Frequently Asked Questions

The screening appointment takes approximately 90 minutes.  It will mainly consist of talking and the clinician will ask questions to guide the conversation. They will also talk through the sensory questionnaire with you if it has been completed prior to the appointment.  There are not usually any further questionnaires to complete however, sometimes it can be useful to do a screening measure for ADHD (for example) due to the overlap between this and autism. Any further questionnaires would be completed with the clinician during the appointment if needed. There are no tasks to undertake during the screening appointment. 

The screening assessment is not a diagnostic assessment.  Whilst it can give an indication that someone may be autistic or have ADHD, it does not follow NICE guidelines for a full diagnostic assessment. The screening is only part of a full assessment and helps decide how best to proceed.  For example, the screening helps to determine which diagnostic tools would be best suited and whether two professionals would need to be involved (Clinical Psychologist and Speech and Language therapist for example) or whether one professional with MDT consultation would be enough. Because autism and ADHD are such complex conditions, no two people with the condition will be impacted in the same way. Although it might be clear from a screening that the diagnosis threshold is likely to be met, the assessment is useful because it helps to identify the individuals’ strengths and challenges in more detail and develop an understanding of what being autistic or having ADHD actually means for the person.

The assessment involves a more in-depth discussion around the areas that were briefly addressed during the screening. The duration of an assessment is around 6 hours but it can vary from person to person. Where possible we speak to someone else who you identify as knowing you well. Typically, this would be a parent and the questions would be around developmental milestones and infancy, but everyone’s situation is different and if there is another person who knows you well we are happy to have them involved. It is your choice how the informant takes part on the day. We can interview them at your appointment or arrange a separate meeting or questionnaire to be completed in advance. Additionally, If there are any reports from mental health services or school, it would also be helpful to see these on the day.

The order of the day is flexible. Generally, we work in chronological order eg: family background, developmental, education, employment, physical and mental health, then the specific areas that map onto the diagnostic criteria. We are accredited to use a variety of assessment tools such as:

• Autism Diagnostic Interview (ADI-R; LeCouter et al. 2003)
• Autism Diagnostic Observation Schedule – Second Edition (ADOS; Lord et al. 2012)
• Monteiro Interview Guidelines for Diagnosing the Autism Spectrum, Second Edition (MIGDAS-2; Monteiro & Stegall 2018).
• Autism Clinical Interview for Adults (ACIA; Parr et al. 2021).
• Diagnostic Interview for Social Communication Disorders (DISCO; Leekam, Libby, Wing, Gould, & Taylor, 2002).
• ADHD Child Evaluation; Adult Version (ACE+; Young, 2016).
• The Structured Diagnostic Interview for ADHD in Adults (DIVA 5.0; Kooij, 2013)

Some of these do involve tasks but these aren't always necessary. At the end of the assessment, we write a thorough report and recommendations and can also arrange a feedback session if needed.

There is usually a break for lunch for longer assessments and as many short breaks as you need throughout the appointment, your clinician will discuss breaks with you on the day. Please feel free to bring anything you need to help you feel more comfortable.

The way we structure the assessment and the time we take increases the likelihood of being able to determine a diagnosis. Throughout the assessment the clinician shares their thoughts and how they are making sense of things, so the assessment is very much a collaborative process whereby an understanding is reached together about what is happening. If the clinician did discover something in the assessment that they felt required a specialist knowledge that the clinician doesn’t have then they would make recommendations for how to access the support needed.

Recognising neurodivergence in adults can sometimes be a sensitive issue. If our conclusions differ from what you were expecting, we will discuss this with you and reflect it in our report. Our team’s primary goal is to provide you with the most thorough and relevant assessment possible, leading to clear outcomes and recommendations. Our diagnostic decisions are based on current guidelines, established criteria, and our professional training and experience. We take this responsibility very seriously and would not make a diagnosis without the necessary evidence. In rare instances we may describe an individual’s neurodevelopmental profile without making a definitive diagnosis. Regardless of the outcome, our reports offer detailed insights, provide well-considered suggestions for support or further diagnostic exploration, and include personalized recommendations.

Because the assessment is so thorough, we can understand the way an individual experiences the world.  Although there can be similarities for example between autism and trauma, there are also differences.  We have extensive experience in assessing adults, many of whom have lived through difficult and traumatic experiences, so we have a good understanding of how trauma presents when conducting the assessment. 

We always recommend the person shares their diagnosis outcome with their GP to help with accessing NHS support. We also recommend people share their outcome with work or education if they need reasonable adjustments. However, as you are a private client the decision who to inform remains with you. You have our permission to share the outcome with whoever you wish but we cannot share this without your consent.

Yes, our service offers post diagnosis support following a diagnosis. 

The general understanding of autism is based on how autism may typically present in men although understanding of the wider autism experience is always developing. We do see men and women presenting differently but this is likely due more to how society treats both genders and the coping strategies which develop rather than autism itself being gendered.  Masking is a really powerful coping strategy for many autistic people and the reason we take our time with the assessment is to help develop a sense of safety within the assessment where masking may be less relied upon. Both Becky and Helen are neurodivergent themselves and are very experienced in assessing women and gender diverse individuals for both autism and ADHD. In our practice we generally receive as many assessment referrals for women as we do for men.

Our aim is to be able to offer people a full assessment within 3 months of the completed screening but wait times do fluctuate throughout the year dependent on staff availability and demand on our service

Report lengths do vary but as an estimate ADHD reports average 15-17 pages, autism reports about 25-28 That includes several pages of recommendations 

In making a diagnostic decision we are required to consider alternative mental health and psychiatric explanations and if we felt that one of these better explained your challenges, we would refer to the appropriate services for support.

Ultimately it is up to the client if they are happy for you to be present in the screening. If the client would prefer to have part of the session without the parent or if they would prefer not to be in the room when the parent was talking, then we can accommodate that. We are flexible depending on the client’s wishes.

As a psychology led service, we do not offer a medication pathway following confirmation of an ADHD diagnosis. We are able to signpost you to services which do prescribe medication privately or you are able to take our reports and recommendations back to the NHS. We advise speaking to your GP first to ensure that they would be able to refer into the ADHD team following a private assessment (sadly some will not, but it seems to vary).

GP's don't typically manage the titration period as this needs to be done by a prescriber. Once titration is set the dispensing of the medication is handed to the GP. The titration would either be done by the local NHS service (or right to choice) or a private prescriber. If you went down the private prescriber route you would need to check your GP would then accept the titrated medication prescription under what is called a shared care agreement.

The private medication route can of course be expensive, and you would want to ensure that the costs and anticipated timescales are clearly communicated before you commit to this. We do recommend a service online (they are based in Northampton) who we have worked with and have a good reputation. They are ADHDshine.net

Medication isn't the only option for managing ADHD symptoms and our services focus on strategies and adjustments in their recommendations.

Neuroaffirmative means that we do not view Autism or ADHD as something that is “wrong” with someone, or that something is “broken” or needs fixing. Instead, we view these as being different Neurotypes that are a part of human diversity. Our assessments are Neuroaffirmative in their approach which means we seek to understand the person holistically and understand their strengths, characteristics and needs within society and environments along with recognising the challenges they may experience.

A Neuroaffirmative assessment recognises that both strengths and challenges exist, and they can change depending on context, but it doesn’t seek to change the individual to improve the challenges; rather it seeks to accommodate needs and to establish the appropriate supports a person requires in order to thrive in their life. 

Although the diagnostic manuals do encourage attributing a support needs level to an autism diagnosis, this is a contentious issue amongst both clinicians and the wider autistic community. We prefer to use a more nuanced understanding of autism that recognises an individual's diversity, and the impact that the environment has on an individual's skills and experience.  Severity labels can be limiting as someone may only have very low support needs in one environment, but medium or high needs in another. We are also aware that someone’s needs vary over time so it is not helpful to attribute a number which does not reflect this and could potentially hinder someone from getting the right support for them.  Instead, we focus more on a person-centred approach that respects the unique experiences and strengths of each autistic individual.

What we do advise if people are in need of extra support, is to request an assessment of need (and we are happy to add this to the recommendations if you wish).  Under Section 9 (3) of the Care Act 2014, the local authority must carry out an assessment of needs wherever it appears that an adult has needs for care and support regardless of the adult’s financial resources and regardless of whether the local authority believes the adult has eligible needs or not. This is also in line with The Autism Strategy (2010).  You can request this assessment by contacting your local social care team.  This approach would mean that any support was tailored to an individual's needs, rather than based on a number.  

All our assessments are in line with NICE guidance and NHS guidance so there should be no concern in the outcome being recognised by professional bodies. There is also guidance which stipulates that individual's should not be over assessed for the same conditions and so to decline an assessment and ask for it to be repeated can only be done on the grounds that the original assessment did not follow due process. The NHS is not supposed to decline an assessment based solely on it being completed by a private provider. We would be happy to provide copies of our qualifications in advance of the assessment should you want to discuss this further with your GP or with your LEA for school adjustments. 

We do not typically offer a repayment schedule but are happy to discuss this on a case-by-case basis. In the first instance we would recommend a screening assessment which is £350 to be paid in full prior to the screening and that the full assessment (if warranted from screening) fee can be broken down into 3 separate payments. We are not able to release the outcome of the assessment or report until the full amount has been settled. 

MDT standard for Multi-disciplinary Team, which is a team of professionals from different specialties (or disciplines) who work together on more complex cases. MDT's are commonly used in healthcare, social work and education and enable a holistic approach to decision making and care planning. As autism and ADHD can influence multiple areas of life, an MDT assessment is beneficial in providing a nuanced, comprehensive assessment as adult autism experiences can appear subtle, or masked, or complicated by other conditions. The MDT assessment ensures that the whole of the individual is understood and that recommendations are targeted at the areas of life which matter most to the individual.