Choosing a Private Autism (ASD) Assessment: What You Need to Know - Part 1

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It can be hard to know what to look for when choosing a private service to complete an Autism (ASD) assessment. There are a lot of services out there. We would like to share our knowledge with you based on our many years of NHS experience of completing Autism assessments as well as reviewing private assessments to see if they are up to NHS standards (these standards are published in the NICE guidelines).

1. Option to have an initial chat - Many services will offer you the opportunity to speak to someone from the service so that you can explain what you are looking for and ask more questions about the service. However, some services skip this step and move straight to screening or even assessment (explained more below). Often parents/ guardians have a strong sense that their child is autistic and it can be tempting to move as quickly as possible to an assessment, however there are some helpful things to consider at this early stage.

   
   

   These include:

   - does your child want an assessment? We have met many children who have rejected their diagnosis and this has limited the options for support. Involving your child from the beginning in the assessment process reduces the chances of this happening.

   
   

   - is now the right time for an assessment? For example, trying to do screening forms just before the school holidays may mean you end up with this stage taking a long time as teachers are not around to provide information.

   
   

   - has your child previously had an assessment? A high quality provider will only recommend providing a second opinion if there is either a clear reason why there was a problem with the first assessment or if there is significant new information.

If a service isn’t interested in these foundational questions, they may be prioritizing "bookings" over your child’s best interests.

2. Good screening - screening allows a mental health professional to find out more information about potential signs of Autism that are seen by you as a family and by other important people in your child's life (usually your child's school but this may also include other people who know your child well like teachers or coaches at afterschool/ weekend clubs or classes they attend). Autism assessments are expensive, they take time and they can be a significant emotional experience for your child and your family. Screening helps us to decide whether there is a reasonable chance that we thing your child is Autistic. This reduces the chances of ending up with an inconclusive assessment result.

   
   

   If a service is not taking the time to complete screening they may be too focussed on people signing up for assessments - again this does not suggest that they take a thorough approach to assessments.

   
   

3. Assessment tools - The NICE guidelines (https://www.nice.org.uk/guidance/cg128) recommend that every assessment should include a developmental history (this focusses on key developmental and behaviour signs of Autism) AND an assessment of your child's social and communication skills and behaviours (this looks for key signs of Autism). The ADOS-2 is the gold standard tool usually used to complete a behavioural observation and the 3DI or ADI are the gold standard tools usually used to complete a developmental history.

   
   

   Its important to say that these tools don't have to be used. Tools are only as good as the person using them. We have certainly seen NHS assessment which have not used any of the above tools and the final report shows that a high quality assessment has clearly been completed by an experienced assessment team. We have also seen assessment reports where gold standard tools were used as part of the assessment but the assessment was still of a low standard. This can happen when assessments are rushed and/ or when the persons completing the assessment have little experience.

   
   

   We would suggest that you ask the person completing your child's assessment what experience they have. A person may have complete training to use gold standard tools but have little practical experience of working with people with Autism. This may mean that they miss out on key but subtle signs of Autism (which might not get picked up on elsewhere in the assessment).

There is much more to consider, but we hope this provides a helpful starting point. At Today Psychology Practice, we pride ourselves on transparency and clinical integrity.

We are always happy to answer your questions about our assessment process. Book a free 20-minute consultation to discuss your child’s needs.