Screening tools issued as a diagnostic report
Fluence Clinic was engaged for an autism assessment of a child in my care, expecting the kind of thorough, multi-source process that a diagnosis of this seriousness calls for. I have direct professional familiarity with how a comprehensive autism assessment should be conducted. What this clinic produced does not come close.
The assessment rested on a single telehealth session, with collateral taken from one source only. The National Guideline for the Assessment and Diagnosis of Autism in Australia, the NHMRC-approved standard, recommends that information be gathered across multiple settings and from people who know the individual in different contexts. That did not happen here. Relevant collateral that was offered early was not meaningfully taken up.
The report issued to me contained unfilled template placeholders in its final version. It also carried an internal inconsistency. The mental state examination recorded cognition within normal limits and good insight, while the diagnostic conclusion described a high-support-needs presentation, and the two findings sit uneasily together in a single clinical document. No formal cognitive assessment was conducted to resolve that gap.
The instruments administered were screening tools, not diagnostic instruments. That distinction is not minor. A screening tool identifies who warrants further investigation. It does not establish a diagnosis. Issuing a formal diagnostic conclusion on that basis is a methodological error, and it is one that a family without clinical training would have no reason to question.
When I raised these concerns directly, the amendments that came back from the assessing clinician, Dr Murugesh Nidyananda, were limited in scope, and they did not reach the substantive issues I had identified about method and conclusion. The diagnosis was left unchanged. The methodology was left uncorrected.
Correspondence continued for some weeks. Responses then stopped entirely, and my understanding is that the direction to cease contact came from the clinic's Medical Director, Dr Manoj Ravindran. A formal written request for access to the records, made under the relevant privacy provisions, went unanswered for months afterward.
A diagnosis like this follows a child for life. It shapes schooling, funding, identity, and the expectations adults form about a person before that person can speak for themselves. My concern is not only with my own experience. Based on how this assessment was conducted, I think this practice carries real risk for families who may not have the clinical background to recognise when an assessment falls short, or the resources to challenge it once it has.
