Is My Child Autistic? What to Expect From a Child and Adolescent Autism Assessment
By Dr Floriana Reinikis, Consultant Clinical Psychologist | ADHD Coach | Oasis Psychological Services | Ashford, Kent
If you’re reading this, you’re probably carrying a question that has been sitting with you for some time. Maybe you’ve noticed things about your child that you can’t quite explain. Maybe school has raised concerns, or perhaps you’ve come to this yourself after months or years of wondering. Maybe your child is older and has started asking their own questions about why certain things feel so hard, or why they experience the world differently from people around them.
Whatever has brought you here, the fact that you’re asking the question matters. And the process of finding answers, when it’s done well, can be one of the most useful and clarifying things you do for your child and your family.
At Oasis Psychological Services, we carry out autism assessments for children and adolescents across Kent, including Ashford, Folkestone, and Canterbury, as well as for families who travel from further afield. This post explains what that process involves, why it’s structured the way it is, and what you can expect at each stage.
Why a Good Assessment Looks Different for Children and Adolescents
An autism assessment for a child or young person is not simply an adult assessment scaled down. The process is genuinely different, because the clinical picture, the sources of information, and the people involved are all different.
With adults, the person being assessed is the primary source of their own history and experience, alongside at times an informant. With children and adolescents, the picture is built from multiple perspectives: the young person themselves, their parents or carers, their school, and the clinical team’s direct observations. Each of these perspectives matters, and a thorough assessment draws on all of them.
For adolescents in particular, this balance requires additional adaptations. Teenagers often sit in a complicated middle ground between child and adult presentations. They may have developed sophisticated strategies for masking or camouflaging their differences, sometimes so effectively that neither parents nor teachers have a full picture of the level of effort, distress, or adaptation involved underneath. Their own account of their experience, including sensory overwhelm, social exhaustion, anxiety, and identity questions, is not just helpful. It can be essential to understanding what is actually going on.
This is why we try to involve young people in a way that respects their growing autonomy, while still holding the important role that parents and carers play in providing the developmental history and context that only they can offer.
The First Step: An Initial Consultation
Before any specialist assessment begins, we always start with an initial consultation. This is an important step, and not one we rush through or skip.
Families come to us at different stages. Some have already spent months researching and arrive with a clear picture of what they think is going on. Others are much earlier in the process and are still trying to make sense of what they’re noticing. Some have been referred following concerns raised by school. Others have come entirely off their own instinct as a parent. All of these starting points are valid, and the initial consultation is designed to meet you wherever you are.
Before this consultation, we ask (with the young person’s and parental consent) parents, school teachers, sport coaches, and where appropriate the young person themselves, to complete detailed questionnaires. These give us quantitative information about the young person’s development, social communication, sensory experiences, behaviour, and emotional wellbeing across different environments. The gaps between how a child presents at home, at school, and in their own account of their experience are often as informative as the similarities.
The initial consultation itself lasts around 90 minutes and is conducted by one of our clinical psychologists. We’ll spend time listening to what’s brought you here, what you and your child have been experiencing, and what you’re hoping to understand. We’ll explore the concerns you and/or they’ve noticed, ask about your child’s development and history, and think together about what might be going on.
We also screen at this stage for autism, ADHD, anxiety, and depression, because these conditions can overlap, look similar, or co-occur in ways that matter clinically. Sometimes what looks like autism turns out to be primarily anxiety driving the picture. Sometimes it’s ADHD. Sometimes it’s a combination of several things. The initial consultation is where we begin to make sense of that together.
After gathering both the quantitative information from the questionnaires and the qualitative information from the conversation, we’ll talk honestly with you about what we’re seeing. We’ll be clear about whether a full autism assessment feels like the right next step, whether there are other things that need to be considered alongside it, or whether a different pathway might serve your child better.
If a full autism assessment is the right way forward, we’ll move to scheduling the assessment day.
The Actual Autism Assessment: What Happens on the Day
For most families, both parts of the assessment take place on the same day. The young person spends time with one of our clinicians, usually a Speech and Language Therapist, for the observational part of the assessment (ADOS-2), while at the same time a clinical psychologist meets separately with parents or carers for the developmental interview. Bringing everything together in a single visit is our preferred approach, and most families find it easier to have the process contained within one day.
There are occasions when the two parts need to happen on separate days. One of the most common reasons for this is when a young person, usually an older adolescent, is invited to join part of the developmental interview. In some cases, we may want the young person to be present for part of that conversation, either to share their own perspective or simply to feel included in the discussion about them. When that is the right approach, it makes clinical sense to complete the observational part of the assessment first and schedule the parental interview separately.
During the ADOS-2, the young person spends time with one of our clinicians doing activities and having conversations that are carefully designed to create natural opportunities for communication and interaction. For younger children, this often feels like play. For older young people and teenagers, it tends to feel more like a relaxed conversation. Our clinician is not testing the young person or looking for them to perform in a particular way. They are spending time getting to know them, and observing how they naturally communicate, interact, and respond to the world around them.
At the same time, or on a separate day where needed, a clinical psychologist meets with parents or carers for the developmental interview. This is a detailed conversation about your child’s history from early childhood to now: how they developed, what they were like as a young child, what school has been like, how they manage friendships, routines, sensory experiences, and change. This perspective, which only parents and carers can offer, is just as important as the direct observation with the young person.
Once both parts are complete, the clinical team meet together to review everything gathered across all sources before moving to feedback.
Feedback and the Discussion Session
Once the clinical team has reviewed all the information gathered, they invite the family back for a feedback and discussion session on the same day.
During this session, we explain what we have found, what the assessment indicates, and what it means. If your child’s presentation meets the criteria for an autism diagnosis, we will explain this clearly and compassionately, and we will begin the conversation about what that means for your child and your family going forward.
If the assessment does not result in a diagnosis, we will explain our findings in detail, explore what else might be going on, and discuss what other support or pathways might be most helpful. A conclusion that isn’t a diagnosis is not an unhelpful one. It is still a clinical picture, and it still points towards recommendations and possible alternative diagnoses.
For younger children, feedback may be given to parents first. Some families prefer to receive this separately before thinking carefully about how and when to talk to their child about what was found. For teenagers, we would usually want to involve them in the feedback process in some way, where the young person is ready, because the assessment is about them and their own understanding of themselves matters.
The Report
Within three to four weeks of the assessment, we will send you a comprehensive written report.
The report draws on everything gathered across the assessment process and how the diagnostic conclusions were reached. It describes your child’s developmental history, their strengths, their challenges, and their specific needs across settings. It includes personalised recommendations tailored to your child’s actual life, their school environment, their family context, and their individual profile.
With your consent, we will share the report with your child’s GP and school. A clear and well-written report is one of the most practical tools a family can have, because it gives you the language and the evidence to advocate effectively for your child’s needs in school, in healthcare, and beyond. It can also support applications for EHCP provision and referrals to CAMHS or other specialist services.
The Role of the Young Person’s Own Voice
For younger children, the assessment is primarily built around parental information and clinical observation using the ADOS-2. But for adolescents, the young person’s own account of their experience is something we take seriously and make specific space for.
Teenagers often have a much richer internal experience than is visible to the people around them. They may have learned, sometimes very early, how to perform in ways that look fine on the surface while managing considerable internal effort. They may have their own questions about their identity, their sensory world, their relationships, or why certain things have always felt harder for them than for their peers.
Where appropriate, we may invite a teenager to contribute to parts of the consultation, particularly where they can speak to their own lived experience in a way that adds important clinical information. This might include their experience of social exhaustion, sensory overwhelm, anxiety, or the way they have adapted and compensated over time.
The assessment is about them. Their understanding of themselves matters, and we treat it accordingly.
School Observations: When They Are Helpful and When They Are Not Needed
School observations are not a routine part of our autism assessment pathway, because we already gather a significant amount of information from the child’s educational setting. This usually includes school questionnaires, teacher reports that we have created to gather a comprehensive narrative, and any relevant school-based documentation. In many cases, this provides a thorough picture of how the child presents in school, including their social communication, peer relationships, sensory needs, emotional regulation, learning profile, flexibility, attention, and support needs.
There are situations, however, where a school observation may be clinically helpful. This might be recommended when the information gathered from home and school is unclear, inconsistent, or limited, or when there are particular questions about how the child manages within the school environment that cannot be fully understood through reports alone. A school observation can also be useful when we need to better understand the child’s presentation in context, including how they navigate classroom demands, transitions, social situations, the sensory aspects of the school day, or less structured times such as lunch and break.
For this reason, school observations are offered as an additional step where clinically indicated, rather than as a standard part of every assessment. When one is recommended, we will always discuss this with you directly and be transparent about what it involves, including the time and any additional cost, before you make any decision.
Helping Your Child Understand What the Assessment Involves
One of the questions parents ask most often is how to explain the assessment to their child beforehand. The answer depends on the child’s age and temperament, but the most important thing is to keep it simple, honest, and positive.
For younger children, you might explain it something like this: “We’re going to visit some friendly people who want to spend time with you and get to know you. You’ll do some activities and have a chat with one of them, and I’ll be talking with someone else nearby. Afterwards we’ll all sit together and they’ll tell us what they’ve learned and how we can help you.”
For older children and teenagers, a more direct explanation usually works better. Teenagers often feel more settled when they know exactly what to expect and feel respected enough to be told the purpose of the visit honestly.
Our team always meets the whole family together at the start of the assessment day, so that the young person can see and speak with the clinician they will be spending time with before anything else happens.
Clinical Standards and Who Carries Out the Assessment
All assessments at Oasis follow the NICE guidelines for autism assessment in children and young people (CG128), which set the national standards for how assessments should be conducted, what they must include, and who is qualified to carry them out.
The NICE guidelines are clear that autism assessments must be conducted by specialist, appropriately qualified clinicians, and that diagnosis should never be based on a questionnaire alone. A quality assessment requires direct clinical observation, detailed developmental history, information from multiple sources including school and home, and careful consideration of differential diagnoses.
Our clinical team brings many years of specialist experience in autism and ADHD assessment across the NHS and independent practice. All team members are HCPC registered, and assessments are carried out within a multidisciplinary team that includes clinical psychologists and speech and language therapists.
After the Assessment: What Comes Next
For many families, receiving a diagnosis brings an enormous sense of relief. Things that have been hard to explain, or that have felt confusing for years, begin to make sense in a new way. For others, there is a period of adjustment as they think about their child’s story through a new lens, and that process takes its own time. Both responses are completely understandable.
What we hope a good assessment offers not just an answer, but a clearer and more compassionate picture of your child and what they need. Our team is always happy to talk through what next steps might look like. A diagnosis is a beginning, not an end.
This might include recommendations for school support and EHCP considerations, referrals to other services, or child therapy and family support where that is appropriate. The report itself is often one of the most practical things you will have, because it gives you the language and the evidence to advocate effectively for your child’s needs in school, in healthcare, and beyond.
Ready to find out more? Get in touch at info@oasispsychologicalservices.co.uk or call us on 07307 385472. Find out more about our child and adolescent autism assessment service.