Picture a parent sitting across from a school counselor, listening to another round of feedback about their child’s behavior. Defiant. Distracted. Disruptive (the 3 D’s!). The words pile up, and so does the guilt and frustration. By the time many families find their way to a specialist, they’ve already spent months, sometimes years, trying this and trying that (e.g., changing the diet, implementing punishments, starting a medication, pleading, bargaining, and so on) with no clear improvement.
Dr. Steve Tutty has heard that story more times than he can count. A psychologist with more than 25 years of clinical experience helping children and families across Washington and Utah, Dr. Tutty has built his practice around a single, steady conviction: that children with ADHD and autism are far more than their diagnoses, and that the right information, delivered at the right time, can genuinely change a child’s trajectory. His work spans comprehensive neuropsychological evaluations, parent guidance, collaboration with pediatricians and educators, and peer-reviewed research. He is also at work on a book expected in early 2027 that will bring many of these insights to a wider audience.
The through-line in everything he does is the same. Understand the child first. Then build from there.
Why Dr. Steve Tutty Started Focusing on ADHD and Autism in the Mid-1990s
Dr. Tutty began assessing and treating ADHD and autism in the mid-1990s, a period when both conditions were often handled in ways that, by today’s standards, look remarkably blunt. Pediatricians were prescribing stimulants to children after quick 15-minute consultations. Educators were routinely separating children on the spectrum from their mainstream peers and placing them into special education classrooms with little nuance about what each child actually needed.
What he noticed, working directly with children and families during that period, was that improving social, emotional, and behavioral skills made a real difference. Teaching a child how to make and keep friendships, how to read a facial expression and “the room”, how to recognize a rising impulse and redirect it before it took over: these skills moved the needle in ways that medication alone did not.
That observation led him to collaborate with researchers and ultimately publish a peer-reviewed randomized controlled trial in 2003 in the Journal of Developmental and Behavioral Pediatrics. The study showed that stimulant medication is not a complete solution for childhood ADHD, particularly given that the prefrontal cortex, the region stimulants target, does not fully develop until the mid-20s.
The research grounded what his clinical work had already suggested. Medication has a role. But it’s only part of the picture.
The Misconceptions That Follow Kids Into Classrooms and Boardrooms
With children who have ADHD, “the big misconception,” he explained, “is that the child is purposely disobedient and oppositional, rather than focusing on their strengths and finding creative solutions for the behavioral challenges in question.” For adults, employers tend to read inattention as laziness or disengagement, when the underlying challenge is neurological, not motivational.
The misconceptions around autism run just as deep. Many people still assume that individuals on the spectrum can’t communicate meaningfully, prefer isolation, or lack empathy entirely. Tutty has worked with enough people to know how far that picture is from reality. Adults on the spectrum are often placed into roles that are isolating and purely analytical, when many of them are capable of providing valuable contributions within a workplace team.
These assumptions don’t just sting. They shape decisions. They determine whether a child gets the right support at school, whether an employee gets a fair chance, and whether a family knows where to turn.
What a Thorough Evaluation Actually Uncovers
For Dr. Tutty, the evaluation process is where things begin to shift. It starts with a detailed developmental interview, charting a person’s progression from prenatal development through their current age. That timeline matters because it shows how physical, cognitive, emotional, and social milestones have unfolded across the years, not just how the person is functioning today.
From there, a psychological or neuropsychological test battery gives a clearer picture of how the individual performs to their age-related peers across multiple domains: memory, language processing, executive functioning, personality, visual and verbal learning styles,, adaptive functioning, and more. It’s during this process, Dr. Tutty said, that strengths often surface for the first time.
He offered the example of a middle school student named Joey. Testing revealed that Joey was twice exceptional: he had dysgraphia, a learning disability affecting written expression, but also an IQ in the very superior range. His parents and teachers had read his refusal to show his work on tests as defiance. What they didn’t know was that his visual memory was twice as strong as his auditory memory, and that writing by hand was a genuine barrier, not a choice.
The interventions that followed were specific and practical:
- Auditory instruction was paired with visual cues, including pictures, videos, and tangible objects representing the learning concepts
- Joey was allowed to use voice-to-text tools on tests instead of handwriting his answers
- His workload was reduced to prototypical problems that demonstrated mastery, rather than repetitive exercises measuring the same skill
- He was moved into an advanced learner track and given opportunities to teach his peers in small groups
The results were significant. Not because anyone lowered the bar, but because the bar finally matched who Joey actually was.
Signs Parents Should Know and When to Seek Guidance
Parents who suspect their child may be struggling with ADHD or autism often describe a kind of quiet, accumulating worry. Something feels off, but they’re not sure what they’re looking at.
Dr. Tutty describes several patterns worth paying attention to. Children with ADHD often struggle to follow multi-step directions from parents and teachers. They’re easily distracted by what’s happening in their visual field during a test or a task. Information doesn’t stick in long-term memory without repetition, unless it’s meaningful or presented in a multi-sensory way. Procrastination tends to be significant. And internally, many of these children are processing what Tutty describes as “multiple radio stations on at the same time,” with the volume and divergence of that information making it hard to plan, organize, and follow through.
For children on the spectrum, the classic signs tend to include:
- Extreme sensory sensitivities, such as covering ears in response to everyday sounds or insisting on soft fabrics over rough ones
- Challenges with eye contact and natural back-and-forth during conversation
- Difficulty knowing how to act in group social situations or sharing enjoyment with peers
- Trouble identifying emotions in others or expressing their own
Neither list is a diagnosis. But Tutty’s point is that these signs often show up long before a family finds the right support, and recognizing them earlier means less time lost.
Accommodations That Work, at School and at Home
Once a comprehensive evaluation is complete, the next step is translating what was learned into practical change. Accommodations, Dr. Tutty emphasizes, are not about lowering expectations. They’re about working with a child’s actual learning profile rather than against it.
In school settings, this might mean extended time on tests, regular breaks built into the day, reduced noise and stimulation, and varied platforms for presenting information. For a student whose visual memory significantly outpaces auditory processing, ensuring that classroom instruction includes images, video, and physical objects isn’t a workaround. It’s simply effective teaching for that student’s brain.
In work settings for adults, accommodations often center on reducing overstimulation, allowing for flexible or hybrid work arrangements, delivering communication across multiple formats, and using visual planners and goal-tracking systems that keep priorities visible. Dr. Tutty is direct about the value of these tools. Without them, capable adults spend an enormous amount of energy compensating for structural mismatches that don’t have to exist.
Follow-up testing, typically six to nine months after the initial evaluation, helps families and educators assess what’s working and what still needs adjusting. It’s not a one-time fix. It’s a process, and Tutty approaches it as a long-term partnership with his clients.
Where the Field Is Heading and Why Dr. Tutty Finds It Encouraging
After more than 25 years in the field, Dr. Tutty is watching the science of neuropsychology develop in ways that feel genuinely promising. The ability to identify specific brain regions on a functional level, to observe how they respond under different conditions and how evidence-based interventions can strengthen them over time, is expanding what’s possible in assessment and care.
The broader field has also moved meaningfully since the 1990s. Pediatricians increasingly recognize the value of comprehensive neurological evaluations before prescribing medication. Educators rely more often on testing insights to implement the right school accommodations. Non-medical strategies are taken more seriously now, and for good reason. They can be just as effective as medication in many cases, and they carry less risk for the developing nervous system.
For families receiving an ADHD or autism diagnosis today, Dr. Tutty’s message is measured and honest. There’s real relief in having a name for what a child has been experiencing. There’s also real work and opportunities for growth ahead. “Navigating this process over time often takes a partnership between the clinician, client, educator, pediatrician, and family over several years to maximize the changes whereby the child can start to unlock their strengths, just like Joey and his family experienced,” Tutty said.
This article is for informational purposes only and does not constitute psychological, medical, or clinical advice. If you have concerns about your child’s development or behavior, consult a licensed mental health or medical professional for a comprehensive evaluation.
