Specialist Assessments for Autism and ADHD
Our response to the BBC undercover investigation of poor-quality private clinics
15 May 2023
Seeking a private ADHD or autism diagnosis can be an anxiety-provoking experience, especially after the recent BBC exposure of poor-quality and dangerous assessments by private clinics (15 May, 2023). Whilst this undercover investigation was for ADHD assessments in adults, we are very concerned about the impact this can have on families seeking a diagnosis or a better understanding of their child. We are also very aware that there may be private providers for children and young people who are offering similarly concerning assessments.
At CAYP Psychology, we have always strived to achieve the highest of standards. Our assessments are thorough, adhere to NICE guidelines and best practice recommendations, and our clinicians are all aware of the latest developments within the academic literature, the scientific consensus, and government policy. Our clinicians all work or have worked extensively within NHS teams (Child and Adolescent Mental Health Services (CAMHS), specialist autism or ADHD services, or neuropsychology services).
We are keen to ensure that our assessments involve a substantial amount of ‘history’. That is, we want to best understand children’s education history, family history and health history. This information is essential to ensure that we have an accurate understanding of children’s difficulties. For example, attentional difficulties at school could be due to an underlying ADHD, or due to a many other reasons, including challenges at home, learning problems, or health concerns. We also complete observations, computerised programmes, structured assessments, and child-specific assessments to ensure we obtain the most detailed picture of your child. We liaise closely with children’s teachers and staff at their school or education provider, in addition to any other professionals involved in their care.
Our team is made up of highly qualified and experienced clinical psychologists, speech and language therapists, counselling psychologists and forensic psychologists. However, we are not medical professionals, and we cannot make recommendations about medication for ADHD. Our assessments do involve discussions with child and adolescent psychiatrists, and their opinions are an essential part of our process, but should families wish to pursue medication, further appointments will be needed with a GP, CAMHS or another service.
We take the BBC investigation very seriously indeed, and want to reassure families thinking about a private ADHD or autism assessment, that we are proud of the quality and detail provided within our assessments. To further reassure families, we offer screening questionnaires before confirming any appointments together, in addition to conversations about their concerns and the assessment process, and there are certainly no hidden charges within the assessment.
If you would like to discuss a possible autism or ADHD assessment for your child, or if you’d like to talk through any concerns following the BBC investigation, please do be in touch. You can contact us by phone (0333 242 0824), email (firstname.lastname@example.org), or live chat to a member of our team on our website (www.cayp-psychology.com).
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Autism is unique in every child and young person. Autism is most often associated with persistent and pervasive differences with social communication and interaction. This refers to differences in making and keeping friends, differences in understanding and expressing emotions, and managing conversations. For some, this also refers to difference in the use of eye contact. Children and young people with autism may also have a keen attention to detail, demonstrate very creative and artistic talents, display substantial expertise in areas of interest, and hold wonderful character traits, such as honestly and loyalty.
Autism is also associated with repetitive or specific patterns of behaviour. This refers to intense interests in certain topics, which may not always seem age-appropriate, taking comfort in routines or feeling distressed with changes to a routine, or differences with emotional regulation and expression. These differences are present across different contexts, such as at home and at school, and they have an adverse impact on a young person’s ability to function and manage day-to-day tasks.
Our autism assessment has been developed in line with the NICE guidelines. It is thorough and comprehensive, and we aim to provide the best understanding of what is going on for your child.
Who can have an autism assessment?
We can offer an assessment to young people aged 6-25 years old who have fluent and comprehensible speech and are showing traits of autism. We can offer assessments for children aged 6 if they have a speech and language assessment report. Unfortunately, we are unable to offer assessments for young people with limited speech, or young people with a ‘moderate to severe’ learning disability (characterised by functioning 2 or more years below expected levels).
What does an autism assessment involve?
The ‘gold-standard’ approach to diagnosing autism in children is to have several clinicians involved. This ensures a comprehensive and objective assessment. Our team is also a multi-disciplinary one – we are clinical psychologists, speech and language therapists, counselling psychologists, forensic psychologists and neurodevelopmental practitioners.
An autism assessment is very thorough and we work hard to ensure that the assessment includes all the relevant information to ensure the outcome is the right one for your child.
Prior to the assessment, we will ask that some pre-assessment questionnaires are completed by you, and by teachers who know your child best at school. These questionnaires ask about your current concerns, social skills and behavioural difficulties, and will ensure that an autism assessment is the most appropriate assessment for your child.
Our Gold-Standard Assessment Appointment
We will meet together for our assessment. This meeting involves a standardised observation and interview, using the most up-to-date and evidence-based tools, called the ADOS-2 (the Autism Diagnostic Observation Schedule), the 3di (Developmental Diagnostic Dimensional Interview) and the DISCO (The Diagnostic Interview for Social and Communication. These tools involve detailed conversations about your child’s development (a developmental history) and engaging and stimulating activities to explore how your child sees the world. We will also assess for any additional mental health concerns and neurodevelopmental differences, such as ADHD. This assessment, which may be spread over multiple meetings, can be several hours in total. We recognise that children may feel anxious about this process. A flexible approach, allowing time to build rapport and ensuring your child feels safe during the assessment is our priority.
As part of our discussions, we will complete a very thorough developmental interview. We will have the opportunity to think about your child’s school history, your family experiences and your child’s emotional wellbeing. This process is specifically designed to identify clinical and sub-clinical autism.
Formulation and Discussion
A detailed discussion will take place between clinicians. The aim will be to understand all the information provided from the assessment so far, and come to a working understanding of what is happening for your child. There may also be consultation and supervision from a Consultant Psychiatrist if needed, to ensure an accurate diagnostic outcome.
Feedback and Report
A feedback appointment is offered for you with at least one of the clinicians who completed the assessment, within two weeks of the assessment. We recommend that this appointment is for you without your child.
A written report will be provided, outlining the diagnostic outcome (where one can be made), a wider understanding of what is going on for your child, and recommendations most appropriate for your child. This report will be yours after this feedback meeting. There will also be an opportunity to request any amendments to the report.
If your child receives a diagnosis, we provide many recommendations for further support. We may also offer you a place on our “What Next?” group.
Difficulties with attention, hyperactivity, or impulsivity
Difficulties with attention, being forgetful, and getting fidgety and hyperactive are all common experiences for children and young people. however, these difficulties can also lead to challenges for children, adolescents, and young people, and can interfere with thier ability to progress at school, or to regulate their emotions. This may be suggestive of ADHD.
There are other tell-tale signs that might warrant a formal assessment of ADHD:
- Unexplained underachievement
- A wandering mind
- Trouble organising and planning
- A high degree of creativity and imagination
- Trouble with time management and a tendency to procrastinate
- A strong will, stubbornness and refusal to help.
- A unique and active sense of humour
- Trouble sharing and playing with others
- Sensitivity to criticism or rejection
- Impulsiveness and impatience
- High energy levels
- Susceptibility to compulsive behaviours
What happens in the assessment?
Our ADHD assessment is a multi-step process, involving questionnaires, conversations with you, your child, and your child’s school, observations an structures assessments. Our assessments are completed by our highly experienced and professional team. We work hard to ensure that assessments include all the relevant information to achieve the best outcome for your child.
Who can we assess?
We can assess young people aged 6-19 years old who have fluent and comprehensible speech and are showing traits of ADHD.
Unfortunately, we are unable to offer assessments for young people with limited speech, or young people with a moderate to severe learning disability (characterised by functioning 2 or more years below expected levels).
What does a ADHD assessment involve?
We are proud to offer an exceptionally high quality assessment, using the most up-to-date technology and ‘gold-standard’ measures. We strongly believe in offering the most comprehensive and objective assessment.
Prior to the assessment, we will ask that some parents and teachers at school complete a pre-assessment screening pack.
These questionnaires ask about your cand your child’s teacher’s perspective of what may be going on.
These responses help us to screen for ADHD.
Our Gold-Standard Assessment
A comprehensive face-to-face appointment will take place. We use multiple assessment tools, with you and your child.
- The ACE clinical interview: The gold-standard structured interview to assess for the core symptoms of ADHD and the extent to which they impair functioning.
- The Qb Check: A computerised assessment to assess for inattention, hyperactivity, and impulsivity.
- The Connors Questionnaire: A thorough assessment of symptoms and impairments associated with ADHD and common co-occurring problems in children and young people.
We will also review any previous corresponsence you may have from school or other services.
Feedback and Report
We aim to feedback the results within two weeks. This appointment is for you with the practitioner who completed your assessment. We will review everything that we completed together, including the outcome and recommendations. All the information from the assessment will be detailed in a report.
After a Diagnosis
We are not able to prescribe medication, but our reports are discussed within our multi-disciplinary team, and a consultant child and adolescent psychiatrist. You can share this report with your GP, your own psychiatrist, or other services, such as Child and Adolescent Mental Health Services (CAMHS), who may be able to prescribe the relevant medication.
We may be able to offer psychological therapies following a diagnosis. We also offer our What Next? group, but this is tailored more to families who have a child diagnosed with autism.