AUTISM / NEURODEVELOPMENTAL SERVICES
What services do we offer?
• Face to Face comprehensive Autism assessments for children, young people and adults. This diagnostic service is available for children and adults. The assessments will be conducted by fully trained clinicians. The assessment will be conducted face to face at your home or at a pre-arranged location.
• Pre-diagnostic consultations - This consultation service is available to parents who are concerned that their child or young person has an autism spectrum disorder and are seeking advice on whether or not pursue a diagnostic assessment now or in the future.
What makes Mind Professionals unique?
Currently, there are a variety of services in the U.K. aiming to deliver Autism diagnostic assessments. Some of these services deliver diagnosis on-line; others assess using one only instrument; others only use one professional opinion to deliver the diagnosis.
Mind professionals is different: we deliver a highly qualified team of experts; face to face assessments; with multidisciplinary clinical discussions using the most up to date evidence-based autism specific tools in a timely and organised way.
Our Autism assessments are based on UK best practice models - they are designed in line with latest research and meet or exceed government standards including the recommendations from the National Institute for Health and Clinical Excellence (NICE) on Autism in children and adults.
What to expect?
Children and adults, together with their parents or carers/family are seen face to face for half day or a full day.
We take a detailed developmental history using the ADI-R. At the same time, we carry out an in-depth assessment with the child or adult concerned using the ADOS-2. We also collect information from previous assessments and any other relevant sources (school, work, as examples).
We bring together all this information to formulate a clear diagnosis and recommendation of needs and prepare in-depth reports.
A clear understanding of the nature of the difficulties experienced by the child or adult concerned is very important for the person, families and professionals involved. It will also help professionals working with the person and their family to provide appropriate intervention and support.
This package has been developed based on evidence based best practice and meets NICE guidelines. It is a very detailed and fully comprehensive Autism assessment involving a total of over 14 hours of time by two different clinicians and a Clinical Lead. This involves screening questionnaires, face to face appointments and a comprehensive report.
What autism specific tools do we use?
The assessment tools used for identifying Autistic Spectrum Conditions are the ADOS-2 (used with the individual) and ADI-R (used with parents/carers). These are considered the ‘Gold standard’ tools for a diagnosis of autism.
Other autism specific tools will be used for pre-screening questionnaires and gathering information for other settings: school, work, family life.
- ADOS-2 Autism Diagnostic Observation Schedule 2nd Version
The ADOS 2 assessment is a behavioural assessment which involves the social interaction between the assessor and the individual. It consists of a series of table top tasks that takes between 30 and 60 minutes. There are no invasive procedures involved.
- ADI-R Autism Diagnostic Interview Revised
The ADI-R is a structured interview conducted with someone who has known the individual closely since early childhood. In the case of a child being assessed, this will be the parent or caregiver. For adults being assessed this will preferably be a parent /caregiver, but it may be possible to carry this out with an older sibling or other relative. The ADI-R takes between 2 and 3 hours to complete. The interview covers the referred individual’s full developmental history.
How can you refer to Mind Professionals?
There are three ways that a person can be referred to us for an assessment.
- A commissioned NHS referral by a medical.
- Commissioned referral by block contract with a public sector service.
How do we provide feedback?
An autism assessment should be a very thorough affair. As ASD is a lifelong condition (there is no ‘cure’) – the team wants to be absolutely certain about an ASD diagnosis.
We explain findings and conclusions in detail two weeks after the assessment. In addition, we discuss recommendations and follow-up pathways with the person, or their parents or carers. There is plenty of time for discussion around the findings.
People often have questions about coping with difficult behaviour and different interventions. We can give some general advice and referrals may be recommended back to local services and to the network of the national and local autism societies for specific help.
We provide a comprehensive report with findings and recommendations. The draft report is discussed with parents, carers or the. We then send the final report to the person and the referrers.
It is important to get an assessment with a team who is trained and experienced in diagnosing ASD, to ensure they consider all aspects of your child’s life and other conditions that may be present.
The ‘gold-standard’ approach to diagnosing Autism in children is to have several clinicians involved – this is known as a multi-disciplinary approach and ensures a comprehensive and objective assessment.
- Pre-assessment questionnaires – we will ask parent and the child’s school to complete questionnaires that are important in understanding how the child behaves in different environments and what challenges they experience.
- Child appointment – the child will meet with a trained member of the team, who will spend some time, using toys, games and conversation to understand how the child sees the world. Whilst it should be a fun experience for the child, the examiner will be using an evidence-based tool to assess the child against the criteria relevant to autism. This tool is called the ADOS-2 – Autism Diagnostic Observation Schedule.
- Parent appointment – a key part of the diagnosis is understanding the child’s development, which is why the parent will meet with another member of the team to go into quite a lot of depth about the child’s developmental history using the ADI-R – Autism Diagnostic Interview Revised.
- Diagnostic report – following the appointments the clinicians will use all the information that has been gathered. The clinicians will formulate and discuss the findings with the Clinical Lead. Following this, a comprehensive report is written, with a diagnosis (where one can be made) and further recommendations.
- Feedback appointment – all too often parents receive the diagnosis then are left feeling ‘What is next?’. It’s natural to have a lot of questions, so as part of our assessment the parent and child will meet with one member of the team again to have time to go through the report and ask any questions you have before the report is finalised.
Is this assessment right for a child?
This assessment package is right for a child if:
- Aged between 31 months to 18 years of age.
- Parent suspect that they are likely to have a diagnosis of an autistic spectrum disorder
- The local NHS, CAMHS, GP or school have suggested this assessment would be helpful.
NOTE: Important things to note about this assessment: Mind Professionals cannot guarantee that the team will be able to determine a diagnosis for a child and they will advise if this is the case. There are several possible outcomes following the assessment process:
a) The consultants can be confident that the child does have a diagnosis of an ASD.
b) The consultants can be confident that the child does not meet the diagnostic criteria for ASD.
c) The consultants cannot be absolutely sure if the child does or does not have a diagnosis of ASD. In this case it is possible they may refer for further specialist input.
d) The consultants may think that the child has a different condition, either with or without a diagnosis of autism as well. Part of the recommendations may include further specialist investigations be required to confirm this.
Adult Autism assessment is a comprehensive package, designed to accurately diagnosis Autism and provide in-depth information about the condition.
What to expect?
Before the assessment, two questionnaires will be sent by post to be completed. These help the team understand more about the situation and the difficulties the person experiences. We may also, with the person’s permission, contact workplace (or other settings) to have a more in-depth understanding of behavioural presentation.
To make a diagnosis, the team will:
- speak with the person and a relative or a friend (who knows the person well for at least 12 months).
- take a full and comprehensive neurodevelopmental history with a family member who knew the person in particular between the ages of 4 and 5. This tool is called the ADI-R.
- analyse pre-assessment questionnaires.
- use a specialist diagnostic tool with the person called the ADOS-2.
- Review all the information with the Clinical Lead.
- Compile a full assessment report with recommendations.
How long does the Autism assessment take?
The face to face assessment takes, on average, 1 hour to complete. During this time the consultant will ask the individual questions about life and complete some table top activities. This is the ADOS-2 part of the assessment.
The ADI-R is full and comprehensive neurodevelopmental history with a family member who knew you in particular between the ages of 4 and 5 can take up to 3 hours to complete.
NOTE: Whilst this assessment process might seem daunting for some, the consultants have years of experience of carrying out these assessments and fully understand how difficult it can be. They will do their best to put the person at ease.
It is helpful, in advance, if the team is aware of any specific sensory difficulties or needs. We will try to keep an assessment to a comfortable length and the clinician will be guided by the person.
What happens after the Autism assessment?
Following the assessment, the team will write a full report, with a diagnosis where one can be made. This report will be discussed as a team with the Clinical lead and then discussed with the person face to face in a draft format.
The assessors may recommend further testing if they think another condition is more likely and this will be discussed in full. Following this, the final report will be completed and sent to the person and referring GP; funding authority; with recommendations, strategies.
Benefits of having an assessment
Children who have been assessed may be offered additional support in school and even a place in a school specialising in Autism as a direct outcome of the assessment results.
Families report that by having better understanding of their child’s behaviour, they are able to find helpful strategies and different ways to engage and communicate with their child.
For adults the outcome is one of relief, they talk about finally understanding why they had difficulty holding down a job or making relationships. A huge burden is lifted.
This is much the same if the assessment results in Autism not being diagnosed. Knowing that can result in different options being explored.