What is Autism?

Autism relates to neurological difference, or a brain being wired differently. This is something that begins in utero, as opposed to a reaction to a life event. Being autistic means that an individual will think, interact, and process information differently to someone with a neurotypical brain. The way in which an autistic individual experiences sensory information, both from within their own body and from their environment, is also likely to be different than for a neurotypical person. These differences are all part of biodiversity and should be celebrated, not considered as ‘wrong’ or part of a ‘disorder’.

The process of diagnostic assessment can be important for some people, as it supports a more detailed understanding of self, which can be helpful in minimising confusion that can arise from being neurodivergent within predominantly neurotypical communities. Being supported to recognise an autistic identity might then also lead to letting others know and raising awareness so that the autistic individual’s specific needs can be met. Of course, many autistic people do not require additional help. However, some may find an assessment a useful way of identifying helpful adaptations that enables them to better access the curriculum, workplace or other opportunities.

Our aims with each assessment are to increase understanding, raise awareness and to be helpful in a way that meets the individual needs of the people we work with.

Who we are

We are a team of qualified therapists (including Clinical Psychologists, Occupational Therapists and Speech and Language Therapists) experienced in working with children, adult and family services within the NHS and Social Services. We are passionate about helping people of all ages and their families in understanding whether autism explains your experiences and to use this information to guide future support and/or intervention. Our team is led by one of our directors, Dr Nicole Stokoe and detailed profiles for all the team can be found here.  

What we offer

We offer assessments to children (aged 4+), young people and adults who think they may be autistic (see below for some of the indicators). Our assessments involve several different stages to help us understand whether a person meets the diagnostic threshold for autism. These include direct clinical assessment, observations and indirect information gathering and analysis.

  • Initial Contact: One of our team will take some basic information from you and send you our information sheet that outlines the phases of the assessment and the pricing structure. If you would like to make a time to speak with one our assessors about the assessment process in more detail, this can be arranged for you.

  • Initial Assessment: We will discuss your reasons for considering an autism assessment and ask for some further information about your early development and experiences through education and into adulthood (where applicable). The assessor 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, to obtain an objective overview of your developmental history. With child and young person assessments, we will be working closely with the core family members as part of the assessment process. Based on the outcome of this initial assessment, we will discuss with you whether the full structured Autism diagnostic assessment is indicated.

  • Assessment of Social Communication: If you decide to go ahead, we will gather more comprehensive information from relevant sources e.g. from your education institution, GP. We will also arrange a time for you to come in for the direct assessment, using the ADOS-2. We will explain more about this to you if you decide 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 feedback the results and to offer post-diagnostic support.

  • Recommendations to support you in moving forward will be discussed. 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?

Often people seek assessments because:

  • they have particular questions that they’d like to be answered.
  • they’re experiencing a degree of difficulty or distress that they’d like to better understand and manage.

Understanding whether or not someone is autistic can contribute usefully to this. Every autistic child or adult will experience areas of strength, difference and difficulty in varying ways. People coming for assessment might report describe some of the following:

  • Differences with communication, e.g., difficulties knowing how and when to initiate conversations, and what to say; differences with use of language; understanding language literally.

  • Differences with social interactions, e.g., making eye contact with others might feel uncomfortable; understanding and expressing feelings might be hard (i.e., sometimes referred to as ‘alexithymia’); being very sensitive to others’ feelings, to the point of overwhelm, or perhaps being less attuned to others’ feelings; confusion with following social conventions, or perhaps following social convention to the extent that it blocks self-expression (i.e., ‘masking’).

  • Differences with sensory processing, which lead to sensory-seeking or sensory-avoidance e.g., being either more sensitive or less sensitive to sound, light, taste, smell or touch; having interoceptive differences that might make it difficult to notice bodily needs; having sensory seeking means of regulating overwhelm, e.g., seeking proprioceptive or vestibular sensations, e.g., using the trampoline, to feel calm.

  • Differences with attention skills, e.g., being able to pay detailed attention to areas of particular interest, which may or may not be to the detriment of other needs; struggling to pay attention to things that are outside of areas of interest.

  • Preferences or requirement for specific routines.

  • Difficulty tolerating planned or unplanned change.

  • Specific ways of expressing emotion or overwhelm e.g., repetitive movements which might be physical (sometimes referred to as ‘flapping’ or having a ‘stim’), verbal or vocal.

It is of course important to remember that even if you/your child exhibit some of these, it doesn’t necessarily mean that they are autistic. 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’s use is recommended in the National Institute for Health and Care Excellence (NICE) guidance for the assessment of autism. Only qualified practitioners who have been accredited through a training process are able to administer the ADOS-2. 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.

Will a diagnosis be reached at the end of these assessments?

Once the screening conversation and initial assessment have been completed, your Lead Clinician 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 someone proceeds to the next stage of assessment, further information would be gathered and a structured assessment would be completed following which the assessment team will meet to score the tools and discuss the 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 would 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.

Will my diagnosis be accepted by the NHS?

Our assessments follow best practice guidelines and NICE guidance, which means that there is no reason why they should not be accepted by the NHS or other services. We have not had any reports of our assessments not being accepted. If this were to happen, we would strongly encourage you to get in touch with your Lead Clinician to discuss this further.

Our pricing system

We have separate pricing systems for self-funders and those that would like to pay via insurance. If you would like further information, please get in touch and let us know which funding stream you require more information about. We are currently registered providers with BUPA, Cigna and AXA, and would require your membership number and authorisation code as part of your registration process. 

Where would my assessment take place?

The information gathering aspect of the assessment can be carried out remotely, via Zoom or telephone, unless a face to face meeting is preferred. For the assessment of social communication (via the ADOS-2), if an individual is over the age of approximately 10 years old, this assessment could be carried out either remotely or in person, depending on an individual’s preference. This appointment would usually take a maximum of 1.5hrs and we would endeavour to offer you this appointment at a location as close to you as possible but would depend on where you live. For young children, we would recommend this assessment happening face to face. We currently have face to face clinics in Ealing (West London), Central London, Betchworth (Surrey), Banstead (South London), St Albans (Herts) and Southampton.

How to register for an assessment

Please get in touch to request our information pack. If you would like to proceed, we would ask you to please complete and return our registration form. If you require help to complete this form, please let us know and we’ll gladly assist you. Please get in touch by either email on neurodivergence@avenuetherapies.com or call 020 7112 8834.