My name is Andy Utley, and I run my own business, Utley Allied Health, alongside my lovely and talented wife. Together, we provide comprehensive assessment and support to children and families at all stages of life. My background is in occupational therapy, and I am now an endorsed educational developmental psychologist. I work closely with psychiatrists specializing in ADHD, and many of my adult clients are referred to me for diagnostic assessments before medication is prescribed. I primarily use MOXO for diagnosing ADHD in adults, as most of the psychiatrists I collaborate with focus on adult patients.
How Utley Allied Health Started
Our journey into attentional assessments began through close relationships with specific psychiatrists who were seeking diagnostic assessments for their patients. This led to a natural progression into ADHD assessments.
In Australia, ADHD is often underdiagnosed, and psychiatrists are typically conservative in prescribing ADHD medication, often requiring corroborating evidence from another health professional before doing so. Since the COVID-19 lockdowns, more people have been coming forward complaining about ADHD symptoms. Being that there are strict regulations around medications, and psychiatrists feel more confident when they receive confirmation from another health professional, which is where I come in. MOXO has been a tremendously helpful tool in confirming the presence of ADHD symptoms, supporting the diagnostic process.
Most of the clients who come for an ADHD diagnosis are seeking a prescription for stimulant medication, which I don’t provide as a psychologist. Instead, I engage with them in cognitive behavioral realms, using various tools and skills to help them manage ADHD symptoms and their behavioral impacts. Generally, medication is seen as the first-line treatment, while other approaches are considered secondary.
Discovering MOXO
I first discovered MOXO in 2021 while subcontracting with NeuroCentrix. The Director of Psychology, Celia, was the first to identify it and mentioned it to me and a few other colleagues. She introduced it as a tool that objectively measures attentional difficulties, aiming to improve the ADHD assessment process.
Prior to discovering MOXO, our ADHD assessments were quite subjective, lacking the objectivity that MOXO provides. Celia encouraged us to try it, and after completing the basic training, I subscribed to the platform. What really appealed to me was the objectivity of the tool – it removes the influence of personal opinions, whether mine or the client’s, and provides a clear measurement of a person’s ability to hold focused attention over an extended period of time. This objective data has greatly enhanced the way I conduct ADHD assessments.
Streamlined Diagnosis
I definitely feel that MOXO has made the ADHD diagnosis process more accurate. It provides objective data, which I value, as it takes away the subjectivity from the assessment.
In Australia, there are no regulations requiring cognitive tests to be performed during ADHD assessments. As a result, most psychologists diagnose ADHD based on the client’s self-reported information, and sometimes feedback from their family. However, I prefer using an objective measure like MOXO, as it focuses on executive function capacity rather than intelligence. This gives me richer, more reliable information about the client’s attention and impulsivity.
Another aspect I’ve noticed is that some individuals diagnosed with ADHD can experience “imposter syndrome,” questioning whether they might have skewed their answers to ensure a diagnosis. MOXO helps address this issue. I can explain to clients that the results are not based on anyone’s opinion, but on objective evidence. We can look at their attentional control, impulsivity, and timeliness, and the results show whether they meet the criteria for ADHD. This helps clients feel more confident in the diagnosis, reducing doubts and stress about the process. MOXO adds important information to the process. It enhances the validity of the test, which is the most significant benefit. It helps provide clearer insight into the client’s challenges, making the diagnosis more robust.
Regarding the diagnostic process, my approach is to start with a detailed conversation covering the family history and the impact of symptoms, screening for differential diagnosis during the first session along with completing a diagnostic interview such as the DIVA5, followed by self-reported questionnaires like the BRIEF2, ESQ-R and ASRS. The second session involves using MOXO and another executive function measure. I prefer to establish rapport and gather comprehensive information from the client before incorporating objective measures like MOXO. Although I’ve sometimes used MOXO during the first session, I prefer to do so in the second session after I’ve had a chance to understand the client’s background and concerns. This ensures that I’m not just interpreting raw data without context, which helps me tailor the assessment to the client’s specific needs.
This structured approach is something I apply consistently across all clients, ensuring the process is thorough and informed.
The educational aspect of my work mostly involves explaining the diagnostic results to the client. During the diagnostic feedback, I show them how their profile fits into the diagnostic criteria, highlighting how their performance fluctuated with different distractors. For instance, we can see how attention deteriorated when visual distractors were present, but improved with audio distractors. This explanation is brief, as I only have around 2-3 minutes at the end of the diagnostic session to review the results.
Typically, after I’ve provided the diagnosis, the psychiatrist takes over, so I don’t usually see the client again.
Future Plans
Looking ahead, I don’t foresee many significant changes in my professional life. I’m already very well-established and quite busy with my practice, so for me, the focus will be on expanding my wife’s speech pathology side of the business, which is outside of my direct area of work. My wife initially trained as a social worker and currently practices as a speech pathologist.
As for myself, I don’t have aspirations to grow into a large corporation or employ other psychologists – I’m very content with the way things are right now. I feel incredibly fulfilled in my role as a psychologist. I view my work as a true honor, being able to accompany people through challenging and meaningful life experiences. The interpersonal connections I form and the privilege of hearing people’s stories are a huge source of reward for me. I’m also satisfied with the ADHD assessment work I’m doing. I enjoy engaging with clients, and the process is well-established and produces good outcomes. Clients have even recommended me to others, which speaks to the rapport I’ve built within the community.
I don’t anticipate any major shifts in the coming years. I plan to continue providing the same level of ADHD assessment services that I find fulfilling, as well as maintaining the affordability of my practice and maintaining a high standard of service for those seeking answers. I charge significantly less than most psychologists for ADHD assessments – about $500 compared to the standard $1,200 to $1,500, and this enables me to remove financial barriers for people who need support.
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