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Autism Spectrum Disorder (ASD) is a recognised clinical diagnosis describing a range of difficulties relating to social interactions, social communication and social imagination. Adults and children living with ASD will experience a range of different strengths and difficulties ranging from no or mild ASD attributes to more severe or profound difficulties. How these strengths and difficulties are experienced is unique to each person and therefore how to best manage and live with ASD is also unique and individual.
Why do we offer ASD assessments?
Our ASD Assessment service is comprised of Clinical Psychologists who all work and practice both in the public sector (i.e. in the NHS and Social Services) and privately. Through our work, we have noticed the increasing gap in service provision for ASD assessments for both adults and children. Our focus is to try and help meet the need of those who would not be able to access this service through the NHS, or other charity organisations, and would find it helpful to explore the difficulties they are experiencing.
Our aim is to help identify areas of difficulty and strength in order to provide meaningful information and feedback that will enable people to develop interpersonal understanding for thinking about the next steps in their future. As an outcome of the assessment, we would aim to provide helpful guidance and recommendations about the types of intervention, support and areas for skill development that may be useful to explore. We will do our best to signpost and provide resources to guide each individual on their forward journey.
Our future aim is to look towards providing opportunities for therapeutic and social engagement through developing supportive community networks local to our current practice locations in London, Hertfordshire and Hampshire. This community would ideally involve not only those individuals living with ASD but also their families and wider support networks.
Who we are
Dr Claire Buky-Webster, Dr Lisa Wilson, Dr Nicole Stokoe and Dr Terri Brown are qualified Clinical Psychologists experienced in working with adult and family services within the NHS and Social Services. We are passionate about helping young people, adults and their families in understanding whether a diagnosis of ASD might explain a pattern of strengths and difficulties and to use this information to guide future support and/or intervention.
What we offer
We offer assessments for ASD to young people and adults from the ages of 14 years and above who are suspected of having an ASD (see below for some of the indicators). We work as a team due to the different aspects required for the assessment including direct clinical assessment and indirect information gathering and analysis. Our assessments involve several different stages, which help us understand whether a person meets the diagnosis of ASD:
- When you contact us one of our clinicians will take some basic information and arrange a time for someone from the ASD team to contact you to offer an appointment. They will also send you some questionnaires to complete and send back to us. A key ASD team Clinical Psychologist will be allocated to work directly with you and will be your main person of contact throughout the assessment process.
- At the first appointment, we will spend some time thinking about your reasons for considering an ASD assessment and will take a history of your development. We will also screen for other neurodevelopmental and mental health conditions. Where possible, it is helpful for us to speak to a family member or someone who knew you from birth in order to obtain an objective overview of your developmental history. At the end of this appointment we will discuss whether you would like to go ahead with an assessment for ASD and if this would be helpful to you based on the outcome of this initial conversation.
- If you decide to go ahead, we will complete a more comprehensive information gathering exercise e.g. from your education institution, GP and other relevant sources of information. We will also arrange a time for you to come in for the formal structured interview process which will involve an assessment tool called the ADOS-2. We will explain more about this to you if we all agree to go ahead with this stage of the assessment.
- Once both the direct and indirect assessment processes have been completed, we will arrange a final appointment to meet and feedback the conclusions of our assessment and think with you about recommendations to support you in moving forward. We will finalise the report with you and then send you a final version of the assessment results and recommendations.
How can I tell if an assessment might be helpful?
As with anything in life, any child or adult with ASD will be different and may experience any difficulties to different degrees. However, people with ASD are generally considered to experience difficulties in three main areas. This is often known as the “Triad of Impairments:”
- Difficulties with social interactions: individuals with ASD often struggle to understand emotions and how to express them. They may struggle to follow rules of social interactions such as turn taking or standing too close.
- Difficulties with social communication: they often have a very literal sense of language and struggle to understand turns of phrase, jokes or colloquialisms.
- Difficulties with social imagination: they may find it difficult to predict other people’s behaviour, or to understand and respond to how others are feeling. People with ASD can often find emotions overwhelming. Adjusting to change and coping in new situations can be very stressful for people with ASD.
It is of course important to remember that even if you/your child exhibit some of these signs, it doesn’t necessarily mean that they have ASD. If you are unsure, do give us a call and we would be happy to answer any questions.
What is the ADOS-2 (Autism Diagnostic Observation Schedule, second edition)?
This is a semi-structured, standardised assessment of communication, social interaction, play, and restricted and repetitive behaviours. It is recommended in the National guidelines for the assessment of ASD difficulties. Only qualified practitioners who have completed the training and been accredited through this training process are able to administer this structured assessment protocol. There are four different modules containing different activities. The team will decide which module is the most appropriate for you or your child based on their developmental stage and language skills. Only one module is administered for each person and usually takes around 60 minutes to complete.
The assessor will present various activities to elicit any behaviours and communication styles that are directly related to a diagnosis of ASD. The assessor will observe behaviours during this assessment to obtain information that will inform diagnosis, treatment planning, and educational placement and support where appropriate. Where the assessment is completed with children, parents are not present during this assessment. This is to enable the child to engage in the activities without seeking any reassurance or prompts from parents and allows us to full assess their interactions and behaviours unaided.
Will a diagnosis be reached at the end of these assessments?
Once the screening conversation and initial assessment have been completed, the Clinical Psychologist you are working with will arrange to meet with you to share the outcomes. This will be an opportunity to think about the initial findings and to discuss whether further assessment is needed or wanted. A diagnosis would not be given at this stage of the assessment process.
If it is decided to proceed to the second stage of assessment, further structured assessment will be completed following which the assessment team will meet to score the tools and discuss their findings. Using the findings from both the direct and indirect assessment process generally enables the assessment team to reach a conclusion regarding diagnosis. On rare occasions where the results from the interview do not match the findings from the other tools, further information may be required before a firm conclusion can be given. We will then arrange to meet with you again to share the final outcomes of the overall assessment process and to think about recommendations and guidance moving forward.
It is important to note that once a diagnosis of ASD is given, it cannot be rescinded for any reason and will remain with the child/person throughout their adult life. Regardless as to whether your child receives a diagnosis of ASD or not a report will be provided detailing the strengths and weaknesses of your child and some recommendations for support.
What we can not assess
We are also not able to offer assessments for those who are suspected of having a learning disability or Pervasive Developmental Disorder.
How to refer
If you would like to discuss what an ASD assessment entails or arrange for an assessment, please get in touch by either email or call (01420) 540220.