Deciding to book an autism assessment is a significant step, and it’s natural to want to know exactly what to expect before making that decision.
Many of the families who come to us have already spent months, sometimes years, looking for answers. They may have spoken to school, their GP or other professionals, and still feel uncertain about what comes next.
Our aim is to make the assessment process as clear and straightforward as possible. From your first enquiry through to your final report, we want you to understand what will happen, who you’ll meet and why each stage of the assessment is important.
Quick Answer
Every autism assessment at Spectrum North West follows the same core approach:
- Two clinicians, from two different professional backgrounds
- A developmental history, gathered through conversation, information from various settings, along with direct observation
- The ADOS-2, and the DISCO for all children
- Carried out face to face, usually over three to four hours
- A written report explaining the outcome and practical recommendations
Read on for a full walkthrough of what happens at each stage, from your first enquiry through to your final report.
Before Your Assessment
Every assessment begins with understanding why you’ve contacted us.
When you first get in touch, we’ll ask you to complete a New Client Questionnaire so we can understand:
- who the assessment is for
- their age
- where you live
- your main concerns
- relevant background information
- any previous assessments or reports that may be helpful
We’ll then match you with the most appropriate clinical team for your assessment.
Unlike some providers, we don’t rely solely on questionnaires to understand a person’s history.
Instead, we gather a detailed developmental history through conversation with someone who knows the person well, usually a parent or carer. We believe this provides a much richer understanding than asking families simply to complete forms: it means you’ll spend longer talking to us, and less time ticking boxes.
We also ask for information from school or other educational settings, or, where a child doesn’t attend school, from someone else who knows them well, together with any previous reports that may help us build a complete picture before the assessment takes place.
If you’re still unsure whether a full assessment is the right next step, our Pre-Diagnostic Consultation offers the opportunity to discuss your concerns with one of our clinicians before committing to a full assessment.
Who Will Carry Out the Assessment?
Every autism assessment is carried out by two clinicians from different professional backgrounds.
Depending on the individual being assessed, this may include a combination of:
- Clinical Psychologists
- Speech and Language Therapists
- Occupational Therapists
The assessment will always involve a Clinical Psychologist.
All clinicians are appropriately qualified, registered with the Health and Care Professions Council (HCPC), and have extensive experience working within NHS neurodevelopmental and/or mental health services.
Having more than one professional involved means we can consider different clinical perspectives rather than relying on the opinion of a single assessor. This multidisciplinary approach helps us build a balanced understanding of each individual and provides greater confidence in the assessment outcome. It also enables us to provide a full formulation of your child’s strengths and difficulties.
Why We Assess Face to Face
All of our autism assessments are carried out face to face in our clinic in South Warrington.
Although online assessments have become more common in recent years, we believe there is considerable value in meeting children, young people and adults in person.
Being together in the same room allows our clinicians to observe many subtle aspects of communication, interaction and behaviour that can be much harder to appreciate remotely.
Our clinic has been designed to feel welcoming and relaxed rather than clinical, helping people feel comfortable enough to be themselves throughout the assessment.
Where travelling to clinic is difficult due to a child’s needs, we can sometimes arrange to see you at home instead, depending on where you live within the North West.
What Happens During the Assessment?
Different parts of the assessment often take place concurrently.
Typically:
- one clinician discusses the developmental history with a parent or carer
- the second clinician completes the direct assessment with the child or young person being assessed
This allows us to gather information from different sources within the same appointment while making the best use of your time. It also gives parents or carers the space to talk openly about things they may feel are difficult to raise in front of their child.
Rather than relying on a single assessment or observation, we combine information from multiple sources before reaching any diagnostic conclusions.
The ADOS-2 Assessment
Most autism assessments include the ADOS-2 (Autism Diagnostic Observation Schedule, Second Edition).
The ADOS-2 is a structured observational assessment that usually takes between 45 minutes and one hour.
The activities vary according to age and communication ability but may include:
- conversation
- picture description
- play-based activities
- storytelling
- imaginative tasks
The ADOS provides valuable information about communication, social interaction and behaviour during the assessment.
That’s why we also pay close attention to how someone presents in other parts of the clinic visit. This might include how they interact with their parents or carers, whether they bring a comfort item such as a favourite toy, or how they respond to food or unfamiliar surroundings.
These observations, alongside the ADOS-2, help us build a fuller and more accurate picture.
We always use the whole ADOS-2 assessment rather than only parts of it, and select the module that best fits the person’s age and ability.
However, it represents only one part of the overall diagnostic process.
We never rely on the ADOS-2 alone to make a diagnosis.
Why We Record the ADOS
With your consent, the ADOS assessment is video recorded.
This allows members of the clinical team to review the assessment together before agreeing the final scoring.
Watching the assessment again often allows us to notice subtle details that may be difficult to capture while simultaneously administering and scoring the assessment.
Once the assessment process has been completed, all recordings are securely deleted.
The DISCO Assessment
For all children, we also use the Diagnostic Interview for Social and Communication Disorders (DISCO).
The DISCO was developed at The Centre for Social and Communication Disorders by Dr Lorna Wing and Dr Judith Gould, and is highly regarded within the autism assessment community.
The DISCO is the most detailed developmental history interview available and usually takes around three hours to complete.
Rather than focusing only on current behaviour, it explores development from early childhood onwards, helping us understand long-term patterns of communication, social interaction and behaviour.
The DISCO is particularly valuable because it often identifies differences that may not be obvious during a single observation. It compares a person’s known skills and difficulties against ICD-11 and DSM-5 criteria, which helps others understand why a diagnosis has been reached.
It is also currently the only formal assessment tool that includes an algorithm relating to Pathological Demand Avoidance (PDA).
Sensory Profile
We offer this in addition to our autism assessment, using a sensory profiling tool developed by Olga Bogdashina (2016). This enables us to explore a child or young person’s sensory processing differences in more detail, and helps us tailor our recommendations more clearly.
Adult Assessments
Adult assessments are tailored to the individual.
Most include:
- a developmental history
- the ADOS-2 assessment
- informal clinical observation
Where appropriate, we may also recommend:
- for young adults, the DISCO assessment, to provide more detail
- a sensory profile, which sets out sensory preferences and offers practical advice to support wellbeing
This can be particularly helpful for adults who feel they have spent many years masking their autistic traits or who feel a more detailed developmental history would better reflect their experiences.
How Long Does an Autism Assessment Take?
The length of an assessment depends on which assessment tools are required.
Typically:
- total assessment time is around four to five hours
- direct face to face clinic time is usually around three to four hours
- some parts of the assessment run simultaneously with two clinicians
Occasionally we may need to gather additional information from school or other professionals before reaching a final conclusion.
What Happens After the Assessment?
In many cases we can tell you the outcome of the assessment within one or two days, and sometimes on the day itself.
We also provide a short written summary confirming the outcome while your full report is being prepared, usually within a week of your assessment.
Your full written report takes longer to prepare because it brings together all of the information collected during the assessment. Many of our reports run to 40 pages or more, particularly where the DISCO has been used, reflecting the depth of information gathered.
Our reports explain:
- how conclusions were reached
- whether diagnostic criteria have been met
- the evidence supporting those conclusions
- practical recommendations for future support
Families regularly tell us that receiving their report helps them better understand their child’s strengths, differences and support needs, giving them greater confidence when speaking with schools and other professionals.
We do not routinely share our reports with anyone other than the client and or referrer. You may wish to share the report with your GP, NHS pathway, education provider and Local Authority to provide evidence of support your child is likely to need. We can also support referral to an independent Paediatrician or Child Psychiatrist.
If we feel that further assessment or intervention is required we will advise of this during our verbal feedback.
At a Glance: The Full Process
A typical autism assessment may include:
- Initial discussion about your concerns
- New Client Questionnaire
- Developmental history interview
- Information from parents, carers and school
- Face-to-face assessment by two clinicians
- ADOS-2 assessment
- DISCO assessment (where appropriate)
- Clinical discussion between assessors
- Detailed evidence-based report with recommendations
What Does an Autism Assessment Cost?
Costs vary depending on which assessments are required, and typically range from £1,850 to £2,350. Please get in touch for a personalised quote based on your circumstances.
How Long Will I Wait for an Assessment?
Waiting times vary according to the time of year, particularly around school holidays and other peak enquiry periods, but we can usually see you within one to three months of your initial enquiry.
Still Deciding?
Choosing whether to book a private autism assessment is an important decision.
If you’re still weighing up your options or would simply like to talk things through first, our Pre-Diagnostic Consultation offers the opportunity to discuss your concerns with an experienced clinician before committing to a full assessment.