Some of our team have worked at national specialist adult autism and ADHD diagnostic assessment and psychological therapy services.  Together, we have substantial experience of doing adult autism assessments.  Debbie is also an ADOS-2 trainer.

At the moment, we are doing all autism assessments remotely via Zoom or Teams.  

What does an autism diagnostic assessment involve?

The assessment is comprehensive and involves several components:

  • A free initial phone or Zoom call for up to 60 minutes to understand a bit more about the reasons for the referral, to offer information about the assessment process and to answer any questions. If we think we are not the best service to provide a diagnostic assessment, we discuss this and may signpost to other services.
  • A clinical interview (a conversation) for up to 4 hours that takes place over two or three meetings depending on what the person prefers. This involves talking about topics including current difficulties, childhood development and what life was like growing up, education and employment, social relationships, physical health and emotional wellbeing, hobbies, strengths and preferences.
  • A developmental assessment called the Autism Diagnostic Interview (ADI-R). The ADI-R is completed with a parent or someone who knew the person very well when they were young. It takes around 2 hours and mainly focuses on early childhood history and development.
  • We know it isn’t always possible to speak to a parent. In this case, we ask if we can meet with someone who knew the person when they were growing up or who has known them for a few years (for example, a sibling, relative, friend or partner). We do not do the ADI-R with them.  We ask them some more general questions about their thoughts about a person’s strengths and difficulties. 
  • Some short questionnaires. These are used to screen for conditions that commonly co-occur with autism (for example, anxiety) as well as to understand a bit more any difficulties a person describes at the clinical interview.
  • A summary conversation for 1 hour to talk through assessment conclusions and recommendations.
  • We send the person an assessment letter within two to three weeks summarising all the components of the assessment, our diagnostic opinion and recommendations. We can also provide a shorter letter, such as for employers, that only states the diagnostic conclusion.
  • A follow up appointment for 1 hour to discuss the assessment letter and recommendations if the person would like.


Sometimes we think it would be clinically helpful to add extra components to the assessment, to inform the diagnostic opinion.  There is no extra charge.  We always make time to talk with the person about why we think this is important.  Extra components can include:

  • The Autism Diagnostic Observation Schedule (ADOS-2). This is a specialist assessment of autistic traits that involves some activities and chatting.  It takes around 1 hour.  The ADOS-2 is only validated to be done in person, and we can do these in our London or Leamington Spa offices.
  • Some additional screening questionnaires about difficulties, coping styles and day to day functioning.
  • An extra meeting with important people in the person’s life (for example, their partner or a friend) to find out more about the person’s strengths and any difficulties.
  • In depth structured assessment of specific mental health conditions (for example, obsessive compulsive disorder, post-traumatic stress disorder).


Rather than simply giving a diagnostic opinion about autism, we offer a formulation-based approach to the assessment.  This means that, together with the person, we aim to develop a shared understanding of the ways in which any difficulties, traits and symptoms may link together, how these have impacted on day-to-day functioning and what skills, strategies or resources have helped them cope and get by. For example, as part of the assessment, we think about whether a person may be experiencing co-occurring conditions alongside autism (such as anxiety, low mood) and how these may interact and influence each other.  We also think about whether there might be a different explanation for the symptoms and difficulties the person describes.  

Irrespective of the diagnostic outcome, we aim to identify a range of recommendations.


Making the decision to book an adult autism assessment

In our experience, some people feel confident that having an autism assessment will be useful for them.  But this isn’t always the case.  Some people, for example, feel unsure if an assessment will be beneficial, yet others in their lives (such as partners or parents) think that this is very important. 

We sometimes offer one (or more) appointments, so that people and anyone else they would like to invite, have a supportive space to talk through issues that come up when thinking about having an autism assessment.  In these appointments, we usually incorporate approaches commonly used in systemic therapy; approaches that can help people share their thoughts and concerns with each other, and find ways of managing difficulties jointly, rather than alone.