Before we meet you face-to-face
We will send your family a selection of questionnaires to complete and return to the clinic before the first meeting. These enable us to gain important background information, which will inform and speed up the assessment process. We also request reports (including questionnaires) from your child’s school/nursery, with parental consent. If your child is not in school, we would normally request equivalent reports from the last school they attended.
Appointments in clinic
Initial telephone consultation
The aim of this consultation is to gain an understanding of your child’s current presentation from the family’s perspective and to identify your hopes and goals for our assessment. It is also an opportunity for you to ask about how the assessment process works, who is involved and how long it is likely to take before the assessment is completed.
Developmental, Dimensional and Diagnostic Interview (3Di)
Parents/carers are seen together for a diagnostic interview with a clinician from the team. The interview is based on a computerised procedure developed here at Great Ormond Street Hospital (GOSH) and covers many aspects of your child’s development and current behaviour. The interview is very detailed and takes around 3 hours.
Autism Diagnostic Observation Schedule (ADOS)
This is an assessment for children and young people that uses a range of age appropriate activities to assess social communication skills. For younger children it includes games, looking at books, cartoons and pictures. For young people it is more conversation-based, although there are also activities and tasks. Most children find the ADOS enjoyable. It takes about an hour. We will ask for permission to video the session so that sections of it could be reviewed if necessary.
Your child will be seen by one of our team’s psychologists for approximately two hours, and will complete age appropriate tasks that assess their abilities. The purpose of this assessment is for us to estimate their intellectual ability (IQ). Many children on the autism spectrum have unusual patterns of strengths and weaknesses in different aspects of their intelligence. For instance, they may be really good at art, or building things, but poor at understanding or remembering complicated instructions. It is important to identify these strengths and weaknesses because they have implications for educational management, as well as how your child copes with everyday life. We may also measure your child’s performance in tasks that are directly related to their ‘adaptive functioning’, meaning how good they are at the tasks needed to cope with day to day demands.
Before a conclusion is reached about a diagnosis we may carry out a school visit in order to observe your child in a more familiar environment. We will ask your permission to conduct this visit if necessary and will be happy to discuss it with you. Some children may also benefit from a speech and language assessment at this stage in order to determine whether language processing difficulties are impacting on their communication skills.
Physical examination and genetic testing
All children coming up to the clinic will have their height, and weight and head size measured. If there is a possibility of a physical problem with your child that has not previously been investigated locally, we may ask one of our paediatric colleagues to see them and to advise on management. We also collect DNA (from saliva) to check for any genetic anomalies.
The feedback appointment offers you the chance to discuss the findings of your child’s assessment with the same clinicians involved in their assessment. This appointment is usually arranged within a month of the diagnostic appointments. Following the feedback session, we send detailed summary reports to the professional who referred your child to us and to the local services that has accepted responsibility for your child’s future care and management. A copy will also be sent to you and the family doctor (GP). No reports are sent to other agencies without your consent. We would encourage you to share these reports with all those involved in your child’s care and education.
After our assessment procedures are complete we may offer a consultation service to local teams and schools to ensure there is a successful handover to your local service providers.