Q: What is the cost of assessment

Following cost applies to self-paying parents/carers Initial Assessment for up to 60 minutes: £350 Initial Assessment for up to 90 minutes: £400 Initial Assessment for up to 120 minutes: £500 Follow up to 30 minutes: £150 to £250 dependent on complexity Any additional time spent over the set limit for assessment, when available, may incur cost of £100 per 30 minutes or part thereof. Please note specialist assessments by other professionals such as Speech and Language Therapist, Occupational Therapist and Clinical or Education Psychologist, investigations etc. may incur additional cost if not advised initially. All investigations requested as a part of assessment are not included in the assessment cost. They are payable directly to the concerned third party. There is a small charge for medication prescriptions outside of consultation appointment for example repeat prescriptions. Cost of Autism and ADHD assessment depends on a number of factors including the age of the child and complexity of presentation. We request parents to contact Autism Doctor for specific cost relevant to their child. Cancellation charges: Any cancellation without a prior notice of at least 48 hrs may be subject to administrative charge of £100/- to cover admin/ room hire fees etc. Please pay to the invoice using BACS ( bank transfer).

Question 1

Do Local Authorities/NHS recognise your diagnosis

Accepted Answer

Our diagnosis is based on international standards such as the Diagnostic and Statistical Manual (DSM)-5 or ICD-11 which are followed worldwide. We follow robust assessment guidelines which are based on NICE * (National Institute of Clinical Excellence) guidelines followed by the NHS. We are happy to work collaboratively with the NHS and primary care such as your GP.   We get requests for assessments from all parts of UK and have undertaken assessments for children resident in ​ Bedfordshire Buckinghamshire Cambridgeshire Derbyshire East Sussex Greater London Harrow Hertfordshire Herefordshire Kent Lincolnshire Middlesex West Essex ​ * The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for driving improvement and excellence in the health and social care system in UK.   Our diagnosis has been well accepted in the UK. Please seek views of your local health and education services to gain clarity on their views on priavte assessments. We are happy to discuss individual situations with you.

Question 2

Are your assessments face to face or online

Accepted Answer

We offer a mixture of telephone and face to face appointments in most circumstances. These are arranged at a time that is mutually convinient to both parties. We endeavour to have face to face appointments for every child.

Question 3

What is the cost of assessment

Accepted Answer

Following cost applies to self-paying parents/carers ​ Initial Assessment for up to 60 minutes: £350 Initial Assessment for up to 90 minutes: £400 Initial Assessment for up to 120 minutes: £500 Follow up to 30 minutes: £150 to £250 dependent on complexity   Any additional time spent over the set limit for assessment, when available, may incur cost of £100 per 30 minutes or part thereof. ​ Please note specialist assessments by other professionals such as Speech and Language Therapist, Occupational Therapist and Clinical or Education Psychologist, investigations etc. may incur additional cost if not advised initially.  ​ All investigations requested as a part of assessment are not included in the assessment cost. They are payable directly to the concerned third party.   There is a small charge for medication prescriptions outside of consultation appointment for example repeat prescriptions. ​ Cost of Autism and ADHD assessment depends on a number of factors including the age of the child and complexity of presentation. We request parents to contact Autism Doctor for specific cost relevant to their child.   Cancellation charges:  Any cancellation without a prior notice of at least 48 hrs may be subject to administrative charge of £100/- to cover admin/ room hire fees etc. ​ Please pay to the invoice using BACS ( bank transfer).

Question 4

How soon can we expect the assessment

Accepted Answer

We are able to offer the first appointment usually within 2-4 weeks of us receiving the referral information.   The reports take up to 4 weeks or so after the last assessment is completed or the information received in most circumstances.

Question 5

What is the test for Autism

Accepted Answer

No two children with Autism Spectrum are the same. The autism assessment is like putting pieces of a jigsaw together. The assessment is often multidisciplinary which means more than one expert is involved. ​ The most important contribution in the assessment of Autism is that of clinical history. We tailor this part of the assessment to each child based on the standardised recommendations. ​ We recommend the right experts who will be able to assess your child for specific aspects of Autism such as their social interaction and communication style etc.   We will also offer a direct observation of the child or young person to elicit their behaviours in the context of Autism. This is all geared to the age and language level of the child. ​ We also ask for information from other settings where applicable. ​ You will be given a clear plan of what assessment tests are being offered that meet your child's needs ​ In rare circumstances where all of these steps may not be possible, Autism Doctor will suggest alternative options, again keeping best practise at the core of assessment. ​   For Autism assessments we use a combination of assessment tools depending on the presentation of the child or young person.   For Autism some of the following assessment tools may be used   Social Communication Questionnaire (SCQ) 3-Di ADI-R  ADOS-2 BOSA (Brief Observation of symptoms of Autism) TELE-ASD-PEDS Children’s Communication Checklist-2 Neurodevelopmental School Observation Report by educational setting Specialist assessment and observations by clinical psychologist and or Speech and Language Therapist (SALT)

Question 6

What is a 3Di assessment

Accepted Answer

The Developmental, Dimensional and Diagnostic Interview (3Di) is a parental interview usually undertaken as a telephone appointment.  The child is not required for this assessment. One or both parents can join in this interview. It takes about 60 minutes to complete in most circumstances. ​ The aim of this interview is to establish how likely it is that your child has symptoms of Autism. ​ During this interview the interviewer uses a framework of questions that cover verbal and non-verbal communication, social relations as well as rigid, repetitive, ritualistic and sensory behaviours of your child. There are often choices of answers to the questions. The interviewer may give you those options as appropriate. The interviewer will ask you some examples of statements that you may have made e.g.: “he always takes things literally” as today he said “it can’t rain cats and dogs as they are animals not raindrops falling from the sky”. ​ At the end of the assessment the clinician will be able to give you feedback as to whether your child is likely to have Autism or an Autism Spectrum Disorder (ASD). Please note that the terms Asperger’s, Autism are currently not in use as they are all now merged into Autism Spectrum Disorder. ​ The 3Di outcome does not mean that the diagnosis is confirmed. The clinician will confirm the diagnosis after collating information from other sources, developmental history and other tools for assessments and information from the 3Di interview. ​ You will be guided throughout the interview. If at any stage you are not sure please ask.

Question 7

What is an ADOS-2 assessment

Accepted Answer

The Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) is an activity-based assessment administered by trained clinicians to evaluate communication skills, social interaction, and imaginative use of materials in children and young people who are suspected to be on the Autism Spectrum Disorder (ASD).   During the ADOS-2 assessment, the examiner presents the person being tested with a series of structured and unstructured social activities or “presses” that provide standard contexts in which social interaction, communication, and particular types of behaviours are likely to appear.  The ADOS-2 alone is not used to make a diagnosis on its own. Further information/ assessment should be done for a full diagnosis.  There are many modules of ADOS-2. The module is chosen based on a particular developmental and language level of the child/young person.

Question 8

What is BOSA assessment

Accepted Answer

BOSA, or Brief Observation of Symptoms of Autism, is a newer diagnostic tool in the assessment of Autism. It is an adaptation of another tool used for assessment of autism in children, the Autism Diagnostic Observation Schedule (ADOS-2).    It provides opportunities for a parent to engage with the child through semi-structured activities, creating a context in which to observe symptoms of autism.  ​ It involves you as parent to administer series of timed activities with your child using standardised toys and activities. You will be given instructions on how to administer these on the day. The instructions are fairly simple. ​ The clinician will observe, ask additional questions as required and analyse the observation and report it.   The clinician will confirm the final diagnosis after collating information from other sources, developmental history and other tools for assessments and information from the BOSA.

Question 9

What is a SCERTS assessment

Accepted Answer

SCERTS is an evidence-based framework to support children and young people with Autism in the areas of Social Communication and Emotional Regulation using Transactional Supports. This can be very helpful if your child has a lot of emotional dysregulation. In other words if they get frequent meltdowns that cannot be explained. SCERTS -based assessment adds rich detail to the strengths and needs of your child in relation to social communication and emotional regulation whilst providing strategies for home and educational settings.  The format is through detailed questionnaires from parents, educational staff and video observations. In some instances, video-calls might be arranged, and in a few instances face-to-face assessment might be required.

Question 10

What is TELE ASD PEDS assessment

Accepted Answer

TELE ASD PEDS is a type of video assessment to observe young children suspected to have Autism. It is a fun and relaxed activity with toys that most children have in their homes.   During this assessment you will be requested to play and interact with your child using a few toys. The observer notices the spontaneous responses of your child with you when you play and interact with him/her. It is a relaxed session with the planned activities that most parents/carers undertake with their children regularly using commonly available toys.   We will provide you with all the instructions and guidance on how to do it when it has been agreed.

Question 11

What is an ADI-R

Accepted Answer

The Autism Diagnostic Interview-Revised (ADI-R) is a diagnostic interview used in determining whether or not children have autism spectrum disorder (ASD).   Administering the ADI-R does not directly involve the child—instead, it is an interview conducted by a trained professioanal with the child’s parents or other caregivers. The ADI-R focuses on the developmental history of the child as well as current problems.   It is a very detailed and therefore lengthy assessment that can be undertaken using teleconsultation.  It is helpful when some symptoms of ASD are not apparent when interacting directly with the child in a face-to-face assessment.

Question 12

How is ADHD assessed

Accepted Answer

ADHD requires careful consideration of the child’s history and behaviour at home, and how it correlates with the child's presentation in another setting such as at school. ​ We use tailor made tools to take a standardised history and correlate it clinically.   For ADHD some of the following assessment tools may be used:   SNAP-IV questionnaire Neurodevelopmental School Observation

Question 13

What is the role of Paediatricians in neurodevelopmental assessment

Accepted Answer

Paediatricians are best suited to establish a good developmental history which is essential for a diagnosis of Autism.   Paediatricians can also consider other possible diagnosis including serious conditions like epilepsy, Developmental Delay, Dyspraxia, medical syndromes, and other a range of medical diagnosis.   Paediatricians are specifically trained for medical examination of children and young people. NICE guidelines recommend physical examination as an essential part of diagnostic assessment  of Autism Spectrum Disorder.

Question 14

Do your clinicians have NHS experience

Accepted Answer

Most clinicians working for Autism Doctor have experience of working in the NHS. Our lead clinician Dr Deepshikha Thakur works for the NHS at Hertfordshire Community NHS Trust. She is the lead doctor for Autism and principal Investigator of KASPAR research project related to interventions in Autism. In addition she is the Designated Medical Officer (DMO) in West Hertfordshire. She has strategic role in supporting children and young people with Special Education Needs and Disability (SEND).

Question 15

Do you assess children covered under insurance

Accepted Answer

Yes we do. Our lead clinician Dr Deepshikha Thakur is recognised by major insurance providers such as ​ Aetna Aviva AXA BUPA Cigna Healix Vitality Health   You will need to obtain an authorisation code to book the first appointment. ​ Speak to your insurance provider if you are not sure. You will need an authorisation code and a GP referral letter​ prior to contacting us for any assessment under insurance.  Please contact us for individual circumstances.

Question 16

How can a timely diagnosis help

Accepted Answer

There are often long and unclear pathways for assessment of Autism and other Neurodevelopmental conditions like ADHD (Attention Deficit Hyperactivity Disorder) , Developmental Delay, Dyspraxia etc. Lengthy waiting times for assessment is frustrating to families and in the absence of clear diagnosis parents and professionals may not be able to adequately support the child's needs.   Delayed diagnosis can lead to increased stress and strain on relationships. It can also deny the child the help they need. ​Research has established that early interventions can be effective for many children.

Question 17

What is the age range of children and young people that you assess

Accepted Answer

We offer assessments of children and young people from birth to 16 years and 11months.

Question 18

Do you offer assessments requested by Local Authority

Accepted Answer

Yes we do. Please discuss individual circumstances with us.

Question 19

I have medical insurance but I am not sure if I am covered?

Accepted Answer

Our lead clinician Dr Deepshikha Thakur is recognised by major insurance providers such as ​ Aetna Aviva AXA BUPA Cigna Healix Vitality Health ​ Speak to your insurance provider if you are not sure. You will need an authorisation code prior to contacting us for any assessment under insurance. ​ Please contact us for individual circumstances.

Question 20

Which guidelines/diagnostic tools do you use?

Accepted Answer

All our assessments are based on recommended standard or national guidelines such as National Institute of Clinical Excellence (NICE) guidelines and Diagnostic statistical Manual-5 (DSM-5).    During the COVID-19 pandemic we are following Public Health England Guidelines for face-to-face assessments.   We are undertaking some assessments online as per new protocols in order to provide safe and standardised care. Please refer to our COVID-19  safety policy. ​ Diagnostic tools are specific to your child's needs.

Question 21

Do you offer a multi-disciplinary assessment?

Accepted Answer

Yes we offer assessments by different clinicians such as speech and language therapist, clinical psychologist, education psychologist, occupational therapist, physiotherapist etc. as required for the child.  ​ Our clinicians are handpicked and experts in their field and have experience of working with children and young people.

Question 22

Can you help in Education Health and Care Plan (EHCP)?

Accepted Answer

A lot of parents often want support in the Education Health and Care Plan (EHCP) process. At a small additional cost we can help with completing the medical information on the EHCP form when requested by the local education authority following our assessment.

Question 23

What information do you need for an assessment?

Accepted Answer

It is helpful to understand why you have come to us for an assessment. If we understand this we can help you best. ​ We need information from other sources for a comprehensive assessment. For most children who are in an educational setting, we will request school information via parents.  ​ We also request parents to send all relevant previous assessments and reports e.g. Speech and Language Therapist (SALT), Clinical Psychologist assessments or Education Psychologist reports, ideally prior to the initial assessment.

Question 24

What are the NICE guidelines for Autism Assessment?

Accepted Answer

NICE recommends that the autism assessment team should include:   paediatrician and/or child and adolescent psychiatrist speech and language therapist clinical and/or educational psychologist The autism team should either include or have regular access to the following professionals if they are not already in the team:   paediatrician or paediatric neurologist child and adolescent psychiatrist educational psychologist clinical psychologist occupational therapist   The autism team should either have the skills (or have access to professionals that have the skills) needed to carry out an autism diagnostic assessment, for children and young people with special circumstances including coexisting conditions such as   severe visual and hearing impairments, motor disorders including cerebral palsy, severe learning (intellectual) disabilities, complex language disorders or complex mental health disorders looked-after children and young people.  At Autism Doctor we are proud to offer assessements that fit in with NICE Guidelines

Question 25

What are typical Autism Symptoms

Accepted Answer

The Autism symptoms include: Difficulties in social interaction and communication Rigid and Repetetive Behaviours Younger children often exhibit flapping, tip toe walking and lining up of objects. Older more verbally fluent children may have unexplained meltdowns

Question 26

What are the signs of Autism in High functioning Autism

Accepted Answer

In high functioing Autism the signs are:   Verbally fluent but not able to hold conversations Melt downs and Emotional Dysregulation Obsessional Interests

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