How does a child or young person get an Autism assessment?

Assessment and diagnosis in Solihull for 0-18 year olds is carried out by a specialist multi disciplinary team.

Who can refer?

• parents or professionals can refer to the SAS for a diagnostic assessment.
• parents will be required to work in partnership with their child's school to gather the depth of information required.

How to refer?

Referral is via the referral form. Medics referring a child cannot be expected to know everything about a child's functioning at home and school but should write a clinical letter referring the child and then a referral form will be sent out to parents by the SAS service . Alternatively medics could hand the form to parents so that the parent can work in partnership with their child's school to complete and gather the supporting evidence.

The form is part of the assessment process and requires a lot of information. GPs and medics are not expected to complete the form. The forms should be completed by parents in partnership with their child's school or a health professional that sees the child over a continuous period of time. A GP may support a referral with a clinical letter, hand the form to the parents to take away. Parents should then complete in partnership with school.

All children will need a fully completed form and supporting evidence before we can accept for assessment as it is the only way to gather the depth of information required. A letter from a GP may come to us and we will then send out the referral form to the parents. We cannot consider the referral until we have all the information required.

If we receive a clinical letter the referral will be closed until we have all the information required. This is not rejecting the referral as we will reopen the referral as soon as the information is submitted.

For further information please visit the Solihull Children’s Community Therapies website.

Please note referrals cannot be made electronically.

Access criteria

• children must have a Solihull GP to access this service. If a child or young person has a GP from a neighbouring area then parents should contact their GP in order to access an assessment in their area.
• child must be under 18 years of age at the date of referral. Assessment for young people after their 18^th birthday can be accessed through their GP.
• information needs to be gathered by looking back over a minimum period of 6 months (2 school terms). This is because the SAS team need to understand the child's presentation over a period of time. This ensures that all aspects of a child's functioning and the context around a child can be taken into account. Details of the information required are on the front of the form.
• evidence of difficulties with 3 areas of development associated with Autism. Social Interaction, communication and flexibility of thought and behaviour. The form is based on the criteria used for the diagnosis of Autism and will guide you step by step around the detail required.

Referral of Pre-school age children

Health Visitors (HV) work with Children from Birth to School Entry. Parents can contact their Health Visiting Team to discuss concerns they may have about their child. Health Visitors can undertake a developmental review of children using the Ages and Stages Questionnaire.

The Health visitor will ensure that services are in place to meet a child's needs. These other services and your HV can then contribute to the information needed for a referral for further specialist assessment.

Where to submit the referral form to

Completed forms should be posted to:

Specialist Assessment Service
Chelmsley Wood Primary Care Centre
Crabtree Drive
Birmingham
B37 5BU

We cannot accept forms electronically .

 What happens to the information after it has been submitted?

 The information is considered by a multi-agency panel. The panel considers

• has all the information required been submitted?
• has supporting evidence been included?
• have the outcomes of adjustments and support over at least the last 6 months been evidenced?
• does this child require a highly specialist assessment for Autism or another service?.
• have the parents consented to the sharing and gathering of information?
• have the school (or another professional that knows the child well in a setting outside of the home ) contributed fully?

If a referral form is incomplete it will be returned this may add unnecessary delays into the process.

Many difficulties that children present with can be accounted for in other ways and do not always indicate that an Autism assessment is required. Once the detailed profile of referral information has been considered by the panel, parents and others involved with a child will be informed of the next steps by letter.

There is a wait time for this assessment. The wait time does vary and all parents will be informed of the current wait time in the letter they receive when a child's name is placed onto the waiting list.

No child's position on the list will be changed for whatever reason unless we are required to do so by law. However we cannot always accurately tell parents when their child will be seen as some children’s assessments take longer than others.

All children are taken off the waiting list in strict date order as all children’s assessments are important. Please be patient if your child is on the waiting list we are doing all that we can to get to your child as quickly as possible.

What happens whilst the child is waiting?  

A child does not need a medical diagnosis in order to gain support from any service or from education and services should support a child whilst they are on the assessment waiting list. Please see this web site for a wide range of details of services available.

Parents telephone calls about the waiting times

Many parents telephone to ask if their child can be seen sooner or when will their child be seen. We cannot indicate when a child will be seen as the assessments of children ahead of a child on a waiting list may take longer than expected. Administrators not clinicians will therefore not be able to answer questions.

Due to the on-going COVID-19 Pandemic the Specialist Assessment Service have made some changes to how they are working. 

When your child/young persons name comes to the top of the waiting list we allocate a lead clinician to work with parents and the child/young person. The clinician will send you an appointment letter. In the team we have a wide range of professionals. These include

• Clinical and Educational Psychologists
• Specialist Occupational Therapists
• Specialist Speech and Language Therapists
• A Paediatrician
• A Psychiatrist
• A Psychotherapist
• Administrators

The assessment process will be led by one of these professionals on behalf of the team. At the first appointment the lead clinician will met with parents/carers without the child present.

This is a lengthy appointment and can last up to 3 hours. At this appointment parents will be led through a series of questions so that we fully understand the child's development and difficulties since they were young.   Parents may ask any questions they wish or explore any issues important to them at this appointment.

At this appointment an assessment plan will be agreed between parents and the lead clinician. Some children may require a range of appointments others may only require 1 or 2 appointments. This plan depends on how much is already known about a child and what may need further assessment.

After each step in the assessment process the lead clinician may wish to gain views from colleagues in the wider team or from other services. The lead will let you know about this process and when it will happen. Some children may also need to be seen at home or at school. Once the assessment is started the appointments will be fairly close together. Most children’s appointments are spread over just 2 to 3 weeks.

At the conclusion of the assessment the lead clinician will meet with parents /carers and/or the child. At this final appointment the outcomes from the assessment will be explained, a diagnosis may be given or an alternative explanation for difficulties offered.  Whether or not to include the child/young person in this appointment will be decided between parents and the lead clinician.

Children with different parenting arrangements: Many children are cared for in different ways. If parenting of a child varies during the week we do like to get views from both parents. If this may cause you any difficulties please speak to your lead clinician so that appropriate arrangements can be made.

Parents are welcome to bring along someone to support them if they wish. Please speak to your lead clinician if you wish to discuss this.

Any parents or carers who may need adjustments to be made e.g.  Support with English, understanding /reading documentation or difficulties attending should always speak to their lead clinician.

The name of the lead clinician will be on your first appointment letter.

After the assessment is concluded a report will be prepared and circulated in line with parents/carers wishes. Young people will also be consulted about circulation if it is appropriate.

In some circumstances the assessment cannot be concluded. Your lead clinician will discuss the period of time that is required before a conclusion may be reached and what needs to happen during that period of time.

Appointments are scheduled well in advance. It is very important that you let us know if you cannot attend immediately so that the appointment can be offered to another family.

The length of the assessment process varies from child to child. Appointments also vary in length as some children can only concentrate for a short period of time.

At the first appointment an assessment plan will be agreed between parents and the lead clinician. Some children may require a range of appointments others may only require 1 or 2 appointments. This plan depends on how much is already known about a child and what may need further assessment.

The assessment is usually completed within a month from the start date and consists of a range of different appointment types.

The clinician leading on your child's assessment is responsible for gathering all the evidence to match against the diagnostic criteria. All assessments meet the requirements of the ICD 10 criteria for the assessment and diagnosis of Autism Spectrum disorders. The lead clinician gathers information, carries out assessment and involves colleagues from other disciplines as required.

The service works to the standards of the NICE guidelines.

The diagnosis of Autism is based on evidence gathered on the triad of impairment associated with Autism.

Difficulties are evidenced across 3 essential areas of a child's development in the areas of:

• social interaction
• communication
• flexibility of thought and behaviour.

Many children and young people also experience difficulties with sensory processing, eating, sleeping and going to the toilet. Some children and young people have additional co-occurring diagnosis.

All outcomes of the assessment will be discussed and explained to parents and the child/young person if appropriate. All parents will receive a written report explaining the outcome of their child's /young persons assessment and this report will be circulated by agreement as it  is helpful if all professionals involved in a child's care receive the assessment report.

Once the assessment is completed a range of explanations for a child's difficulties will be considered. A diagnosis of an Autism Spectrum Disorder can only be given if here is no alternative explanation for difficulties.

There are a range of neuro-developmental difficulties where presenting symptoms are similar to difficulties associated with Autism. For example difficulties may indicate dyspraxia, ADHD, Speech and language difficulties, sensory processing disorders, specific learning difficulties or mental health concerns. Any alternative explanations for difficulties will be explained to parents/carers.