Autism assessment: what to expect

I provide diagnostic assessment for children and young people with suspected Autism in Bristol, Bath and the surrounding area. Assessment follows best practice guidance from the National Institute for Health and Care Excellence (NICE) and is carried out jointly with my colleague Christelle Bryan, Occupational Therapist.

Assessment typically involves

• Autism Diagnostic Observation Schedule (ADOS) with child/young person face to face – approximately one hour

• Autism Diagnostic Interview (ADI) with parents or carers – approximately two hours (usually online)

• Assessment of emotional well being – approximately one hour (usually online with parents and face to face with child/young person)

• Developmental history

• Standardised questionnaires assessing emotional well being

• School liaison call with someone who knows your child well at school

• File review

On occasion school observation is also required and is charged separately according to my hourly rate. A feedback session (usually online) and an assessment report with recommendations are included in the assessment fee. Fee for diagnostic assessment for Autism Spectrum Disorder is £2150. A non refundable 20% deposit is payable upon booking an assessment with the outstanding balance payable prior to the start of the assessment.

Autism Diagnostic Observation Schedule (ADOS)

Your child will be invited to attend an ADOS assessment at my consulting rooms. The ADOS is a semi-structured standardised assessment of communication, social interaction and play or imaginative use of materials for individuals referred because of possible Autism Spectrum Disorder. The ADOS consists of standard activities allowing the examiner to observe behaviours important to diagnosing Autism Spectrum Disorders at different developmental levels and chronological ages. Best practice guidelines indicate that more than one professional view should be included in Autism assessment. Christelle Bryan, Consultant Occupational Therapist will be present to administer ADOS assessment in order to ensure this. Imogen Clarke will also be present.

Autism Diagnostic Interview, Revised (ADI-R)

The ADI-R is a structured interview conducted with parents and carers of individuals with suspected Autism Spectrum Disorders in order to support assessment of their child. This focuses on behaviour and qualities in relation to the individual’s capacity for reciprocal social interaction, communication and language, and restricted and repetitive, stereotyped interests and behaviours.

Assessment of Emotional Wellbeing

As part of the diagnostic assessment I carry out assessment of the child or young person’s emotional and behavioural well being. This involves a conversation with parents and carers which takes place during video calls where ADI-R assessment is carried out. For older children and young people there will also be a conversation with them about how they are finding life. This part of the assessment helps with understanding what aspects of the difficulties a child or young person is facing relate to emotional and developmental factors, and with making appropriate recommendations for support.

Questionnaires

I will send you questionnaires about your child’s development and wellbeing, which you will need to complete and return to me.

Information on File

You will need to send me copies of previous assessments or therapeutic input carried out with your child so that I can review these as part of the assessment process. If your child has an Education Health and Care Plan I will need a copy of this.

School/Nursery Liaison

You will need to provide contact details for a staff member who knows your child. I will schedule a call with them to discuss your child’s social, emotional and academic functioning at school. Usually, a parent does not need to attend this.

What happens After Assessment?

Feedback Appointment

You will be offered a feedback appointment via video call within two weeks of the completion of your child’s assessment. If you would prefer for this meeting to be face to face please let me know and we can arrange this.

Assessment Reports

Following assessment you will receive a written report setting out the findings, the diagnostic conclusions and recommendations. The report is written for clinical purposes and is yours to share with your GP, other health professionals, and your child's school or nursery as you see fit. My reports are not written as expert evidence for court or tribunal proceedings. I do not undertake medico-legal work and I do not act as an expert witness.

Combined assessment for suspected Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder

Autism and ADHD often occur together, and it is common for parents to recognise features of both in their child. Where that is the case, a combined assessment looks at both in one integrated process rather than two separate ones.

A combined assessment includes every element of the Autism assessment and every element of the ADHD assessment, carried out together and written up as a single report. That means one set of appointments, one feedback session and one coherent picture of your child, rather than two assessments that each look at half of it.

A combined assessment for Autism Spectrum Disorder and Attention Deficit Hyperactivity Disorder can be arranged as appropriate. Fee for combined assessment is £2950.

Frequently Asked Questions

Will a private Autism diagnosis be accepted by the NHS?

Assessment is carried out in line with NICE guidance and the diagnostic outcome is a valid clinical diagnosis. In my experience NHS services accept these outcomes without difficulty. If you have any concerns, I would encourage you to check with your local service before proceeding, and I am happy to discuss it with you.

Will my child's school act on the report?

Schools and local authorities are required to consider a report as evidence, but are not bound to act on its recommendations. A diagnosis does not in itself secure an Education, Health and Care Plan or any particular support.

What happens if my child does not receive a diagnosis?

An assessment may conclude that criteria for a diagnosis are not met. This is a valid and useful outcome, and the fee is the same. You will receive a full explanation of the findings and recommendations in every case.

How long does the whole process take?

This varies with appointment availability, I make every attempt to ensure that the assessment takes place in a timely manner. You will be offered a feedback appointment within two weeks of the final assessment session, and the written report usually follows within four weeks after that.