If you are looking at private autism assessments, it is usually for one of two reasons. Either the wait where you live is long, or someone has told you your child does not meet the threshold and you do not agree. Both are ordinary reasons, and neither means you are being difficult.
What is harder is working out which assessment is worth paying for. From the outside they look alike, and the prices do not tell you much. Here is what actually differs, in the order it matters.
An assessment is not a questionnaire
Screening questionnaires are useful. They are also cheap to administer, quick to score, and easy to sell. A questionnaire tells you whether a child’s profile resembles other children who were later diagnosed. It cannot tell you whether this child is autistic, because it cannot see the child.
A proper assessment involves someone spending structured time with your child, someone taking a careful developmental history from you, and those two accounts being compared. If what is on offer is a form and a phone call, you are buying a screen, not an assessment — whatever it is called on the invoice.
Ask directly: how much time will someone spend with my child, and doing what?
One clinician is rarely enough
The reason multidisciplinary assessment is the standard is not bureaucracy. It is that the things autism is confused with are the province of different professions. A speech and language therapist sees a language disorder that a paediatrician might read as social withdrawal. A paediatrician spots the neurological sign that explains everything. A psychologist notices the profile that is really an unrecognised learning difficulty.
NICE guidance on recognising and diagnosing autism in under-19s (CG128) describes assessment by a team, not by one person with a checklist. A single-clinician assessment can still be excellent. But you should know that is what you are buying, and you should ask what happens if the answer is not clear.
What the report has to do afterwards
This is the part most people do not think about until too late. A diagnosis on its own changes very little. What changes things is a report that a school, a local authority or another clinician can act on.
A report worth paying for says what was done, what was found, what it means, and what should happen next in enough detail that someone who has never met your child can act on it. A report that says “meets criteria for autism spectrum disorder” and stops has passed the problem back to you.
Ask to see an anonymised example report before you book. A clinic that will not show you one is telling you something.
Will the NHS and the school accept it?
Honestly: it depends, and anyone who promises otherwise is guessing on your behalf.
Schools are generally interested in a well-evidenced report because it helps them do their job, and the SEND Code of Practice expects them to respond to a child’s needs rather than to a label. Local authorities assess needs, not diagnoses. Some NHS services will accept a private diagnosis into their pathway; others will re-assess before offering NHS-funded support, particularly where medication or a specialist service is involved.
The practical question to ask a private provider is not “will the NHS accept this?” It is “what happens if they don’t — will you speak to them?” A clinic willing to write to, or speak with, your child’s GP and school is worth more than one that hands you a PDF.
A diagnosis is not the only useful outcome
Sometimes the honest answer is that a child is not autistic, and something else explains what you are seeing — a language disorder, a hearing problem nobody has checked recently, an attention difficulty, anxiety, or a developmental picture that is simply still unfolding.
That answer is worth as much as a diagnosis, and a good assessment is designed to be able to reach it. Be cautious of any service whose process only has one possible destination.
Questions worth asking before you pay
- How much time will be spent directly with my child, and doing what?
- Who is involved besides the assessing clinician?
- May I see an anonymised sample report?
- What happens if the picture is unclear at the end?
- Will you communicate with our GP and school?
- What follow-up is included, and what costs extra?
Where we fit
Our UK clinic is in Ickenham, West London. Our approach to assessment, including what we do when the answer is not clear cut, is set out in how we assess, and the background on autism explains what we look at and why.
If you are not sure whether an assessment is the right next step, that is a reasonable thing to ask us before booking one.
This article is general information about how assessment works. It is not a diagnosis and not advice about your individual child. If you have an urgent concern about your child’s health, contact your GP or NHS 111.