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  • Writer's pictureDr Jennifer Turner

What do I need to know when booking an assessment?

Navigating the world of autism assessments can be a tricky one. Do you wait for an NHS assessment? Do you seek a private assessment? If so, how do you know it is good enough and will be recognised by education and health services?

As you are probably already aware, there are two main routes for assessment. Firstly through the NHS and secondly through a private provider. I’ll try in this post to give you some information about each.

NHS assessments

The benefits of an NHS assessment are that they are free at point of access and universally accepted by health and education services. However, many services currently have incredibly long waiting lists, often years, and this may feel too long for your child and family.

If you decide to follow the NHS pathway there will be differences between authorities in their referral route. Often you will have to be referred by your GP or health visitor to your local CAMHS team or a paediatrician depending on the age of your child. Some services allow you to self refer. You should be able to find this information through your local branch of the National Autism Society or your Local Offer website. You also have some rights to choose where you are referred, this information should be available through your GP.

When you are referred you will likely be offered an initial appointment to confirm they agree a full assessment is required. This assessment may be carried out by a paediatric team, CAMHS or may be contracted out to another service commissioned by your local health service. Please see below for what to expect from an assessment.

Private Assessments

The second route is through a private provider. The advantages is that waiting times are often much shorter and you could be seen within a few months. However, some people have concerns that their assessment is not as high quality or may not be accepted as evidence for a support in school. They can also be costly, around £2000-£2500 because of the time and number of clinicians involved.

What to expect from an assessment?

When looking for an assessment ensure the service is compliant with NICE guidelines. In simple terms this means the assessment should:

  • be conducted by a team including a minimum of two clinicians from different professions (often a psychologist, speech and language therapist, occupational therapist, psychiatrist or paediatrician, mental health nurse specialist).

  • include a full developmental history. This may involve a structured interview such as an ADI-R, DISCO or 3DI. You should expect this to take at least a couple of hours. Autism is a lifelong condition and although it may not be clear in early life.

  • include an observation of your child, usually through the ADOS 2.

  • include information from multiple sources - your child’s school will usually be asked to complete questionnaires or they may ask to observe your child in school. If you home school, the clinicians may ask for other sources of information.

  • consider whether there are any other explanations for your child’s difficulties. This may involve an assessment of their speech and language, learning ability or sensory needs. In private assessments this will likely incur additional costs.

Will my assessment be accepted by other services?

The question of whether a private assessment will be accepted by the education services or health services in your area is more complex. It is worth asking the provider whether this has been a problem in the past. In my experience if your assessment is thorough and well evidenced it is generally accepted. When I worked in the NHS we were occasionally asked to ‘verify’ private assessments. When this happened we would look at the report and confirm the assessment was compliant with the criteria above.

If you need a report as part of an EHC assessment (for extra help in school) it is useful to be aware of the SEN Code of Practice. Section 9.46 states ‘the Local Authority must gather information about the child or young person’s educational, health and care needs’. Section 9.47 highlights the principle of sharing information once to avoid parents having to share multiple times. And the Local Authority must not seek further advice if such advice has already been provided as long as it is sufficient for the purpose of the assessment (this is where it is important your assessment is compliant with NICE guidelines). Your school SENCo or local SENDIASS team should be able to advise you further on this.

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