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Autism assessments for children and young people

Autism assessments for children and young people

A guide for parents & carers

What is autism?

Autism is a lifelong developmental disability that typically affects how a person communicates and interacts with the world around them. The causes of autism are still uncertain, but as a spectrum disorder, autism will affect children to different degrees, some severely and others in more subtle ways. Signs that a child may be on the autism spectrum include:

  • Not responding to their name
  • Avoiding eye contact
  • Lining up toys or objects in a particular order
  • Getting very upset if they don't like a certain taste, smell, or sound
  • Struggling to make friends or preferring to be on their own
  • Enjoying a strict daily routine and getting very upset if it changes
  • Behavioural issues such as biting, pinching, kicking
  • Putting inedible items in the mouth, or self-injurious behaviour
  • Repetitive behaviour, like playing the same game repeatedly in the same way

Choosing the right path

Receiving the right diagnosis is the first step to getting the most appropriate support. But we know how hard it can be to make the right choice. Some assessment options may seem unreliable and untrustworthy. Others might take too long and not provide you with the necessary support after your assessment. Ultimately, the right option must be the one that gets all the details right and opens the door for meaningful change. This guide will explain our procedures and diagnostic methods in detail to provide you with everything you need to confidently choose the path that’s right for your child.

Completing pre-assessment questionnaires Once the assessment appointment is booked, there will be several questionnaires to complete in the portal or via email. These questionnaires are widely trusted tools that help establish if your child is likely to be autistic or have other co-occurring conditions.

They will help the clinician to build a fuller picture of your child’s current strengths and difficulties and need to be seen and scored before the appointments, so it’ essential to complete them as soon as possible so we have a well-rounded view of your child’s development. You may have completed similar questionnaires in the past, but it’s important to also complete these ones so that we have the most up to date information about your child. If we don’t receive your completed questionnaires, your child’s assessment could be delayed.

If your child is aged eight or above, we may ask them to complete a questionnaire themselves. If this is the case, the team member who books your appointment will explain what to do at the time. We may also send a link to further questionnaires to be completed by your child’s teacher or school SENCo (Special Educational Needs Coordinator).

Additional supporting information Certain documents such as school reports, speech and language, psychology or other medical reports can help your child’s clinician better understand their developmental history and current behaviour. You can add these documents to the online portal once the assessment has been booked.

We use the most reliable and well-validated diagnostic measures available Our autism assessments bring together the two most trusted, accurate and widely used diagnostic procedures available: the Autism Diagnostic Interview – Revised (ADI-R) and the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). These are the diagnostic methods of choice for leading clinicians when assessing autism.

Who will carry out the Assessment?

Your child’s assessment will be carried out by a clinical team experienced in assessing and diagnosing autism. The team will be extensively trained in the relevant diagnostic tools and will be there to support, update and help you feel comfortable throughout the assessment.

The ADI-R interview will be with a senior clinician with specific ADI-R training.

The ADOS-2 assessment will be with a specialist clinician matched to your child’s specific requirements. This will either be a Clinical Psychologist, Neurodevelopmental Specialist, Occupational Therapist or Speech and Language Therapist.

The Autism Diagnostic Interview-Revised (ADI-R)

The ADI-R is one of the most widely used diagnostic tools used to determine whether or not children have autism. Together with the ADOS-2, it is one of the most reliable and well-validated methods when evaluating children suspected of being on the spectrum. Conducted by an ADI-R trained senior clinician with the child’s parents or carers, the interview can last up to three hours and will ask lots of questions about a child’s behaviour, including language and communication, social interactions, and special interests with the aim of building a complete picture of the child’s development from an early age.

ADI-R preparation tips

Before the appointment, we encourage you to have a good think about the different behaviours and challenges your child has had throughout their life.

 Think back to when they were younger. You might want to look back at some photos or videos or ask other family members to jog your memory.

Did your child behave differently to other children their age? What were their interests? How did they play with others?

 Think about how old your child was when they first walked, talked and potty trained. Was there anything different compared to other children of the same age?

 Think about your child’s likes and dislikes. Do they have any sensitivities to noise, texture or light? How do they react when they don’t like something?

Think about your child’s routine. How do they feel about unplanned activities or changes to routine?

Think about your child playing with toys. Was there anything unusual about how they played e.g. lining things up, not using the toy how they should, or becoming obsessed over a particular toy or game?

Think about your child’s difficulties and how it impacts your family. Is there anything your child or your family would like to but feel you can’t do?

The Autism Diagnostic Observation Schedule Second Edition (ADOS-2) The ADOS-2 is a standardised observational assessment of:

  • Communication
  • Social interaction
  • Play or imaginative use of materials

This differs from the other diagnostic tools as it’s not based on developmental information and therefore only looks at your child’s current behaviour and skills. It can be used to evaluate people of all ages across different developmental levels, from those with no speech to those who are verbally fluent. The purpose is to observe your child’s behaviour and social responses using different scenarios, tasks, and conversation topics. It will assess a number of aspects of their social communication, interaction and play skills, such as eye contact, use of gestures, body language, repetitive behaviours and imagination.

The ADOS-2 summarised

  • Lasts up to 90 minutes
  • Directly between child and clinician
  • An observation of your child’s behaviour and social responses using different scenarios, tasks and conversation topics.

Has different modules. The clinician will choose one to depend on your child’s age and language ability. Your child may be nervous about this appointment, which is completely understandable. Although the ADOS-2 is directly between your child and their clinician, please make sure you’re close in case they need your support. Before the appointment, reassure your child that there is nothing to be afraid of, there are no right or wrong answers, and they can take their time during the appointment.

Online appointment tips & technical requirements

If the appointment is online, please take a few minutes to familiarise yourself with the following preparation tips. Setting up your equipment for online appointments, we recommend using a PC, laptop, or large tablet with a camera and microphone. Please note that the clinician must be able to clearly see your child to observe their body language and physical behaviours. For this reason, some smaller screens such as smartphones may not be suitable for this part of the assessment. The important thing is you can communicate with the clinician clearly. If you don’t have access to any of these devices, please let us know as soon as possible. Please also do your best to find an environment with a reliable internet connection. Again, clear communication is essential, and a good internet connection will improve the chances of a successful, uninterrupted, and smooth interview.

All interviews are conducted virtually using Zoom.

If you haven’t used Zoom before, please take a few minutes to familiarise yourself with the platform on their website. Find a private, quiet, and comfortable space It’s important that your child is relaxed and comfortable throughout the appointment, so find the best space, close the door and windows, and switch off any potential distractions like your mobile phone or the TV. If you’re using a laptop or PC, make sure the only window open is Zoom. We also recommend that you minimise the brightness of light behind you to help the clarity of the on-screen picture.

Your child’s diagnostic report

Once complete, you will be notified that your child’s report will be available to view in the portal. This will detail the outcome reached and offer helpful recommendations tailored to your child’s specific needs. Schools and other professionals are often keen to know the outcome so they can put the appropriate provisions in place to support your child. Therefore, it can be helpful for you to share a copy of the report with them. We can share all diagnostic reports with your GP, school and other professionals involved in your child’s care, provided you give your consent.

What should I do next?

If you are interested in finding out more or would like to know when the next available appointment is, please call us on 0333 3390115. Our experienced team help thousands of people every year access the care they need and will be able to give you expert advice as to whether this is the right choice for your child.

All treatments and services are designed to help focus on what's truly important - the very best patient care. Our clinicians are all accredited, or members of professional governing bodies and all treatments and therapies are evidence-based and follow guidance from the National Institute for Health and Care Excellence (NICE). Speak to us in confidence today.