CARES: The Framework That Bridges Neurodiversity Philosophy and Assessment Practice

The neurodiversity movement has reshaped how clinicians think about autism and ADHD. The philosophy is clear: neurological differences are human variation, not pathology. But philosophy does not conduct assessments. And the gap between "we should not pathologize" and "how do I actually write this report" has left many psychologists in an uncomfortable middle ground — sympathetic to the paradigm but unsure how to operationalize it.

The Problem CARES Addresses

Traditional psychoeducational and neuropsychological assessments are built on a deficit model. You test. You find what falls below the norm. You document deviations. The report lists what the person cannot do. For decades, this served its purpose — it opened doors to services, accommodations, disability benefits. But it also produced a consistent side effect: clients left the assessment feeling reduced to their lowest scores.

The neurodiversity-affirming movement challenged this. Autistic self-advocates and allied clinicians argued that assessments should recognize strengths, center the person's experience, and avoid framing neurological differences as inherently disordered. The problem was that this remained largely philosophical. Clinicians who agreed with the principle still opened their test kits the same way, still wrote reports the same way, and still framed findings the same way.

Woods, Brook, and Angoff — working from the University of Washington Autism Center — built CARES to close this operational gap. It is not a new battery of tests. It is a framework for how to conduct and communicate any assessment in a way that is consistent with neurodiversity principles.

Five Components, One Shift

The acronym maps the territory. Collaborative Understanding means the client (or their family) is a partner in the assessment process — not a passive subject. Goals, concerns, and questions are defined together before testing begins. Accessibility requires that the assessment environment, materials, and communication are adapted to the individual — sensory accommodations, breaks, plain language, flexible scheduling. Recognizing Intersectionality demands that the assessor consider how race, culture, gender, socioeconomic status, and other identities interact with the neurotype being assessed. Empowerment ensures the process itself is therapeutic — the person should leave the assessment understanding themselves better, not just labeled. Strengths Recognition rebalances the report: what works, not only what does not.

The integration with Therapeutic Assessment is deliberate. Stephen Finn's model — where the assessment itself is designed to produce psychological change in the client — aligns naturally with the CARES philosophy. The difference is that CARES explicitly embeds neurodiversity principles into that therapeutic frame.

What This Means in Practice

For psychologists conducting evaluations: CARES does not ask you to stop testing. It does not ask you to ignore deficits. It asks you to restructure the process so that the person being assessed is an active participant, the environment does not itself create barriers, and the final report presents a full picture — not just a deficit profile.

This is particularly relevant as adult autism and ADHD referrals surge. Many adults seeking late diagnosis have spent years masking. A deficit-focused assessment may miss them entirely because their compensatory strategies are too effective. A CARES-informed approach — starting with collaborative goal-setting, recognizing intersecting identities, and actively looking for strengths alongside challenges — is more likely to capture the full clinical picture.

If you assess neurodivergent clients and your reports still lead with what is "below average," CARES offers a structured alternative that preserves diagnostic utility while respecting the person in front of you.