What Is a NICE-Compliant Autism Assessment?
If you are looking for a private autism assessment, you may have seen providers describe their assessments as “NICE-compliant”. But what does that actually mean, and what should you look for when choosing an assessment?
What NICE guidance is
The National Institute for Health and Care Excellence (NICE) produces evidence-based guidance for health and care services in England. This includes guidance about how autism should be recognised and assessed in both children and adults.
When a provider describes an autism assessment as NICE-compliant, they are saying that their assessment process has been designed to follow this guidance.
It is important to know that NICE does not approve individual providers or award a “NICE-compliant” status. It is therefore a good idea to look beyond the phrase itself and ask what an assessment actually involves.
Why should I check that an assessment follows NICE guidance?
An autism assessment is an important decision and when you are paying privately, a significant financial investment too. You should feel confident that the assessment is comprehensive and that any diagnostic decision is based on much more than the result of one questionnaire or assessment tool.
NICE guidance recognises the importance of bringing together information from different sources. This includes understanding developmental history and current experiences, direct clinical observation and, where appropriate, information from other people or settings.
This is important because autistic people are all different. Someone may communicate or behave differently depending on where they are, who they are with and how comfortable they feel. Some people also mask or develop ways of managing difficulties that can make their experiences less immediately visible.
A comprehensive assessment therefore looks at the whole person and their experiences over time, rather than relying on how someone presents during one appointment.
What does this look like at AYC?
At AYC, our autism assessments follow NICE guidance and use a multidisciplinary approach. This means different clinicians contribute their professional expertise and we bring together several different sources of information before reaching a diagnostic decision.
Our assessment pathway includes:
A detailed developmental history
Before the assessment, we gather information about early development as well as current strengths, experiences and areas of difficulty. Our developmental history questionnaire is based on the ADI-R framework and is reviewed by a member of our multidisciplinary team. If we need further information or clarification, we may contact you before the assessment.
Understanding sensory experiences
We use the SPM-2 to explore sensory processing and how sensory experiences may affect everyday life. This information contributes to the wider assessment and can also help us make useful recommendations.
Information from school for children and young people
Children do not always present in the same way at home and at school. We therefore gather information from education wherever possible. We recognise that some children mask or may be supported by the structure of the school environment, so differences between home and school are considered as part of the overall picture rather than one account automatically being given more weight than another.
A face-to-face assessment
Assessments take place at our Warrington clinic and include the ADOS-2, a standardised observational assessment that helps us explore areas including social communication and interaction.
The ADOS-2 is one part of the assessment and is never used on its own to determine whether someone is autistic. Its findings are considered alongside developmental history, information from other settings and the wider clinical assessment.
Our clinic rooms are designed to be comfortable and sensory-aware and our clinicians understand that attending an autism assessment can feel daunting. We aim to make the experience as relaxed and person-centred as possible.
A multidisciplinary diagnostic decision
Our autism assessment team includes a Clinical Psychologist, Speech and Language Therapist and Occupational Therapist. Two members of the multidisciplinary team are involved in the face-to-face assessment, while the third reviews other assessment information and contributes their professional perspective to the overall picture and report.
Your assessment takes place in person at our Warrington clinic. Our rooms are sensory-aware and we aim to make the assessment feel as relaxed and low-pressure as possible. The ADOS-2 may sound formal, but in practice it is conversational and, depending on the person’s age, may include a range of activities designed to help the clinicians understand communication and social interaction.
Following the assessment, the clinicians bring together everything that has been gathered, including developmental history, sensory information, information from other settings where relevant, the ADOS-2 observations and their own clinical expertise. No single questionnaire, score or observation determines the outcome.
Sometimes the information is clear enough for the clinicians to discuss the outcome with you on the day. At other times, they may need to consider the information further, speak with another member of the multidisciplinary team or gather some additional information before reaching a conclusion. We would much rather take the time needed to reach a carefully considered decision than rush an outcome where the picture is less clear.
Once the multidisciplinary team has reached its conclusion, the findings and recommendations are brought together in your final report.
What will my report tell me?
Following the assessment, you will receive a detailed report bringing together the information gathered throughout the process. It will explain the assessment findings, the diagnostic outcome and the reasons for the decision reached by the multidisciplinary team.
Where a diagnosis of autism is given, the report will describe the person’s individual profile, including their strengths and areas where they may need additional understanding or support. It will also include personalised recommendations relevant to everyday life, education or employment, where appropriate.
The report can be shared with other professionals, such as schools, colleges, universities, employers, GPs and other healthcare professionals. It can provide useful evidence when discussing support, reasonable adjustments or an individual’s needs.
If the assessment does not result in an autism diagnosis, you will still receive a full report. We will explain the findings and why the diagnostic criteria were not met, rather than simply giving a “yes” or “no” outcome. Where appropriate, we will also include recommendations and signposting to other services, resources or areas that may be helpful to explore.
What should I ask when choosing an autism assessment provider?
If you are considering a private autism assessment, it is absolutely fine to ask a provider how their assessment works before deciding whether they are right for you or your family.
- Does your assessment follow current NICE guidance?
- Who will be involved in the assessment and is it multidisciplinary?
- How do you gather information about developmental history?
- Which recognised autism assessment tools do you use, and how do they contribute to the overall assessment?
- For children and young people, do you gather information from school or other education settings?
- How is the diagnostic decision reached, and what happens if the outcome is not immediately clear?
A good provider should be happy to explain their assessment process clearly, including who is involved, what information they gather and how they reach a diagnostic decision. You should feel comfortable asking these questions before committing to an assessment.
Thinking about an assessment
AYC Psychology is a National Autistic Society (NAS) Diagnostic Partner and part of the NAS Community of Practice. If you are considering an assessment, you can get in touch with our team for more information, and we are happy to arrange a call if you would like to talk things through first.
You can reach our team on 01925 249228 or enquire through our website.
