What we offer

We will be undertaking a variety of assessment procedures, depending on the needs of your child and the family circumstances. Most families attend between three and five appointments, over the total period of assessment.

We will send you - as the child’s parents or carers - a selection of questionnaires to complete and return to the clinic before our first meeting. These enable us to gain important background information, which will inform and speed up the assessment process. Parent-rated reports should be completed as fully and accurately as possible. We also request reports (including questionnaires) from your child’s school/nursery, with your consent. If your child is not in school, because they have been excluded or withdrawn or refuse to attend, we would normally request equivalent reports from the last school they attended.

We invite families to have an initial discussion with us, either in the clinic or by telephone. This provides an opportunity for us to obtain an update on your child’s current behaviours and the history of their problems, before you come to the clinic for the formal diagnostic procedure. It is also an opportunity for you to ask about how the assessment works, who is involved and how long it is likely to take before we have an answer for you.

In the first stage of our work-up, parents/carers are seen together for a diagnostic interview with a clinician from the team. The interview is based on a computerised procedure developed here at GOSH and it covers many aspects of the child’s development and current behaviour. The interview takes up to 3 hours.

We may arrange for you to come with your child for this first diagnostic appointment, or we may see you as parents on your own, on this occasion. If we meet with you all as a family, we will arrange for your child to spend a little time with the interviewer. Usually they will spend the majority of the appointment elsewhere with another team member, doing tests and the observational assessment. As we do not provide any childcare facilities for siblings this appointment should only be attended by parents and the child being assessed. Please call us to discuss if this is difficult for you to arrange.

At the diagnostic assessment with your child, we will use the ADOS. This is a semi-structured observation conducted by one of our clinicians. For younger children it includes games, looking at books, cartoons and pictures. For older young people it is more interview-based, although there are also activities and tasks. Most children find the ADOS enjoyable. It takes about an hour. We will ask for permission to video record the session so that the whole team can evaluate it and give it full consideration if necessary.

We will normally conduct a cognitive assessment of your child. They will be seen by one of our team’s psychologists for approximately two hours, and will complete age appropriate tasks that assess your child’s abilities. The purpose of the tests is for us to estimate their intellectual ability (IQ). Many children on the autism spectrum have unusual patterns of strengths and weaknesses in different aspects of their intelligence. For instance, they may be really good at art, or building things, but poor at understanding or remembering complicated instructions. It is important to identify these strengths and weaknesses because they have implications for educational management, as well as how your child copes with everyday life. We may also measure your child’s performance in tasks that are directly related to their ‘adaptive functioning’, meaning how good they are at the tasks needed to cope with day to day demands.

All children coming up to the clinic will have their height, and weight and head size measured. If there is a possibility of a physical problem with your child that has not previously been investigated locally, we may ask one of our paediatric colleagues to see them and to advise on management. Because we know that many children with Autism Spectrum Disorders have genetic anomalies that could contribute to risk, we arrange to collect DNA (from saliva), which is analysed by our Regional Genetics Service.

Before a conclusion is reached about a diagnosis we may carry out a school visit in order to observe your child in a more familiar environment. We will ask your permission to conduct this visit if necessary and will be happy to discuss it with you. We may also request a specialist speech and language assessment.

The feedback appointment offers you the chance to discuss the findings of your child’s assessment with the same clinicians involved in their assessment. This appointment is usually arranged within a month of the diagnostic appointments. Following the feedback session, we send detailed summary reports to the professional who referred your child to us and to the local team that has accepted responsibility for your child’s future care and management. A copy will also be sent to you and the family doctor (GP). No reports are sent to other agencies without your consent. We would encourage you to share these reports with all those involved in your child’s care and education.

After our assessment procedures are complete we may offer a consultation service to local teams and schools to ensure there is a successful handover to your local service providers.