How to Use the MIGDAS-2 in Autism Assessments: A Practical Guide for Australian Clinicians

By Emily Hanlon

If you have landed here, chances are you already know what the MIGDAS-2 is. You might have the kit sitting on your desk. You might have done a one-day training and walked away feeling like you understood the theory but were not quite sure how to translate that into a real assessment with a real client, a real family, and a real blank report page at the end.

That is exactly the gap I want to address in this post, and in the workshop series I run for Australian clinicians. This is not about what the MIGDAS-2 is. It is about how to actually use it well.

A Quick Recap: What Makes the MIGDAS-2 Different

The Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS-2), developed by Dr Marilyn Monteiro, is a sensory-based, qualitative interview process for autism assessment. Unlike the ADOS-2, which uses structured tasks to elicit observable behaviours in a clinical setting, the MIGDAS-2 invites the person being assessed into the process through their own interests, sensory experiences, and way of making meaning.

The result is not a score; it is a brain style profile. A rich, descriptive picture of how an individual communicates, relates, and experiences the world. And for many of the clients we see in Australia right now, particularly high-masking girls and women, autistic people with co-occurring anxiety or ADHD, and those with internalised profiles, that qualitative picture is the most clinically important thing you can produce.

MIGDAS-2 vs ADOS-2: Which Should You Use?

This is probably the question I am asked most often, so let me be direct: it is not either-or. The MIGDAS-2 and the ADOS-2 complement each other, and many Australian clinicians are now using both in a single assessment battery.

Here is how I think about it:

• The ADOS-2 gives you structured, quantitative observational data: it is examiner-driven, highly standardised, and produces algorithm scores that carry weight in diagnostic documentation

• The MIGDAS-2 gives you qualitative, contextual, person-centred data: it captures lived experience, sensory world, social understanding, and communication style in a way that standardised tasks cannot

• Together, they cover each other's blind spots: the ADOS-2 may miss a high-masking client who holds it together in a structured 45-minute session; the MIGDAS-2 will often show you exactly what the ADOS-2 could not

If you are assessing a child with complex needs, high cognitive ability, significant anxiety, or an internalised profile, or if you are assessing a girl, a teenager, or an adult...the MIGDAS-2 is not optional. It is essential.

If you can only use one tool and the client presents with clear, observable traits in a clinical setting, the ADOS-2 remains appropriate. But if you are seeing the kinds of presentations that are increasingly common in Australian practice, and you are, the MIGDAS-2 will make your assessments more accurate, more complete, and more meaningful.

The Components of the MIGDAS-2

The MIGDAS-2 involves interconnected components, each targeting a different domain and a different informant:

• The Parent Interview: a structured interview exploring the individual's early development, language and communication style, social relationships, sensory experiences, and interests. This is usually 60 to 90 minutes and is rich with clinical information

• The Teacher or Support Person Interview: collateral from someone who knows the individual in a structured setting. Often reveals masking, compensatory strategies, and context-specific presentations that the parent interview misses

• The Individual Interview: a sensory-based, interest-led interview with the client themselves. For children, this is structured around their special interests and sensory world. For adolescents and adults, it becomes more reflective and conversational

Each component informs the others, and the synthesis is where the real clinical skill lies. Writing a MIGDAS-2 report that is accurate, readable, and clinically useful, and that holds up under scrutiny, is the skill most clinicians tell me they want to develop.

Where Clinicians Get Stuck: The Three Common Challenges

In my work with Australian clinicians, the same three challenges come up repeatedly:

1. Administration Confidence: Many clinicians feel unsure how to follow the individual interview when it does not go as expected. What do you do when a child will not engage with the opening questions? What do you do when an adult gives you very brief answers? What do you do when the sensory discussion opens up something unexpected? The MIGDAS-2 requires flexibility and clinical judgement, and that only comes with practice and guidance from someone who has done hundreds of these assessments.

2. Integrating Multiple Sources: The MIGDAS-2 involves a lot of data from multiple informants across multiple domains. Knowing how to weight different pieces of information, identify discrepancies between parent and teacher report, and integrate all of it into a coherent clinical picture is genuinely complex. It is not something a single training day fully prepares you for.

3. Report Writing: This report is unlike anything else in assessment report writing. It is descriptive, qualitative, and person-centred, which is exactly what makes it so valuable, but also what makes it harder to write. Many clinicians tell me they stare at a blank page after a MIGDAS-2 assessment, unsure how to start, how to structure it, or how to make it readable for families and other professionals while still being clinically rigorous.

MIGDAS-2 and the Neuroaffirming Assessment Movement

One of the reasons the MIGDAS-2 has become so popular in Australia right now is that it aligns naturally with the neuroaffirming practice movement. At its core, the MIGDAS-2 is a strengths-based, person-centred tool; it describes how someone relates to the world, not what they cannot do. It produces reports that families can actually read, understand, and feel seen in. For Australian clinicians who are trying to move away from deficit-based frameworks and toward affirming, identity-first approaches, the MIGDAS-2 is a natural fit. The report it produces, when written well, is one of the most powerful clinical documents you will ever hand to a family.

Getting Trained in the MIGDAS-2 in Australia

To use the MIGDAS-2 competently, you need more than a read-through of the manual. The tool is qualitative, which means your confidence in using it comes from practice, feedback, and exposure to a wide range of presentations. Training options in Australia include workshops run by the publisher (Western Psychological Services), training offered by experienced clinicians, and online professional development courses. When choosing a training option, look for:

• Training that goes beyond the theory to address real-world administration challenges

• Coverage of how to use the MIGDAS-2 with different presentations, children, adults, high-masking individuals, complex profiles

• Specific guidance on report writing

• Opportunities to ask questions and discuss case material

• Training delivered by clinicians who use the tool regularly in their own practice

The MIGDAS-2 Workshop Series: Kit to Clinic to Report

See my criteria for good quality MIGDAS training above? I struggled to find a training that actually reflected the clients I was seeing in clinic, and members of the Clinicians Forum made me realise, that I wasn't alone. So, frustrated by the lack of training options that showed you what to do if a client wasn't able to sit through an assessment, didn't touch a single sensory item, became agitated or distressed, or disclosed information that abrubtly ended the session, I created my own training.

I now run a dedicated MIGDAS-2 workshop series for Australian psychologists and allied health professionals called Kit to Clinic to Report. It is designed specifically to bridge the gap between initial training and confident, skilled use of the MIGDAS-2 in real clinical practice. It is self-paced and you have lifetime access to the content, include report templates and checklists.

The series covers:

• Understanding the full MIGDAS-2 kit and how every component works together

• Curating your MIGDAS-2 kit (with a look into my personal kit, and linked items)

• Administering each of the four components with confidence across different presentations

• Integrating data from multiple informants into a coherent clinical picture

• Writing reports that are clinically rigorous, family-friendly, and affirming

• Navigating complex presentations: high masking, co-occurring ADHD, anxiety, PDA profile

Whether you are early in your assessment career or an experienced clinician looking to sharpen your practice, this is the end-to-end MIGDAS-2 training built for the complexity of real Australian clinical work. You can find the workshop details and enrol here.

Before you go...

The MIGDAS-2 is one of the most powerful tools available to Australian psychologists and allied health professionals doing autism assessments right now. And when used well, it produces assessments that are more accurate, more complete, and more meaningful for the families and individuals who receive them.

If you are ready to build genuine confidence with the MIGDAS-2, from kit to clinic to report, I would love to see you in the workshop series.

PS - Have a question about the workshop series? Send me an email. I'd be happy to help!