The “gold standard” approach to the assessment of ASCs places an emphasis on multi-professional input, but in practice this is often difficult to arrange even within established NHS services.

As a consequence, diagnoses are often made by professionals in isolation, or are not made at all.

Healthcare On Demand (HoD) offers a comprehensive assessment service for children, young people and adults where there are queries around Autism Spectrum Conditions (ASC) and, where required, bring other highly qualified HoD professionals alongside to contribute to the assessment and subsequent management.

We accept referrals from GPs, other healthcare professionals, also individuals and families may self refer, if wished.

Our preference is always to work in close collaboration with GPs and others, as this is the best practice, and is the approach most likely to ensure you get optimal care.

Please consider seeking a referral from your GP to the HoD clinic, if at all possible. It is in your best interests to do so, however we will not turn you away if this is not possible, for whatever reason. The practitioner(s) you consult may well seek your consent to keeping your GP informed of any diagnoses or treatment being undertaken, whether you enter the service via a GP or self referral.

This broad range of experience means that we are able to provide a combination of clinical and educational assessments that highlight a person’s strengths as well as difficulties.

Why seek a diagnosis of possible Autistic Spectrum Conditions in Adult life?

The benefits of getting a formal diagnosis of autism can include:

  • It may help you to understand why you may experience certain difficulties and what you can do about them
  • When the people close to you understand why you may see and feel the world in a different way and find certain things difficult, it’s much easier for them to empathise
  • It may help you to get access to support and benefits
  • Your employer may be required to make any necessary adjustments

See also NICE Guidance on Autism spectrum disorder in adults: diagnosis and management by clicking HERE.

Your Options regarding Next Steps

Healthcare on Demand is committed to ensuring that individuals and families do not pay for services that they do not need, or that they could access freely from the NHS. Following the preliminary screening, clinician recommendations can be provided via the clinic coordinator. Therefore you will receive appropriate guidance on the correct next steps for you.

Step 1: Initial Screening

  • If you are not sure what you are looking for, or even whether a full autism/ ASCs assessment is indicated, you may request a preliminary screening step (Step 1), at a modest cost, before deciding whether to proceed with a full assessment, which is more costly and time consuming.
  • This initial review takes an hour and a half. This initial screening is carried out by a Psychologist using  standard ASC-related questionnaires, the Autism-Spectrum Quotient – 10 items (AQ-10), Empathy Quotient questionnaire plus the Strengths and Difficulties Questionnaire (SDQ; Adult version) . This can be done with only the individual with suspected ASC difficulties or with their family member(s) too, as is appropriate. (This is in line with the NICE Guidance on diagnosis of autism spectrum disorder in adults.)
  • The consultation will include a discussion of the difficulties that make you think an autistic spectrum condition may be present, including anything in your history that may be significant, from childhood through to the present day. Your family history may also be thought to be relevant, as will your education and employment history.
  • The Psychologist will have a general discussion with you, and will summarise the nature and range of difficulties experienced.
  • The questionnaires will be administered, and can be scored during the consultation to give you a preliminary indication of potential findings.
  • After the session, the Psychologist will write up the report, including all items addressed plus the formal AQ-10, EQ and SDQ results.
  • You will be provided with a copy of the report after the consultation.
  • On average, most women score about 47 and most men about 42 on the Emotional Quotient test. Most people with Asperger Syndrome or high-functioning autism score about 20.
  • Where the  person scores above six on the AQ-10, less than 32 on the EQ or autism is suspected ( based on clinical judgement and any past history as provided by an informant plus results of the SDQ), a comprehensive assessment for autism would be appropriate.
  • In this situation you should consider progressing to a full autism assessment (Step 2) for a definitive diagnosis.
  • If there is a low score on the AQ-10( 5 or below) or a high score on the EQ measure (e.g. 33 or more) then it is much less likely that the criteria for a diagnosis of ASD can be met, and so no further ASC- related assessments would be indicated.

The cost for Step 1 – Screening Consultation, including written report provision is £200.

Screenings will be conducted by Margot Heurtematte. You can learn more about Margot by clicking on her picture below:

It is important to note that the screening step provides important indicators for your consideration, but it is not in itself a diagnostic process. It gives you an indication of whether it is likely that you may meet the thresholds for diagnosis. You need to progress to Step 2 – if appropriate and wished – to establish a full, positive diagnosis.

It is in Step 2, a longer, more detailed and complex set of assessments with two practitioners from different disciplines that the firm diagnosis is established, and further recommendations on treatment and other forms of support can be made.

Step 2: Full Diagnostic Assessment

This full diagnostic assessment ( Also referred to as Step 2) includes:

  • Consultation with an Adult Psychiatrist, including Medical/ Social history and General Developmental Assessment, which may also include the ADI-R. Also includes AQ-10 test and SDQ tests if not already performed in a screening step.
  • Direct observation / interview with the individual, and partner, if appropriate.
  • Full assessment testing using the Autism Diagnosis Observation Schedule version 2 (ADOS) with a specialist Clinical Psychologist or specialist Speech and Language Therapist.
  • Full report within 10 days, including recommendations for education/ employment, social factors and family implications
  • Clinic letter to GP
  • Face to face feedback session with as appropriate and agreed

The practitioners who offer full adult ASCs assessments are:

Dr Ravi Mehrotra

Marisa Ciesla

Just click on the clinicians’ names to be taken to their profile pages, where you can see their qualifications, experience, fees and can even book an appointment by clicking on the Request an Appointment button  (the green button below the individual practitioner’s photograph).

Each practitioner sets their own fees; this information is provided on their webpage.

The practitioner will then contact you to discuss any questions you may have, prior to the assessment consultation.

In rare instances, there  may be unexpected findings that require a further consultation with the Adult Psychiatrist. This service, which is beyond the standard autism assessment is available by arrangement at additional cost.

Interested in exploring the Assessment Options further? Please contact us by emailing info@HealthcareOnDemand.org.uk

Further Useful Links

National Autistic Society (NAS) – general site http://www.autism.org.uk/ – the UK’s main ASC-specific support organisation. A great starting point for families or individuals with questions about Autism Spectrum Conditions

NAS services directory http://www.autism.org.uk/directory.aspx – a comprehensive list of resources for people with an ASC and their families, searchable by area and type of input required

Wrong Planet.net http://www.wrongplanet.net/ – a web community designed for individuals (and parents / professionals of those) with Autism, Asperger’s Syndrome, ADHD, PDDs, and other neurological differences