KEY INFORMATION
Background
All of our assessments are compliant with guidance provided by the National Institute for Clinical Excellence (NICE). This guidance states that assessments should be undertaken by multiple professionals and use established, standardised tools. Typically, our assessments are completed by two professionals. One will undertake direct work with the child / young person / adult themselves, using the Autism Diagnostic Observation Schedule (ADOS-2). They also link with schools and colleges. Another professional will undertake the detailed developmental assessment using the Diagnostic Interview for Social and Communication Disorders (DISCO). These measures are seen as ‘gold standard’ in the ASD community, and are used and recognised by services across the UK.
Timescales
Waiting times vary according to demand, and you can request an update about this once you have submitted an enquiry.
Once we have commenced the assessment we would look to complete it within six weeks, provided that mutually convenient appointments can be arranged, and report two weeks after that. All things being equal you will have a completed report within an overall timespan of eight weeks from initial meeting. Sometimes this is extended: typically, this happens if there is a need for additional work (see below) or, in relation to children and young people, if the assessment period overlaps with school holidays. We would always keep you informed of any delays.
Costs
The cost for of a full assessment is £2,000. We request half of this before each core assessment component (DISCO; ADOS-2). Costs can increase if additional assessments are required, e.g. where particular issues or co-existing difficulties complicate the diagnostic process. For example, if a young person appears to have learning difficulties, or if they have had a complex personal history (e.g. attachment issues, adoption, trauma, complex family dynamics etc), we would recommend undertaking additional interviews / standardised assessments to try and tease these issues out from any underlying Autism Spectrum Disorder.
Sometimes, parents request an additional age-appropriate summary letter for their child alongside the main diagnostic report. This would entail additional cost unless that assessment has been particularly straightforward, in which case it is likely to be covered by the agreed funding.
Very occasionally, we have to ask another professional to get involved. This is almost always when there are questions around a young person’s speech and language development. Again, we will keep you informed at every stage if we feel that additional work is necessary and will always explain our reasoning for it.
Format
We undertook developmental interviews via video during the pandemic and continue to do so for those who would prefer this option. However, the ADOS-2 cannot be undertaken remotely so we always look for meet with the child, young person or adult either at home or a convenient external venue such as a school.
Assessing females for ASD
Over the past two years, enquiries to our service relating to females have outnumbered those for males. Many people want to ensure that we have specific expertise in this field, given the differences in how ASD is expressed. We have extensive experience of assessing not only females but also persons who identify as gender neutral or transgender. We are now very experienced when it comes to recognising what is commonly referred to as 'masking' and differentiating between this and more naturalistic social skills.
Pre School Children and children with learning disabilities
Assessing pre-school children is a complex process. We believe that this work is best undertaken by a full multidisciplinary team, hosted within the NHS or a similar organisation. The assessing team must have strong links with nurseries and other relevant settings, and have the capacity to map a child's general developmental profile due to the wide band of 'normal' presentations in infancy. The same is true for children who have, or are suspected of having, significant additional developmental needs such as global learning difficulties or a language impairment. We cannot currently offer this type of intensive input, so our assessments focus on school-aged children with otherwise typical learning and language profiles.
Independence
Our assessments are completely independent, and this sometimes means that the conclusions do not align with parents' or individuals' expectations. In the vast majority of cases this is a positive for those seeking a robust outcome. It is essential that we maintain this independence, as our assessments will not be taken seriously by local services if we do not.
We cannot adjust our clinical findings even if parents have very strong, differing view, as this would a) undermine the validity of our assessments, and b) be potentially harmful for the children and young people who we assess. We will always explain our reasoning, but if our assessments do not support a diagnosis, we cannot make one.
Moving forward
We hope this information is useful. If you feel you have read enough and want to progress with an assessment, please use the contact form on our website as this helps us to keep a track of our enquiries and waiting list. You can access the form here.
Many thanks again for your interest in our services.
Dr Simon Bird and Dr Jonathan Jones
Consultant Clinical Psychologists