Neurodevelopmental assessment

What is autism spectrum disorder (ASD)?

Young people with autism have difficulties with social situations, communication and certain behaviours like routines, rituals, or obsessions. As part of an autism assessment, we also look at sensory sensitivities (such as being sensitive to noise, touch or textures). We need to see evidence of difficulties across these different areas in order to give a diagnosis. Lots of people have some of these difficulties but do not have autism.

What is attention deficit hyperactivity disorder (ADHD)?

Young people with ADHD have difficulties with concentration, attention, hyperactivity and impulsivity (acting without thinking). You might find it hard to sit still or focus on tasks which require your attention, like homework. You might be forgetful, you might lose things and you might struggle to follow instructions. Sometimes, these difficulties might mean that you get into trouble at home or at school.

Assessments within CAMHS

CAMHS stands for child and adolescent mental health services. All children and young people seen within CAMHS have an initial assessment with a specialist CAMHS worker or mental health nurse.

They will offer between 1 and 6 sessions to assess the current mental health concerns and provide support. If it is felt that an autism or ADHD may be present in you, they will arrange for a screening questionnaires to be completed.

The clinician will take the results of these questionnaires, along with other relevant information to our neurodevelopmental assessment team specialists who will decide if you have autism or ADHD. Sometimes clinicians may suggest that both conditions are assessed for at the same time.

If an autism or ADHD assessment is needed, you will then be placed on an internal waiting list to be seen and assessed by our neurodevelopmental assessment team.

What happens during the assessments?

Collecting a detailed history

We will ask your parent or carer about your development, starting from pregnancy till now and their current concerns.

We will ask what you did at different ages, such as when you walked, talked and were potty trained. Depending on whether it is an autism assessment or an ADHD assessment, we will also ask about different aspects of your childhood. We may want to know more about your play, social interactions and communication or the questions may be more about how active you were, and whether you could concentrate and pay attention.

Observations

There are some different clinic observations we do depending on the type of assessment.

If we are assessing for autism, we may invite you in for an assessment called the autism diagnostic observation schedule (ADOS). This involves different tasks and activities, such as creative tasks and questions about emotions.

If we are assessing for ADHD, we may see you in clinic to make some observations and talk to you about what you find hard. We may also invite you to do a short computerised test called the QB test which measures your attention, activity levels and impulsivity.

Collecting information from others

We will gather information from your school and sometimes might come to observe you at school. If there are other professionals who know you well, such as social workers or previous CAMHS workers, we will also ask them for information.

Team discussion

Once we have gathered all of the information needed, we will have a discussion within our neurodevelopmental assessment team. Your worker and others in the team will review all of the information we have collected. The team will then decide whether there is enough evidence to give a diagnosis of autism or ADHD or both. If there is no evidence, we will think about whether another explanation such as anxiety, low mood or difficult life events may explain some of the difficulties you are having.

Feedback

Once the above assessment has been completed, we will arrange a feedback session to discuss the outcome with you and your parent or carer.

Report

A report will be sent to you and to your GP to summarise the assessment and the outcome. This report may include recommendations for extra support.

After the assessment

If you receive a diagnosis of autism, you may be offered a space in our CAMHS autism follow-up clinic.

If you receive a diagnosis of ADHD, we will talk to you about whether you would like to be referred to see one of our child psychiatrists to explore whether medication might help.

If you do not receive a diagnosis, we will discuss next steps with you. You may need some therapy from CAMHS, such as for anxiety or low mood. You may not require any further support following assessment and in this case you would be discharged from CAMHS. You may be signposted to other services who can help.