yes or no, it will almost certainly prompt a discussion about your coping strategies!
- Remember that your assessor has likely seen lots of people perform these tasks; even if you are struggling, they will be used to people finding these tasks challenging.
- Remeber that you have strengths as well as difficulties and that the assessment will highlight these, too.
- If there’s anything you’re unsure of, ask.
What about for professionals who are doing these assessments? Any tips?
- Check that the environment is comfortable. What my assessor thought was a quiet and brightly-lit room was overly warm to me, and the desk was too high. Opening a window or fetching a higher chair were relatively easy and helpful adjustments.
- If you are more used to assessing one condition than another, consider whether this impacts on how you interpret the tests or other information. Are you used to listening for signs of dyslexia? If so, is there a risk you might interpret some information as indicating dyslexia that could also indicate something else? What additional questions or information might help counteract this?
- Ask if there is anything the person thinks is important for you to know about how they approached or achieved a task. You may get extra information that helps you understand the person’s process or difficulties, and even if you don’t, it will help the person to feel understood/considered as an individual and not just as a series of difficulties.
- Remember that a good assessment experience can be the first time anyone has tried to understand our experiences, and as such has a lot of value to us in its own right, separate from the outcome.
Are you glad you got assessed?
Yes, definitely. It hasn’t always been easy and being diagnosed has not been wholly positive, but I am still glad and the benefits have far outweighed the negatives. I’ll be talking more about the impact getting my diagnosis has had for me in another post later this week.
I think I or my child might be dyspraxic, how can I arrange an assessment?
- Contact your GP (be aware that the extent to which people have found their GP helpful has varied greatly)
- If you are at university, contact your Student Support service, ask your personal tutor or contact your university Disability Team or Neurodiversity Team
- If you are employed, consider whether you would want to ask your employer or union for support/advice
- Contact the Dyspraxia Foundation Helpline.
- Start gathering supporting evidence – for example, this questionnaire is a screener questionnaire for possible dyspraxia.
I hope this post has helped to answer any questions you have about diagnosis. The process is likely to look different depending on what professionals you see – an Occupational Therapist may do a very different assessment, for example – so please do bear in mind that this is only my experience of getting a diagnosis through my university.
For more information about getting a diagnosis, you can contact the Dyspraxia Foundation or contact your GP.