Our Submission on the Future of Employment Services

Getting an adult assessment for autism or ADHD in Australia commonly costs somewhere between $800 and more than $4,000 out of pocket. Public pathways for adults are limited.

So if support depends on producing a diagnosis, a lot of people simply won’t be able to reach it — and they’ll tend to be the people whose difficulties are least recognised in the first place. Many adults with AuDHD are diagnosed late, identified with one condition but not the other, or told for years that what they have is anxiety or depression.

That’s the heart of what we asked for in our submission, lodged on 30 July in response to the Department of Employment and Workplace Relations’ Shaping the future of employment services Discussion Paper: assess function, not only diagnosis.

An assessment should be able to record a functional barrier on the basis of the person’s own account of it. Not instead of clinical evidence where it exists — just not conditional on it.

What “function” means in practice

This is more concrete than it sounds. Terms like “executive function” and “organisational difficulties” tend to produce under-reporting, because people either don’t recognise the language or read the difficulty as a personal failing rather than something worth mentioning.

Plainer questions get much better information:

• Do you have difficulty starting tasks, even ones that matter to you?

• Do you lose track of time?

• Is it hard to switch between activities?

• Do you need instructions in writing?

• Are open-ended tasks with no obvious first step difficult?

None of these requires a diagnosis to answer. All of them tell you something useful about what kind of support would actually help.

And one more question

We also asked that the assessment ask about reliability, not just capability.

Standard assessment logic establishes whether a person can do something. For people with AuDHD, the more useful question is whether they can do it consistently. Capacity is genuinely variable — the same person can be highly capable in one area and significantly impaired in another, and their capability in a given area can shift week to week.

So we suggested adding questions like: are there tasks you can do easily on some days and not at all on others? And is there a gap between what people expect of you based on your qualifications and what you can consistently deliver?

This matters for scoring, too. Numerical instruments compress fluctuating capacity into a single point estimate, and they tend to resolve it towards a person’s best day. We’ve suggested scored tools inform stream allocation rather than determine it, so an assessor can record variability that a score can’t hold.

Why now

The Department has committed $27.5 million over four years to develop and trial a new assessment and triaging process, and has said it will apply across the whole employment services system. Which means these tools are being designed right now — and changes at the design stage cost far less than changes later.

Where we’re coming from

We’re a small organisation and a new one. We don’t deliver employment services, hold provider contracts or receive program funding, so we have nothing to gain commercially from this reform. We said in the submission that we can’t offer longitudinal data, because we don’t have any yet.

What we can offer is a clear account of how this group meets the system. So we offered the Department five practical contributions — including developing a working set of assessment prompts with our members, and running a national AuDHD workforce survey with a question set aligned to departmental and ABS instruments.

We’d rather be useful than represented. If any of it is taken up, we’ll let you know.

Read the full submission: AuDHD Council Submission: Shaping the future of employment services [PDF, 11 pages] — published in full, as lodged.

Work like this is what the Council exists to do, and it isn’t funded by government or by providers. Membership is what makes it possible.

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