For years, Joey carried the wrong label. The middle school student rarely showed his work on math tests and struggled to follow lessons presented aloud. His parents and teachers saw a bright child who seemed unwilling to apply himself. No one understood what stood between Joey and the work they knew he could do.
Dr. Steve Tutty found the answer through neuropsychological testing. Joey was twice exceptional, with an IQ score in the very superior range and presenting with dysgraphia, a learning disability that affected his ability to write. “His parents thought he was defiant, as did his teachers, for never showing his work,” Tutty said. “We also discovered his visual memory was twice as advanced compared to his auditory memory.”
The assessment greatly impacted Joey’s education. Upon receiving the report, his school allowed Joey to use voice-to-text accommodations on tests. In addition, his teachers paired spoken instruction with pictures, videos, and tangible objects, reduced repetitive assignments in exchange for prototypical ones to measure competency, and moved him into an advanced learner track. They also invited him to teach concepts he had mastered to small groups of classmates, which was more meaningful for Joey rather than sitting in a chair and listening to a lecture.
These changes gave Joey a way to demonstrate what he knew, and more importantly, inspired him to invest time in learning more. The changes also helped the adults around him recognize the difference between a child’s ability and the way he expresses it.
Stories like Joey’s sit at the heart of Dr. Tutty’s work and will appear in a book he plans to release in 2027, drawing on decades of clinical experience. They reflect a central principle in modern child psychology: replacing assumptions with evidence can give families a clearer path for change and accessing your unique talents across the lifespan.
Dr. Tutty, a licensed psychologist in Washington, Utah, and Idaho, has worked in clinical practice and research since 1996. He specializes in therapy and psychological testing for children, adolescents, and young adults with autism, ADHD, and related challenges. Trained in the scientist-practitioner model, he applies evidence-based standards to testing and treatment planning. He has presented nationally and published peer-reviewed research on depression and ADHD, including work in JAMA.
How Has Dr. Steve Tutty Seen Child Psychology Change?
When Dr. Steve Tutty entered the profession in the mid-1990s, pediatricians faced criticism for prescribing stimulant medication after brief appointments, while schools often moved students with autism out of general education classrooms and into separate programs.
Dr. Tutty questioned whether either approach addressed the whole child. That concern led him to collaborate with researchers on a randomized controlled trial examining the limits of stimulant medication in treating childhood ADHD.
“These experiences prompted me to collaborate with researchers and ultimately publish a peer reviewed randomized controlled trial showing that stimulant medication is not the panacea for treating childhood ADHD, particularly given that the prefrontal cortex, the area that stimulants target, does not fully develop until the mid-20s,” Tutty said (Journal of Developmental and Behavioral Pediatrics).
Nearly 30 years later, Dr. Tutty sees a field more willing to match treatment with evidence. Clinicians have stronger tools for studying development, memory, language processing, executive functioning and behavior. Schools also rely more on testing to design accommodations around how a student learns.
“The psychiatric and psychological field has become more advanced in their ability to identify and improve these conditions compared to three decades ago,” Tutty said. “Instead of relying on medication only, the field has recognized that non-medical strategies can be just as effective, if not more, and places less risk on the developing nervous system in children.”
Dr. Tutty says evidence-based treatment does not reject medication. It rejects one-size-fits-all care. His approach considers the child’s development, cognitive profile, school environment, family dynamics and daily functioning before building a plan.
What Signs Can Point to ADHD or Autism?
Long before a formal diagnosis, patterns often emerge at home and in the classroom. Steve Tutty said recognizing those signs early can change a child’s trajectory.
Children with ADHD may struggle to follow multistep instructions. Busy environments can make focus harder, while spoken information may not reach long-term memory without repetition or visual support. Many also gravitate toward fast-paced content because constant stimulation holds their attention.
“Internally, many ADHD children have multiple radio stations (information pathways) turned “on” at the same time, and the volume and divergence of information processed, almost at a simultaneous level, further sabotages their ability to plan, organize, monitor and execute, the hallmarks of executive functioning,” Tutty said.
Autism often presents in sensori-motor ways, such as through sensitivity to sound, clothing, or food textures. A child might cover their ears during ordinary household noise or refuse to touch rough fabrics, like blue jeans. Communication differences may include discomfort with eye contact, difficulty maintaining the natural back-and-forth rhythm of a conversation, particularly when engaged in small talk, difficulty understanding how to relate emotionally to others, and expressing blunt opinions that others may view as rude.
No single behavior confirms ADHD or autism. A comprehensive psychological or neuropsychological evaluation includes an analysis of the developmental patterns across a backdrop of extensive test batteries often delivered during a full day, which allows the clinician to discover how those differences affect a child across their ages and stages. Anxiety, learning disabilities, trauma, and other conditions can sometimes resemble ADHD or autism on the surface, or add complex layers to unravel during the evaluation process.
What Does a Comprehensive Psychological/Neuropsychological Evaluation Include?
Dr. Steve Tutty rarely begins an evaluation with a diagnosis in mind. He first builds a developmental picture that stretches from prenatal development to the child’s current stage of life.
“The approach for identifying the unique strengths and abilities of children and adults with ADHD or on the autism spectrum begins with a developmental interview,” Tutty said. “Charting the progression from prenatal development to their age today is critical, which allows one to understand how their physical, cognitive, emotional, and social developmental milestones unfold.”
Tutty then selects a psychological or neuropsychological test battery based on the referral question and patterns from the interview. Testing can examine memory, language processing, executive functioning, visual-spatial skills and emotional regulation, not simply academic achievement or IQ.
“It is often during the test battery assessment that unique strengths are identified and shared with parents, educators, counselors and medical providers,” Tutty said. “Once that happens, then the lifespan changes begin to take shape, and testing follow up is often helpful in six to nine months to determine what is working and what still needs adjusting.”
A strong autism spectrum assessment or ADHD evaluation should explain more than whether a child meets diagnostic criteria. It should show how that child learns, where daily demands break down and which supports could make the greatest difference.
Why Do Individualized Recommendations Matter?
A diagnosis may give a family language for what they have been seeing, but it does not automatically tell them what to do next. As a child psychology expert and ADHD specialist, Dr. Steve Tutty views recommendations as one of the most important parts of the assessment.
Joey’s school did not simply add a diagnosis to his record. It changed how teachers presented information, how he completed tests, and where he belonged academically. Each recommendation grew directly from his testing profile.
Other students may need extended testing time, visual schedules, sensory breaks or written directions. The right accommodations depend on the child, not the label.
Dr. Tutty also emphasizes multidisciplinary collaboration. Parents, educators, counselors and medical providers often see different parts of the child’s functioning. Sharing that information can prevent treatment plans that work in one setting yet fail in another.
“This is important for all stages, the clinical interview, the testing battery and interventions selected, as they are heavily influenced by peer-reviewed psychological and psychiatric studies,” Tutty said. “Without this approach, the counseling experience falls short by walking away without the core strategies for change, and the testing experience is limited to one aspect or domain, such as academics or IQ, without fully knowing about the others, like memory, language processing, executive functioning, personality and so on.”
The goal is not a report that sits in a file. It is a working plan that families, schools and healthcare providers can revisit as the child develops.
Where Is Neuropsychology Headed Next?
Dr. Tutty sees some of the field’s most promising advances in neuropsychology, particularly the ability to study how specific brain regions function and change over time.
“I am very drawn to the advancement of neuropsychology and in particular, the brain regions that can now be identified on a functional level, how they operate and respond under specific conditions, and how those regions can improve, as well as collaborate differently with their neighboring regions, over time with evidence based interventions,” Tutty said.
Those advances may sharpen diagnosis and treatment by helping parents and professionals understand why children with the same diagnosis can function so differently.
Three decades into his career, Dr. Tutty still approaches each evaluation the same way he approached Joey’s case. He looks beyond a set of symptoms to understand the child’s development, abilities, environment and relationships, then uses that evidence to build a practical path forward.
As research continues to reveal more about how the brain functions and changes, Dr. Steve Tutty sees new opportunities to make assessments and interventions even more precise.
“Both conditions, ADHD and autism, can impact a child’s trajectory in a significant way,” Dr. Tutty said. “The more evidence-based information parents, pediatricians, counselors and educators have about these conditions, the greater the likelihood we can maximize their strengths across the lifespan.”
