Autism assessments can help families and schools to better understand a child’s experience,  and  identify areas that require support to allow them to thrive across settings.  Going for an autism assessment does not automatically mean your child will get a diagnosis, the outcome will be determined after a multi-disciplinary team have carefully considered your child’s strengths, differences and needs alongside the diagnostic criteria.

Navigating the process of an autism assessment can feel overwhelming, but understanding what to expect can help ease anxiety and prepare you and your family. This blog aims to guide you through what typically happens in an autism assessment. 

1. Initial referral

The journey usually begins with a referral, often from a GP, teacher, or other healthcare professional who has noticed attributes of autism. A referral from a professional is needed for a NHS autism assessment but most private autism assessments allow parents, or individuals, to “self -refer” to their services.

2. Preparation

Before the assessment, you may be asked to complete various questionnaires or provide detailed background information about developmental history, behaviours, and any other relevant details. This can include school reports, medical records, and observations from family members and teachers. Most providers will also at this point send some standardised questionnaires to the parents, teachers and young person (depending on the age and ability of the child completing the questionnaires).  

At the Gesher Assessment Centre we give parents/carers a social story that they can talk through with their child before the assessment.  This is designed to help the child feel more at ease before their assessment, and to help them understand more about what happens on the day. It includes details such as pictures of the actual assessment room, who they are likely to meet on the day and time guidelines of how long each part of the assessment may take. Parents/carers also have an option to provide more detail by including their own pictures at the end relating to what they will do after the assessment.  

3. The assessment process

The Team:

Autism assessments are typically conducted by a multidisciplinary team of professionals. This team can include:

• Clinical Psychologists 
• Speech and Language Therapists 
• Occupational Therapists 
• Specialist Nurses or other qualified healthcare professionals 
• Psychiatrists 
• Paediatricians 
• SENCOs

Interviews:

These are a key component of the assessment. These can include: 

Parent/carer Interviews: To obtain a detailed developmental history of the child/young person and to gain insight into the child’s behaviour and social interactions. This would usually follow a structured interview approach which is standardised (such as the ADI-R or 3di5). Parents/caregivers can prepare themselves for this by having a think about their child’s early developmental and a timeline regarding any medical history/significant events in the child’s life. It may also help to think about any areas of difficulty and examples of when these present a challenge, as well as  any recent changes that have been noted. They can also think about ways they may already be supporting their child,  such as using a family calendar to plan events, or adapting the home/family outings to suit the needs of the child.  

Individual Interviews: For older children, adolescents, and adults, interviews with the individual who is being assessed are conducted to understand their personal experiences and challenges. 

Child/young person observations & assessment:

The assessor will observe the child/young person in at least one setting, often a clinic. This could be through structured play sessions for younger children, or more informal interactions and tasks for older individuals. Observations focus on social communication, behaviours, and reactions to the child’s environment to give insight into their preferences. 

Several standardised tools and tests may be used, such as the Autism Diagnostic Observation Schedule (ADOS-2). This is a series of structured and semi-structured tasks involving social interaction, communication, play, and imagination. The test has different modules, and the assessor will select the appropriate model based on the child’s expressive communication skills. You can help prepare your child by reassuring them that it is not an ‘invasive’ test such as a hospital appointment where they may receive injections or blood taken. Although some people may refer to it as a ‘test’, the different tasks are not scored like a typical ‘school test’ and there is no ‘right or wrong’ answer. The aim of the assessment is to understand them better, and to ensure that the adults in their lives can support them optimally.  

Other questionnaires or tools as deemed necessary to inform differential diagnosis (other conditions that may present with similar challenges).  

4. Feedback and diagnosis

After the assessment, the multidisciplinary team will review all the collected information to determine the outcome of the assessment. This process involves the team members scoring their different parts of the assessment, and then a  discussion/collaboration of findings and observations and a review of the diagnostic criteria.  The diagnosis is based on criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and/or the International Classification of Diseases (ICD-11). 
 
A feedback session is arranged where a team member will explain the findings and the outcome, including the diagnosis (if one is made). During this session you can expect to receive explanations of the assessment results and the basis for the diagnosis, any other conditions that were considered, and some information on recommendations. Parents should have the opportunity to ask questions and discuss the implications of the diagnosis. 

5. Assessment report and post diagnostic support  

A comprehensive report is provided, which includes the diagnosis, detailed findings, and recommendations for support and interventions.  At The Gesher Assessment we include the following in our autism assessment reports: 

• Your child’s medical history 
• A breakdown of each of the areas that were assessed 
• A formulation/conclusion summary 
• Your child’s diagnosis if applicable 
• Various recommendations relevant to your child 
• Useful strategies and advice for you to support your child. 
• Recommendations for the type of support that child might need in the educational setting 
• Recommendations on which other professionals could offer support and guidance on finding therapists in your area 
• Signposting to local services, charities and other organisations which offer help 
• Useful strategies and advice for you to support your child at home and within the community. 

This practical advice and information can be shared with your child or young person’s educational setting, and any other relevant people or professionals. 

Understanding and preparing for the assessment process can make a significant difference in managing expectations and navigating the path ahead.  At the Gesher Assessment Centre we guide you through every stage of the assessment process.  We also offer a free 30 minute initial consultation so you can find out more about us and ask any questions you may have about the assessment and the assessment process.   

Citations: 

NICE guidelines

The Gesher Assessment Centre process