Types of Clinical Assessment Tools

Psychometric Instruments

What they are: Standardized tools with fixed items that produce numerical scores

• Examples: ADOS-2, CAARS, Beck Depression Inventory, PHQ-9
• Characteristics: Fixed scoring protocols, established norms, statistical reliability/validity data
• Evaluation criteria: Require validation studies, norming samples, peer-reviewed research
• Purpose: Provide standardized scores for comparison to population norms 

Structured Clinical Interviews

What they are: Systematic clinical methods for exploring diagnostic criteria

• Examples: SCID (Structured Clinical Interview for DSM), Cherry AADI, clinical mental status exams
• Characteristics: Framework-based, flexible clinical exploration, qualitative data gathering
• Evaluation criteria: Based on diagnostic criteria adherence and clinical utility
• Purpose: Support clinical judgment and diagnostic decision-making

Assessment Batteries

What they are: Collections of multiple instruments used together

• Examples: Neuropsychological test batteries, comprehensive ADHD evaluation batteries
• Characteristics: Multiple tools administered as a coordinated package
• Evaluation criteria: Combination of individual instrument properties plus clinical utility

Assessment Protocols

What they are: Comprehensive frameworks that may include multiple tools plus clinical processes

• Examples: Hospital intake protocols, comprehensive diagnostic protocols
• Characteristics: Broad clinical procedures incorporating tools, interviews, observations, records review
• Evaluation criteria: Clinical outcomes, practical utility, professional standards compliance

Cherry Adult ADHD-Autism Diagnostic Interview (Cherry AADI)

The Cherry Adult ADHD-Autism Diagnostic Interview (Cherry AADI) is a comprehensive, ICD-11 compliant clinical assessment methodology specifically designed for identifying ADHD, autism, and co-occurring presentations (AuDHD) in adults. Developed by Lindley Cherry, LCMHC, QS, NCC, this innovative structured clinical interview addresses critical gaps in traditional assessment approaches while providing legally compliant, culturally responsive neurodivergent evaluation.

Why Cherry AADI Exists:

Adults seeking neurodivergent assessment need accurate, affirming diagnoses that lead to meaningful accommodation and self-understanding. Traditional tools often fail because they were designed for children, based on white cis-male presentations, and don't account for decades of masking and adaptation. The Cherry AADI was built specifically to bridge this gap.

If traditional assessment tools are like using a roadmap designed for children to navigate an adult's complex life journey, the Cherry AADI is like having a GPS that accounts for all the detours, alternate routes, and unique destinations that adults have developed over decades of experience.

The Cherry AADI is a structured clinical interview - the gold standard of mental health diagnosis. Like the Diagnostic Interview for Adults with Verbal Fluency within the widely respected MIGDAS-2 (Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition), it provides systematic exploration of diagnostic criteria through skilled clinical conversation rather than relying solely on standardized scores.

Assessment Duration: 180 minutes of comprehensive interview plus 30-minute follow-up session, demonstrating the thorough nature of evaluation.

Clinical Rigor: Includes systematic data gathering, differential diagnosis protocols, and comprehensive documentation that meets professional standards for accommodation requests and medical treatment.

Innovative Assessment Components:

Core Diagnostic Areas:

• ADHD Assessment: Attention regulation patterns, hyperactivity-impulsivity presentations, and executive function variations
• Autism Assessment: Social communication differences, behavioral patterns, sensory processing, and special interests
• AuDHD Recognition: Assessment of co-occurring presentations (research shows 50-70% overlap)

Advanced Clinical Components:

• Masking and Camouflaging Assessment: Based on L. Hull, et al.'s research and CAT-Q concepts, addressing how social performance obscures underlying traits
• Pathological Demand Avoidance (PDA) Evaluation: Recognition of autonomy needs and demand responses within autism spectrum
• Late Identification Factors: Gender, sex, cultural, and environmental influences on delayed recognition
• Strengths and Environmental Optimization: Focus on individual neurological profile and support needs

Addressing Common Misconceptions

❌ "All assessment tools need validation studies"

• ✅ Reality: Only psychometric instruments require formal validation studies. Clinical interviews are validated through their adherence to established diagnostic criteria (such as the ICD and DSM) and clinical outcomes.

❌ "Clinical tools need to be peer-reviewed"

• ✅ Reality: Peer review applies to research publications, not clinical practice tools. Clinical methods are evaluated through professional standards and outcomes.

❌ "Assessment methods need to be 'normed'"

• ✅ Reality: Only scored instruments need population norms. Clinical interviews gather qualitative information for clinical judgment, not numerical comparison.

❌ "Newer tools are less legitimate than 'established' ones"

• ✅ Reality: Clinical innovation is essential for addressing gaps in current practice. Many "gold standard" tools started as clinical innovations.

"How does it compare to standardized tests?"

• Clinical interviews and standardized tests serve different purposes. Interviews allow for individualized, culturally responsive assessment that standardized instruments cannot provide.

“Shouldn’t it be based on the DSM because that’s what we use?”

• The DSM, developed by the American Psychiatric Association and on its 5^th edition-revised (DSM-5-TR, is primarily based in the United States but was originally created based on the ICD. The ICD, developed by the World Health Organization, is used by 194 countries worldwide and is on its 11^th edition. While ADHD and autism are recognized in both frameworks, with very similar diagnostic features, ICD-11 allows for more nuanced clinical judgment, which is ideal for complex adult presentations. It covers the same conditions as the DSM with equivalent accuracy but provides better flexibility for adult presentations. It's like choosing the GPS system that works everywhere in the world instead of just one country.

Evidence-based practice in clinical assessment includes:

• Using established diagnostic criteria (e.g., DSM-5-TR, ICD-11)
• Applying systematic clinical methods
• Incorporating clinical expertise and judgment
• Considering client values and cultural context
• Demonstrating positive clinical outcomes

Evidence-based practice does NOT require:

• Every clinical method to have research validation studies
• All tools to be decades old before being considered legitimate
• Abandoning clinical judgment in favor of only scored instruments

The Cherry Adult ADHD-Autism Diagnostic Interview exemplifies appropriate clinical tool development:

• Foundation: Built on ICD-11 diagnostic criteria and current research on adult presentations
• Method: Structured clinical interview with flexibility for individual presentations
  Integration: Can incorporate psychometric tools (like ASRS-O and CAT-Q) when clinically indicated, but is not required
• Validation: Demonstrated through clinical outcomes and professional acceptance
• Innovation: Addresses specific gaps in adult neurodivergent assessment

Scope of Practice Clarity

Licensed Mental Health Clinicians (LCMHCs, LCSWs, LPCs, LMFTs, psychologists, psychiatrists) within most U.S. states are fully qualified to diagnose ADHD and autism within their scope of practice. The misconception that only psychologists can provide these assessments has been definitively addressed through professional standards and regulatory review.

Remember: Licensed mental health clinicians are trained and qualified to:

• Conduct clinical interviews
• Apply diagnostic criteria
• Use clinical judgment in assessment
• Innovate within their scope of practice
• Develop clinical methods that serve their clients

The goal is not to use the oldest or most researched tools, but to use the most appropriate and effective methods for each individual client and clinical situation.

Evidence-Based Method: The Cherry AADI represents established clinical practice combining:

• ICD-11 diagnostic criteria (internationally recognized)
• Structured clinical interview techniques (gold standard approach)
• Differential diagnosis protocols (essential for accuracy)
• Cultural competency frameworks (preventing bias and misdiagnosis)
• Adult-specific assessment considerations (addressing developmental masking)

For Clinicians: The Cherry AADI offers a comprehensive, evidence-based method that enhances your ability to serve adult neurodivergent clients while maintaining full professional compliance.

For Clients: This assessment provides the thorough, affirming evaluation needed to understand your neurological profile and access appropriate accommodations and supports.

The legitimacy of any diagnostic assessment lies not solely in its name recognition, but in its adherence to professional standards, regulatory approval, clinical rigor, and demonstrated outcomes - all of which the Cherry AADI consistently demonstrates.