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Autism: During assessment

Rygate, Becton and Centenary House

What to expect at your child’s autism assessment 

The aim of your assessment appointment is to identify whether your child fits the diagnostic criteria for autism. The assessment team will work with you and your child to find out about their strengths and needs.

We will NOT be able to provide specific individual advice and strategies at the assessment, as this appointment is only to identify whether your child has autism or not. However, we will make recommendations about how you can find further information and support after the assessment (see after your autism assessment – link to webpage). The assessment will have a different format depending on the age of your child. 

Your child will either be assessed by the Child Development and Neurodisability Service (known locally as the ‘Ryegate team’) or Child and Adolescent Mental Health Service (known as CAMHS). Professionals will select the most appropriate service based on your child’s needs. Autism assessments can take place in different locations for example:

  • Ryegate Children’s Centre
  • Centenary House
  • Becton
  • Other location

You will be told which service your child’s assessment is with when the referral is accepted. Your appointment letter will also tell you which service you are being offered an assessment with and where to go for your appointment. 

Child Development and Neurodisability Service (Ryegate)

We will consider all information from the different parts of the assessment to decide if your child fits the criteria for autism or if their profile is best described in a different way. We may sometimes need to gather more information before concluding, such as assessing your child’s learning ability or their language skills.

If your child is school-age (around 4 years or older)
You will be offered a face-to-face appointment. This will be a multi-professional appointment where we will work with you to decide whether your child fits the criteria for autism. These appointments may be 1½ to 2 hours long.
If your child hasn’t started school yet (around 2-4 years old)
Your first appointment will be with one of our team (e.g. a psychologist or a speech and language therapist). This may be a video or telephone call or a home visit. This first appointment will be around 45 minutes They will start gathering the information about your child and will discuss with you what the next steps in the pathway will be.

A speech and language therapist may also contact your child’s nursery (if applicable). After this you and your child will have another appointment in a clinic. This next appointment will be approximately 1 ½ hours. This will be a multi-professional appointment where we will work with you to decide whether your child fits the criteria for autism.

Both the pre-school and school age assessment will involve a range of professionals (e.g. doctors, psychologists, speech and language therapists). We will choose the best combination of professionals for your child based on the information from the referral.

There are two parts to the autism assessment

Taking a detail history from you, the parent or carer
This will cover information all the way from before your child was born to the present day. We will want to know about your child’s health, their development, and how they play. We will ask about your health and your family’s health. We will ask questions about how your child interacts with others, their communication style, their friendships and their interests. You will have the chance to tell us about any concerns you have around specific behaviours, sleep, eating, anxiety, difficulties in nursery or school and any other worries you have.  
Observing your child and gathering observations from different settings.
This is done in different ways depending on the age of your child. Members of the assessment team will interact with your child during their assessment and carefully observe for their areas of strength and any areas of difficulty. We gather information from other settings in different ways. Pre-school children may be observed in different clinic settings, during speech and language therapy groups, in nursery or at specific play sessions. For older children we gather detailed information from staff who know them at school through the questionnaires and we may contact their school or do a school visit if this is needed.  

We will discuss the outcome of the assessment with you and talk through what will happen next. We will give you information about any support which would be useful for you and your child. Please see after your autism assessment for more details. 

Child and Adolescent Mental Health Service 

If your child is assessed within CAMHS they will be seen by one of our clinicians with specialist skills in assessing for neurodevelopmental conditions. This could be a Clinical Psychologist, a Psychiatrist or a Specialist Nurse. Sometimes, your child may have had another CAMHS clinician before this assessment, within our six-session clinic. This clinician may have requested that an autism assessment is completed, in which case you would have been placed on an internal waiting list for our specialist neurodevelopmental assessment team (NAT). Sometimes, the clinician your child sees in six-session clinic may be one of our neurodevelopmental clinicians and they therefore may be able to do the autism assessment within the clinic, without referring your child to someone else.

There are different parts to our autism assessments.

Collecting a detailed history from the parent/carer
We will ask you lots of questions about your child’s development, from your pregnancy to your current concerns about your child. We will ask you about what your child did at different ages, such as when they met milestones like walking, talking and potty training. We will also ask about their play, social interactions and communication during their childhood. You will have the opportunity to share your current concerns and your views about autism as a possible diagnosis for your child.
Collecting information from your child through observations and/or discussions
Depending on their age, we may offer your child a session to talk about their difficulties and their views about an autism diagnosis. We will also observe your child, regardless of their age. This is most likely to take place in our clinic setting but occasionally may take place in another environment instead, such as school. This is because we need to have evidence of difficulties across more than one setting in order to diagnose autism. During these observations, we will be considering  your child’s communication, social interaction and engagement in activities, such as play or creative tasks.
Collecting information from others
We will have received information from your child’s school as part of the referral. Sometimes, in addition, we may need to observe your child directly at school. If there are other professionals who know your child well, such as social workers or previous CAMHS clinicians, we will also seek information from them, with your consent. This is to ensure that we get a thorough understanding of your child’s strengths, difficulties and life experiences from different perspectives. Occasionally we may also review other information, such as primary school reports if your child is now at secondary school, or social care records that have been shared with us.
Discussing your child within our multi-disciplinary team
Once we have gathered all of the information needed, we will discuss your child’s assessment within our multi-disciplinary team. Others in the team, who may or may not have met your child, will review all of the information which is presented by the assessing clinician. The team will then together decide whether there is enough evidence to meet the criteria for a diagnosis. If there is not, we will explore another explanation for their difficulties. There could be a range of explanations such as anxiety, low mood, trauma or early life experiences with significant others (attachment). Your child’s difficulties may also be explained by another developmental condition such as Attention Deficit Hyperactivity Disorder (ADHD) or a learning disability.
Feedback
Once the above assessment has been completed, we will arrange a feedback session to discuss the outcome with you and, depending on their age, your child.

Please see after your Autism assessment for more details.

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