How do children get an autism diagnosis?
If you suspect that your child may be on the autistic spectrum, you may decide to have them formally assessed. This may result in their being given a diagnosis of an autism spectrum condition (ASC). Receiving a diagnosis can be very beneficial to children and young people, as it means that the right support can be put in place to meet their needs.
There are multiple pathways for receiving an ASC diagnosis. These can be categorised as:
- Social Communication Disorder (SCD) Pathway. This is the most common pathway to a diagnosis of ASD. It is carried out by one of the Child Development Services.
- Child and Adolescent Mental Health Service (CAMHS) Pathway. If the child or young person has mental health difficulties in addition to signs of autism, they may be assessed and receive a diagnosis through the CAMHS pathway.
- Adult Autism Assessment & Diagnosis Pathway. This pathway is followed if a young person is aged 18 or over. Please click here for more information on assessment as an adult.
In all cases, if you think your child may be autistic, you should talk to a health, education or social care professional from their educational setting (e.g. the SENCO or speech and language therapist at your school / college). They will ask you questions to understand why you think your child is autistic. Based on the information gathered, they might refer your child onto a specialist autism assessment pathway.
Most children and young people (aged under 18) who present with social communication difficulties will be referred, by their GP or other health or social care professional, to the Social Communication Disorder (SCD) Assessment Pathway at their local Child Development Service.
Which Child Development Service your child is referred to depends on the location of your GP:
- GPs located in the north of the borough refer to the Woodfield Child Development Service.
- GPs located in the south of the borough refer to the Cheyne Child Development Service.
For details on the specific pathways at either service please see below:
Woodfield Child Development Service
The pathway involves assessment, diagnosis, support and intervention for children who display social communication difficulties. A multi-disciplinary team will seek to gain an understanding of your child’s strengths and difficulties across three areas: social interaction, social communication and social imagination. Following the assessment the team will decide if diagnosis of an Autism Spectrum Condition (ASC) will be useful in explaining your child’s pattern of difficulties.
The number of appointments, and types of assessments carried out, will depend on the individual circumstances of your child. For most children, the assessment process takes less than one year from initial referral to review.
The pathway typically consists of the following steps:
1. Initial Appointment. Following referral by your GP or other health / social care professional, you will receive an invitiation for an initial appointment at the service. You will meet with a team of professionals that will always consist of a paediatirican, with either a speech and language therapist and/or clinical psychologist also present.
Some assessments will be carried out in this appointment and it is possible that there will be enough evidence to make a decision on a diagnosis by the end of the session.
For a list of assessments that may be carried out, please download the Assessment Pathway Leaflet.
2. Further Assessment. Depending on the needs of your child, the service may carry out further assessments to get a better understanding of your child's strengths and difficulties.
This may include observations at your child's nursery or school.
For a list of assessments that may be carried out, please download the Assessment Pathway Leaflet.
3. Review. When all of the assessments have been completed, you will be invited to a review appointment where the SCD pathway team will let you know the outcome of the assessment. A report with the findings of the assessment will be sent out and shared with all agencies involved (e.g. your child's nursery / school)
If the outcome is that diagnosis of an autism spectrum condition (ASC) is given, you will be invited to a post-diagnosis support group and told about interventions that can help.
If your child is not given a diagnosis, you may be referred onto other services that can help with your child's needs.
Cheyne Child Development Service
If you are unsure why your child has been referred, ask the person who made the referral to explain their reasons.
Children are referred for various reasons. There may be concerns around the following:
Communication: Some children are referred because they have difficulties with their speech or other aspects of their communication. For example, they may be delayed in learning to speak, or they may have lots of speech but speak in a way that is quite formal or grown up for their age, or may not use non-verbal gesture.
Social Interaction: Children are often referred because of difficulties interacting with others. They may find it difficult to make friends or engage in social conversations, they may misunderstand social cues, or may appear uncomfortable, awkward or anxious in social situations.
Other behaviours: Children may be referred because they show certain behaviours or interests. They may flap their hands, have unusual interests, or want to follow certain routines. Others have sensory difficulties and are over-sensitive to sounds, smells or textures.
At the Cheyne Child Development Service, your child will be seen by a team of multi-disciplinary healthcare professionals. The team may include a:
- Speech & language therapist
- Clinical psychologist
This assessment focuses on a child’s communication, social interaction, imaginative skills, behaviour and interests. Children who present with difficulties in these areas may have a Social Communication Disorder or an Autism Spectrum Condition (ASC).
The assessment also seeks to rule out other possible explanations for a child’s difficulties.
What will the assessment involve?
1. Information Gathering:
Prior to the assessment, you may be asked to complete a questionnaire about your child’s communication skills. You may be asked to pass on questionnaires for your child’s nursery to complete about how your child is progressing in nursery. This helps us to build up a clearer picture of your child’s strengths and areas of difficulty.
These are usually appointments with a paediatrician and may or may include a Speech and language therapist or a clinical psychologist. There may be more than one appointment.
Assessments may include some of the following
- An initial discussion about your concerns, your child’s development and family history.
- A physical assessment of your child: height and weight measurements, and other non-invasive checks.
- A diagnostic interview with the paediatrician, which includes questions about all aspects of your child’s communication, social interaction, play/imaginative skills, behaviour and interests.
- Activities with your child to assess their communication, social interaction and play skills.
- At the end of the assessment, we will provide recommendations specific to your child’s strengths and needs, and you will be given information about national and local resources. We may also refer your child to other services (with your consent).
- You will be welcome to share your views and ask questions at this meeting. We recommend that carers don’t attend the feedback meeting on their own. If two carers cannot attend, you are welcome to bring a friend or other family member with you.
3. Written Assessment Report:
After any assessment, you will be sent a report detailing the assessment, outcome, diagnosis and action plan
4. Post Diagnosis Appointments
If your child is given a diagnosis of Autism Spectrum Condition (ASC) they will be offered a post diagnosis appointment, where the diagnosis will be discussed in more detail and local support services will be discussed.
The Child and Adolescent Mental Health Service (CAMHS) Pathway is an alterative pathway to diagnosis for children and young people (aged 5-18 years) who are experiencing mental ill health in addition to social communication difficulties.
To access this pathway, your child's GP (or any other health, education, or social care professional) needs to make a referral to CAMHS. Depending on the type and severity of mental health need, CAMHS may then either invite you for an initial assessment, or signpost you to a more appropriate service.
Typically, the assessment process consists of the following steps:
1. Initial appointment. During this initial appointment, a comprehensive assessment will take place. This will include taking a developmental history and details of your child's milestones around social communication, observing your child's social communication in practice, reviewing any evidence available from previous assessments (e.g. occupational health, educational psychology etc.) and exploring any co-exiting mental health, physical health, or neurodevelopmental difficulties that might help to explain your child's social communication difficulties.
2. Post-Assessment Discussion. A team of multi-disciplinary professionals will meet after the initial appointment. They will talk about whether they think diagnosis of an autism spectrum condition (ASC) would be helpful in explaining your child's difficulties, and whether there is enough evidence already collected to support a diagnosis. Many children and young people will be told the outcome of the assessment at this point.
3. Further / Specialist Assessment. It might be agreed that there was not enough evidence collected in the initial appointment to be able to make a decision about whether to give an ASC diagnosis. In this case, further assessments may be conducted. These further assessments might include
- Taking a more in-depth history of your child's development
- Observing your child at school or as they interact with peers
- Conducting a cognitivie / educational psychology assessment
Sometimes, even with this extra information available, there is still not enough evidence to make a decision about a diagnosis. In this case, a specialist assessment will take place.
There will be another post-assessment meeting of the multi-disciplinary team to discuss the findings. This will results in a decision about whether or not to give an ASD diagnosis.
4. If a diagnosis is given, your family will receive post-diagnosis information and support. A report will be sent out to you and (with consent) your child's school. This will explain your child's areas of strength and difficulties and make reccomendations for their support. Your child may also be referred to other services (e.g. speech and language, educational psychology) that could be able to help, and support you with an application for an Education, Health and Care Plan (EHCP) if considered appropriate.
If a diagnosis is not judged to be appropriate, a report will be sent out to you and (with consent) your child's school. This will explain your child's areas of strength and difficulties and make reccommendations for their support. Your child may also be referred to other services (e.g. speech and language, educational psychology) that could be able to help, and support you with an application for an Education, Health and Care Plan (EHCP) if considered appropriate.