Autism Spectrum Disorder (ASD) in children: Assessment and management
Understanding your child’s autism spectrum disorder, together
When you’re worried about your child, it’s natural to want clear answers – but also to be selective about who provides those answers. Our role is not just to assess; it’s to take the time to understand your child as an individual, including their strengths, communication style and the way they experience the world.
Our CAMHS team uses a child-centred, integrated approach, drawing on clinicians within the neurodevelopmental team, child and adolescent psychiatrists, child development specialists, child and adolescent clinical psychologists and a clinical nurse specialist.
Most importantly, we work with you. You know your child best, and your insight matters. Together, we build a clear, realistic plan that supports your child’s confidence, comfort and day-to-day functioning at their pace.
Wherever your child sits on the spectrum, we’re here to help
Autism exists on a spectrum, which means that it presents in various forms and degrees of severity, and management strategies will depend on the outcome of your child’s assessment.
In some cases, the assessment may point towards other developmental or emotional challenges, other than autism spectrum disorder. Whatever the outcome, our caring and compassionate team will guide you towards the right care pathway.
Flexible & collaborative in our support of you & your child
Our clear and reliable autism assessment tools
Following a consultation, we will plan in-person assessments in a structured clinical setting, allowing us to observe your child’s communication, behaviour and social responses directly. We can also arrange for assessment to be carried out remotely. As part of this process, we will use the following gold-standard assessment tools:
The ADOS is widely regarded as one of the gold-standard tools for assessing autism. It is a semi-structured assessment that allows our clinicians to observe how your child communicates, interacts socially and engages in play or conversation. Rather than relying on checklists alone, ADOS gives us the opportunity to see how your child responds in carefully designed activities that gently draw out social and communication behaviours.
There are four modules, each tailored to a child or young person’s age and level of speech – from children who are pre-verbal or using single words, through to adolescents with fluent speech.
The ADI-R is a structured interview carried out with you, as a parent or carer. It focuses on your child’s early development, communication, social relationships and patterns of behaviour over time. Your insight is invaluable, and this detailed developmental history helps us build a fuller picture of how and when certain traits first appeared.
By looking at patterns across childhood, rather than just current behaviours, the ADI-R supports a careful and accurate assessment. It helps us understand not only what may be happening now, but how your child’s strengths and challenges have evolved over the years.
Depending on your child’s age and presentation, we may use additional questionnaires or screening tools to strengthen our understanding. For example, with adolescents we may consider measures such as the Camouflaging Autistic Traits Questionnaire (CAT-Q), which explores whether a young person may be masking or compensating for social differences in ways that can be emotionally exhausting.
These additional tools help us ensure that quieter or less obvious presentations or autism are not overlooked, and that your child’s individual experience is properly recognised.
Personalised support following an autism assessment
Autism spectrum disorder is a lifelong condition, but with the guidance of an experienced team of mental health professionals applying the latest assessments and an integrated approach, the challenges of ASD can be managed effectively.
Every child is different. Following a detailed assessment, we develop an individualised management plan based on your child’s specific strengths, challenges and needs. This may include recommendations for psychoeducation, specialist educational input and treatment which can include behaviour management strategies and social skills support to help your child feel more confident in everyday life.
We place strong emphasis on psychoeducation, helping you, your child and the important adults in their life, such as teachers, to better understand how autism affects them. When everyone involved has a shared understanding and practical strategies to use at home and in school, children are far more likely to feel supported and able to thrive in their own way.
Frequently asked questions
about autism spectrum disorder support at The London Psychiatry Centre
How are children assessed for autism spectrum disorder (ASD)?
Assessment for Autism Spectrum Disorder (ASD) is detailed and multidisciplinary. It usually involves:
- A developmental history taken from parents or carers
- Direct observation of the child
- Standardised assessment tools
- Information from the child’s GP, and nursery or school where appropriate
Two gold-standard diagnostic tools are commonly used:
- ADOS (Autism Diagnostic Observation Schedule), a structured, play-based assessment where a clinician observes how a child communicates, interacts socially, and responds to different activities.
- ADI-R (Autism Diagnostic Interview – Revised), a detailed interview with parents or carers about the child’s developmental history, behaviour, communication and social interaction.
Clinicians may also assess speech and language skills, cognitive ability, and emotional or behavioural functioning to build a complete picture. A diagnosis is made using criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
What are the different types of ASD?
Instead of “types” of autism, clinicians now refer to levels of severity, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5):
- Level 1: Requiring support
- Level 2: Requiring substantial support
- Level 3: Requiring very substantial support
These levels reflect how much day-to-day assistance a child or young person needs, particularly in social communication and managing restricted or repetitive behaviours.
What are the symptoms of ASD?
Symptoms vary widely from child to child depending on the severity of ASD, but typically affect:
Social communication and interaction:
- Limited eye contact
- Difficulty understanding social cues
- Delayed speech or unusual language use
- Challenges forming peer relationships
Restricted or repetitive behaviours
- Repetitive movements (such as rocking)
- Strong preference for routine
- Intense, focused interests
- Sensory sensitivities (to noise, textures, light or smells)
Can a child go undiagnosed with ASD?
Yes. NICE guidelines note that autism may be under-recognised and under-diagnosed, particularly in girls and young people with a learning disability. Some children – particularly those with milder traits, strong language skills, or good academic performance – may not be recognised as having ASD early on.
Girls are more likely to be under-diagnosed, as they may mask social difficulties by copying peers. In some cases, difficulties only become more noticeable when social demands increase, such as during secondary school.
If concerns arise at any stage, assessment is still appropriate, even if a child is older.
When do signs of ASD start?
Signs of level 2 or 3 ASD usually become apparent in early childhood, often before the age of three. Some early indicators may include:
- Limited response when calling their name
- Reduce eye contact
- Delayed babbling or speech
- Limited use of gestures (such as pointing or waving)
In some children, signs become clearer later when social and communication expectations increase. In those with level 1 ASD, signs may not become clear until adolescence or adulthood, especially if the child practices “masking” (hiding or suppressing their behaviours to fit in with societal expectations).
At what age should a child be assessed for ASD?
A child can be assessed at any age if there are concerns that they may have ASD.
Early assessment – often between 18 months and three years – can be helpful because it enables early support and intervention. However, it is more likely to be picked up at primary school. Assessment at primary school age, adolescence or even adulthood is also appropriate if traits were previously overlooked.