Support with your child’s Autism or ADHD assessment

At the first appointment it is important for you to bring your child. This means we can meet them, talk to them, complete some activities or play with them – this all forms part of our assessment. 

However there can be some appointments where you might just want to focus on talking with the doctor. For these, it might be better if your child remains at school/nursery or home. We will let you know in advance if it will be beneficial for your child to be there. 

Yes! The appointments can be long and it might be nice for your child to have familiar things with them to keep them entertained. This will not affect the assessment process as it is important for us to understand what interests your child and how they play. 

During the appointment, we may use specific toys and items to assess your child’s development and behaviour. We will let you and your child know if and when these will be needed. 

We need your consent prior to starting your child’s assessment. This shows that you understand why we are assessing your child and what will happen during and after the assessment.

We also seek consent for us to obtain and share information with other agencies that support you and your child – such as your child’s school.  This helps us understand your child’s strengths and difficulties in different contexts and environments.

If you are unsure about giving consent, please contact us to discuss this further as this may impact on whether the assessment can go ahead.

There are several reasons why a child’s referral may be rejected by our neurodevelopment diagnosis service.

Often, this happens because the screening forms have not been sent with the referral. Please ensure these are all completed in full and sent with the referral.

When reviewing referrals and questionnaires we may also determine that the child does not meet the criteria for ADHD/ASD assessment. ADHD and autism can cause behavioural and emotional difficulties but so too can other mental health problems like anxiety, poor anger control or learning difficulties. 

Each referral is reviewed and discussed with a multi-disciplinary team. Following this discussion, if we feel there is sufficient evidence that your child is unlikely to suffer from ADHD/ASD we will advise you of alternative services rather than leaving you to wait for an assessment.

We will give you reasons and provide information to help you find appropriate ongoing support and alternatives to ADHD/ASD assessment. 

Remember that a child or young person does not need a medical diagnosis in order to get support in education. Please see the ‘further support’ section for details of local support for children with neurodevelopmental needs. 

We are sorry that your child is struggling at the moment and we wish we could provide an assessment quicker.

However, there are currently long waits for neurodevelopmental assessment due to the number of children being referred for this services. We are working very hard to tackle this long wait and shorten waiting lists.

Parents/guardians who have concerns for their child’s neurodevelopment may wish to access a range of local resources in the first instance. You can see details of these under the ‘further support’ tab.

You can also discuss your concerns with your child’s Special Educational Needs and Disabilities Coordinator (SENDCO) at your child’s school or educational setting. You should discuss any provision currently in place and consider any changes required.

Children who have certain disabilities or long-term conditions who are being assessed for a neurodevelopmental condition (ADHD or ASD) will be offered support via the neurodisability pathway.

This pathway is for children who will need regular review and may need support from a paediatrician. Children who may be seen on this pathway include children with cerebral palsy, Down syndrome, genetic disorders, global developmental delay and children who are being investigated who are presenting with developmental delay or difficulties.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition. There are three subtypes: ‘inattentive’, ‘hyperactive’ and ‘combined’.

The symptoms of ADHD include:

• Inconsistent attention (struggling to focus on something expected of the child or young person but may hyper-focus on something else).
• Hyperactivity (fidgety and finding it difficult to stay still when needing to)
• Impulsiveness (frequently suddenly doing or saying things without considering the consequences)

People with ADHD may also find it difficult to organise, plan, start tasks, finish tasks, and self-regulate.

As part of development, children typically will take time to learn how to listen, concentrate and follow expectations in everyday activities such as listening to a story, sitting down to dinner, playing with their friends. As a child grows, they may find it difficult to develop these skills at the same rate as their peers. This may suggest that further assessment in these areas could be considered. ADHD is often diagnosed in childhood but sometimes in adolescence or later. 

For an ADHD diagnosis, characteristics must be present in two or more settings (for example, home and school) and must not be better explained by another diagnosis. As we are all different, some children may present with inconsistent attention, hyperactivity or impulsivity but be below the threshold for a diagnosis.

Before receiving a diagnosis of ADHD, it is important that your child has a detailed assessment completed by a specialist paediatrician or ADHD Advanced Clinical Specialist Practitioner.

They will seek detailed information about your child’s ADHD symptoms, behaviours, emotional difficulties and school progress. Parents/guardians and teachers will be asked to complete medical questionnaires (also called rating scales).

The doctor can then make a diagnosis of ADHD if your child meets the diagnostic criteria set out in medical manuals: The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) or International Classification of Diseases 11th Revision (ICD 11).

To meet the criteria for a diagnosis of ADHD, your child must have had ADHD features before the age of 12 years, for at least 6 months, present in more than one setting (usually home and school), and with ongoing significant impairment.

There are no specific blood tests or brain scans recommended to prove the diagnosis of ADHD. Your child’s doctor may carry out certain tests, as required, depending on your child’s clinical condition or difficulties.

Autism spectrum disorder (ASD), often known as just autism, is a lifelong developmental condition that affects how a person communicates with and relates to other people and how they experience the world around them.

An autistic person may have difficulties with  verbal and nonverbal social communication skills that affect their daily life. They may struggle to interact with other people, cope in social situations and form or maintain relationships. Autism is also associated with restricted and repetitive behaviours, such as finding it hard to cope with changes, repetitive movements, fixated interests and sensory processing differences.

These features must be present in the early developmental period but may not be recognised by others until later on in a person’s life. These may become apparent as the social demands increase, or conversely may be masked by learned strategies as a person gets older.

Having a diagnosis of autism does not mean that there is something ‘wrong’ with a person, although we acknowledge that differences in social communication and interaction can lead to challenges in life, such as finding it hard to cope at school. We also recognise that autistic people have many strengths and with the right understanding and support around them can lead a fulfilled and meaningful life.

How to best manage and live with autism is different for each individual. A diagnosis should not be required for interventions that support your child, but it will help your child and others understand the way they think and perceive the world.

The autism spectrum disorder (ASD) pathway includes assessment, diagnosis, support and intervention for children with social communication difficulties.

When a child or young person is referred to us, we hope to gain an understanding of their strengths and difficulties across three areas: social interaction, social communication and social imagination.

Following your child’s assessment, we will decide if a diagnosis of ASD will be useful in explaining your child’s pattern of difficulties.