What happens during an Autism Assessment ?

We asked one of our families to answer key questions around what happens during an autism assessment

How did you feel going to the Autism Assessment?

We had mixed feelings about the assessment and whether our son would actually end up with a diagnosis. I’d been worrying about whether he would labelled or miss out on things in the future because of the label. Our concern was also whether the whole ‘autism thing’ would affect how other people saw him and lead to issues at school. In the end we decided it was important to understand what he needed to be happy and for us to know how to support him so we went ahead.

We also thought it could be helpful so he understand more about himself and doesn’t feel different.

Why did you have an Autism assessment?

Our son was starting to struggle at school confidence wise and with making friends and he really didn’t enjoy going to school. He seemed to be getting more anxious about school work and what his teachers were asking him to do.

He was worrying about things other kids weren’t and he seemed to be withdrawing into himself.

His body language changed from happy to sad and nothing we were doing or saying was helping.

The class teacher was starting to pick up him panicking and worrying about his work and he was starting to cry because he didn’t understand what he needed to do.

We looked for someone to bee able to help with his anxiety and confidence and to understand why he was finding school so hard. We didn’t want it to get to the point where he was refusing to go to school. This all lead to the doctor recommending the autism assessment.

What happens during an ASD assessment?

There were a few stages and these were all booked in at the beginning of the assessment.

1 History

We met with the psychologist and talked for a couple of hours about our family and our son’s childhood. We answered questions about his development going back to when he was born and even the pregnancy. They appointment was called the ADI-r and the doctor asked us about things our son was good at and things he found difficult.

We chatted about moments that stood out, areas we were worried about and behaviours that drew our attention.

We discussed all sorts from school and family life, his friendships and interests,  his passions and turn offs. It was pretty tiring to be honest  and intense as we had to go back a long way. We did find it reassuring and therapeutic in a way as well because we were sharing everything.

2 School visit

A member of the assessment team went into the school for a school observation. They watched him in class and with his friends at lunch and I understand they spoke to the teachers. We weren’t involved in this stage so I don’t know too much about it other than the findings and thoughts were included in the report.

3 one to one assessment

We went into the Evolve clinic for an hour long appointment called the ADOS. He really enjoyed this session.

Two ladies played, set challenges and chatted with him. The mood seemed very relaxed and the team were friendly to us both.  He said he’d really enjoyed it and I did too as I waited downstairs and had a coffee!

4 Feedback session and report

My husband and I had a video call with the leading Psychologist to go through the assessment and the report.  The doctor made her conclusions and was really thorough talking about what they’d seen.  She seemed to really understand him and had some great suggestions and observations.

It was also useful to go through each of the areas of the assessment and then to see what this all meant practically.

The report was sent to us and we shared this with school. We were keen for the school to see it and to use it to help support him.

What is Autism Spectrum Conditions or Autism or ASD ?

Our understanding is that if you meet a certain amount of behaviours and they are strong enough then you’ll receive a diagnosis. The professionals probably put it another more complicated way but that’s what I understand.

We weren’t sure if our son would get a diagnosis because he seemed on the whole, to be managed pretty well and often would hide how he felt. Now we know more about the condition we are so proud of him.  We know now how much it must take for him to get through a day at school or when things change and he feels uncomfortable.

I think the title autism or being autistic, gives people a specific image of someone and I think the name is too small for what I now understand it to be.

 

Have you talked about Autism and ASC with your family?

We have always told our children that we are all different and that it’s good to be different.

We say everyone is full of different ingredients; some sweet, some spicy, some healthy, some indulgent,  that’s what makes them unique.

We were always really honest about what the therapy was and why it was helpful.

Rather than talk about the assessment itself we have discussed different things we have learnt from the doctors. We know more so feel like we are able to prompt him to share more and anticipate problems and what to do to help him.

 

Has the assessment helped your family?

It feels like a bit of a relief to be honest because we understand more about how he feels, why he behaves in certain ways and how he sees things.

We have changed the way we parent and we hope we are now more patience. The dynamics in the family have changed because we respond differently and thankfully we  feel like we are getting somewhere.

There have been times when it’s been tough, wondering if we did the right thing and what other people would say but we came to realise that the assessment helps him and us in the long term.

 

Who should you speak to for an Autism assessment?

We  asked our GP for a therapy referral then ended up with a private psychologist.  The therapy side of things then led to us into having the assessment. It may be different for different families.

 

How would you help someone looking to have an Autism Assessment?

I think it’s important to talk to the people actually doing the assessment to check you trust them and like their approach.

I’d say do some research so you know what happens and how the appointments work. I’d ask what the report includes and whether it is an MDT (multi disciplinary team) who do the assessment . We found a lot of information online, on local forums and groups as we didn’t have anyone we knew who had been through an assessment. You could also ask the school to see if they know any good companies.

 

How long does an Autism Assessment take?

Ours took 10 weeks but apparently it normally takes under 8 weeks.

 

What happens after an Autism Assessment?

After the report and our call with the doctor we sent the report  to school.

We read books and found articles and sites that have been useful. We aren’t rushing into anything in terms of having anymore sessions or support as we are managing. The assessment has given us a lot of information and food for thought.

 

Find out more about the Evolve team 

Contact Evolve to find out more about the assessments we offer.

Useful links: National Autistic Society (autism.org.uk) , Autism | Society | The Guardian and Aspect Australia | Autism Spectrum Australia (Aspect)

Support services – post diagnostic

Post diagnostic workshops

We are launching post diagnostic workshops for families and carers of children on the autism spectrum.

Our workshops are online or in person and can be in group sessions or as private family groups. The workshops are across 10 weeks and aim to:

  • Help you understand how children on the autism spectrum see the world
  • Identify potential symptoms
  • Understand your child’s behaviour
  • Offer you strategies
  • Problem solve
  • Create behavioural strategies
If you are interested in finding out more then please contact us
You may also want to read some of out other blogs here including girls masking autism  and choosing a school for a child on the autistic spectrum or with ADHD

What is ADHD?

What is ADHD?  ADHD (Attention deficit hyperactivity disorder) is a condition that affects people’s behaviour. People with ADHD can seem restless, may have trouble concentrating and may act on impulse. (www.nhs.uk)  Symptoms of ADHD tend to be noticed before  years old and may become more noticeable when a child’s circumstances change, such as when they […]

Girls with autism

 

According to Autism in Pink autism in women and girls is “often overlooked or diagnosed late”.

Here we will explore why more boys than girls are assessed and diagnosed for ASD, how girls are masking their traits and the impact of masking and the signs of autism in girls and women.

 


 

Source: Autism Diagnostic Service | NHS GGC


Why are less girls diagnosed with autism?

Girls with autism

Masking ASD

There is some evidence that there are biological factors which explain why fewer girls and women receive a diagnosis for ASD. Another argument is that women with autism simply don’t fit into the standard ASD profile (signs and traits).

We know that parents can be reluctant to seek a diagnostic assessment for their child because the child is coping or the parent is unaware of the full impact on the child.

If their daughter appears to be coping reasonably well then any changes in behaviour can easily be explained away by puberty, shifting social pressures, school transitions and academic pressures. It may appear to be a leap to thinking any behaviour or symptom could be the result of ASC.

Teacher likewise often under report traits in girls because the child is masking the full extent of their traits effectively. Clinicians similarly may hesitant to commit themselves to a diagnosis unless the signs are significantly different from “a normal range” of behaviour and abilities.

 

 

 


How are girls and women masking autism?

Our clients will often have their own personal strategies to mask or camouflage their difficulties.

They have worked out how to act, what to say and what expression to give. This may be by basing behaviour on mirroring from another scenario or research. The masking can be exhausting (as you’d imagine) because they have to actively manage their inner anxiety whilst appearing calm and confident on the outside. At school the child may be managing to appear social in the play ground at lunchtime and then and a model student in the classroom, but as soon as they get home they collapse. They crave some down time and if they are put into another ‘pressured situation’ then it can be too much. After school clubs for example may sound like a great idea but to someone on thee spectrum it may feel like another performance that they don’t want to do.

Successfully masking means constantly prove oneself and in effect being  ‘fake’ . This can lead to feeling misunderstood and that in itself can lead to feelings of frustration.

Coming up with ingenious and creative ideas to imitate, model and camouflage difficulties can include developing ‘social scripts’ for real-life situations. They prepare themselves for a social situation,  like an actor learning a part. They think about all the permutations that may appear, understanding what they could say, how they could act and what may be expected of them. 

Here the Art of Masking shows what impact this masking can have on the individual.

 

Masking autism in girls

Girls masking autistic traits

Source The Art of Masking: Autistic Women who Mask | Tiimo (tiimoapp.com)


What are the signs of Autism in girls?

11 signs of Autism in girls

11 signs of Autism in girls

Verywell / JR Bee

You can read more about autism in our other blog but when we are talking about girls with autism these points are important to note:

  • Create imaginary friends
    Girls can use these imaginary friends or play with dolls to substitute for real people. This make believe can help them experience some sort of connection without the social pressures.
  • Fascinated with a subject
    Whether it’s history, literature, or a subject girls can become very educated and interested in a specific subject.
  • Tone of voice
    This can resemble a much younger person and have a childlike quality.
  • Different to their friends
    They may not hold the same values as their friends and can then feel different.

Read more signs and symptoms of autism in girls

How can we better support girls with autism?

We hear client’s saying “I don’t came across as autistic” but wish they had the confidence to stand up and say “I am actually autistic.”

Many girls, young women and adults we have spoken to, wish friends and family knew the ‘real them’ and that their struggles and differences were understood and accepted.

If this sounds familiar and you are looking for some help and support than a good starting place maybe an assessment. We assess children and adults for neurodevelopmental conditions and you can find out more here Autism Assessments 


Other useful resources to make time to read are:

Emma offers a personal account. Unmasking, personal growth and reaching my potential as an autistic person

Read more about Autism masking Blending Into the Crowd: What is Autism Masking? – Autism Parenting Magazine

Read more information about girls, women and autism with Scottish Women’s Autism Network (swanscotland.org) 

More information around Autism and children can be found at Autism Diagnostic Service | NHS GGC 

Autism: Supporting your teenager

Autism: Supporting your teenager

Download Autism supporting your teenager by Caroline Hattersley. Containing resources, activities and exercises for you and your child to complete.

Find resources at Autism: supporting your teenager

 

 

 

 

 

What to expect from an Autism Assessment

 

Neurodevelopmental Assessments are incredibly beneficial for children and adults because they help us understand our strengths and difficulties. This article gives you more information about what ASD assessments are and when they are useful tools.

 


Why is it important to get an Autism Assessment?

There is currently no known single cause of Autism but an early diagnosis can help children because it means the people around them understand their strengths and difficulties and they therefore can enjoy the right support at home and in school.

We also offer Autism Assessments for adults and we are seeing more and more adults coming into Evolve for assessments. It is never too late to be assessed because it can help in so many ways. We find clients say that the assessment gave them a great understanding of themselves. They could go onto make better choices, get closure on a feeling they always had or gain a greater understanding on why they feel or act in a certain way.


What is Autism Spectrum Condition?

Autism Spectrum Conditions or ASD is a lifelong developmental disability that affects the way a person communicates and how they experience the world around them. ASC is a complex, lifelong developmental condition that typically appears during early childhood and  impacts on social skills, communication, relationships, and self-regulation.

One in 100 people are on the autism spectrum and there are around 700,000 autistic adults and children in the UK. The National Autistic Society

There is a growing awareness around Autism through more documentaries, tv shows and articles in the media and we are increasingly seeing a celebrations of neurodiversity.

Sites like the NHS offer a lot of information around autism so please visit the NHS site to find out more : What is autism? , Signs of autism

The National Autistic Society and The Guardian are also rich in resources, personal accounts and information that families, young people and adults may find useful.

 

 

Content Hampshire Child and Adolescent Mental Health Service

 


What are the core features of Autism?

Autism is defined by a certain set of behaviours and is a “spectrum condition” which means it affects people differently, to varying degrees.

The core features are present in early childhood but they often go unnoticed until something big happens. For example a change that leads to new social demands can exceed their ability to cope and that’s when you see a change in behaviour. This basically means when there is too much change and too many unknowns and someone who may have been able to cope before, suddenly can’t because their coping strategies no longer work.

  • Persistent differences in communication, interpersonal relationships, and social interaction across different environments.
    Including:
    – Speech and language difficulties (including an absence of speech),
    – Unusual accents or speech patterns
    – Trouble understanding and using nonverbal communication (body language)
    – Difficulty making and keeping friends
    – Difficulty maintaining typical back-and-forth conversational style
  • Restricted and repetitive behaviour, patterns, activities, and interests.
    Including:
    – Repeating sounds or phrases
    – Repetitive movements
    – Preference for sameness and difficulty with changes of routine
    – Rigid or highly restricted and intense interests
    – Extreme or significantly lower sensitivity to various sensory stimuli such as noises

For more information around ASC then please visit Autistic Spectrum Condition (ASC) :: Healthier Together (what0-18.nhs.uk)


What is an Autism (ASD) assessment?

We offer a gold standard comprehensive multidisciplinary Autism Assessments for adults and children which typically take 6-8 weeks to complete.

The Autism Assessments are useful for adults and children to gain an understanding of the individual’s strengths and difficulties following the guidelines set out by the National Institute for Clinical Excellence (N.I.C.E)

The Autism assessment includes:
  • Full developmental assessment which focuses on developmental and behavioural features ( DSM-5 criteria)
  • Autism Diagnostic Observation Schedule (ADOS-2) to gain a thorough understanding of the young person’s strengths and difficulties
    • This is an assessment of social communication skills & behaviours and speech & language 
  • School observation and school input 

What are Neurodevelopmental Screenings appointments?

If you are unsure about where to start then an initial screening appointments can be a good starting point.

During a screening we look at the following areas : 

  • Discussing reasons for the assessment 
  • Talking through the assessment processes 
  • Discussing possible outcomes from the assessment
  • Gaining an understanding of the young person’s presenting difficulties 
  • Discussing the advantages and disadvantages of assessment and/ or diagnosis 
  • Completion of screening questionnaires at home and by school 
  • Individual time with the young person and parents 
  • Consideration of the most appropriate assessments to be undertaken by the team 

At the end of screening we provide a summary report with recommendations. This may include a full assessment or other strategies. 


Who is in the ASD Assessment team?

We approach all assessments as a multi disciplinary team.

Our teams include Consultant Psychiatrist, Forensic and Clinical Psychologist, Speech and Language Therapist and Senior Mental Health Practitioner. The team includes an Assistant Psychologist who may undertake some observation or information gathering.


Are ASD Assessments face to face or online?

We offer face to face assessments and undertaking school observations.


What happens after the ASD assessment?

 

Autistic Spectrum Condittions

At the end of the assessment you will have a feedback session to fully discuss the outcomes of the assessment. You will also receive your gold standard report which includes strategies, resources and recommendations . The report is incredibly useful as an ongoing referral tool and we recommend it be shared with schools and GPs where appropriate.

We also offer ongoing support with therapeutic management services for families, children, young people and adults . (Emotional Wellbeing therapy services)


Support Services

We also now offer support workshops for families which are available online in group format or privately as family workshop sessions.

The sessions are part of a 10 week program where parents and families work with qualified practitioners to understand ASC, symptoms, behaviours and develop strategies to manage behaviours.

This is a service not offered from other statutory services, and we currently have no waiting times.

For details click here

 


Find out more about Autism Spectrum Conditions and about why less girls are getting diagnoses than boys in our blog on Girls masking ASD

You may also find the blog on Visual Guides and Social Stories (TM) useful

Choosing a school for a child with Autism or ADHD

There is a huge amount of pressure when it comes down to choosing the right school for your child. This pressure is compounded when you are choosing a school for a child with Autism or ADHD.

The priority of course is understanding the child’s individual needs and choosing the right learning environment where they can learn and thrive. The challenge is finding the school that will meet your child’s needs and help them to flourish.

 


Choosing the right school for your child

 

ASD & ADHD

Here are three areas that may help act as a starting point in your journey.
  1. Listening to personal experiences and accounts from friend and other parents
    1. 1st hand experiences and recommendations are important
    2. remember your child’s needs and expectations may differ
  2. Research
    1. Look up the school’s individual policies around SEND
    2. Their approach to pastoral support
    3. Focus of the school on academic and personal successes
    4. Visit schools’ and council’s websites
  3. Visiting the school itself with your child
    1. Use the open days to look around the school with your child and get a feel for the school spirit
    2. Review the facilities and layout of the school
    3. Look at the size of cohort
    4. Indoor and outdoor space
    5. Proximity to the transport
    6. Ask to speak separately with relevant, knowledgeable people i.e. the class teachers, Heads of years and SENCo

Areas to consider when choosing a school for a child with Autism or ADHD

  • Consider what support your child needs and will their specific learning needs be met in the right way?
    • Pastoral support
    • SEN approach and integration in the classroom
    • Day in the life of a student?
    • OFSTEAD report results
    • Academic success has the school had
    • Resources and facilities are available in school
  • What will the transition look?
    • Familiarity of other students from their current school be going
    • Do they know anyone already there?
    • Can you organise a school visit – with peers and parents?
  • What are the practical logistics of the school?
    • Working independently
    • Class and school size
    • Logistics of getting to and from school?

Considerations for choosing the right school for your child

If you’re children are a little way off ‘big school’ and you are wondering where to start, then below are a few considerations
  • Talk to your child – what do they think, what have they heard, where are their friends going, what concerns do they have?
  • Research local schools via their website and local social media forums on Facebook
  • Visit schools / virtual open days
  • See what your existing SENCo or Head thinks
  • Meet with new staff who would be working with your child to understand their approach
  • Talk to other primary and secondary school parents
  • Read OFSTED reports
  • Speak to the SEN team
  • Visit resources such as SENDIAS http://sendiassnorthyorkshire.co.uk/
  • Choosing a school England (autism.org.uk)

Neurodevelopmental assessment and emotional wellbeing therapy support

We understand that the school transition can not only be exciting but is often unsettling and challenging.
If you need to talk to us then please get in touch.

What are Social Stories?

If you are on the autistic spectrum you may find it hard to master communication and social skills.  Social Stories are a great tool to help autistic children prepare for and respond to situations and events. The idea is simple; through story telling, children can navigate different issues, gain a better understanding of how and […]