We offer online private autism assessments for those aged over 10, as well as offering in-person assessments for all ages at our clinics across the UK.
In this article, we discuss fully online autism assessments to help you make an informed choice about which option is right for you.
Information gathered during a private autism assessment
When assessing whether someone meets the diagnostic criteria for autism spectrum disorder, our clinical team gather and reviews a range of information across the age range and considers whether the Diagnostic and Statistical Manual, 5th Edition (DSM-5) criteria for autism spectrum disorder are met.
During our private autism assessment process, we gather historical information, information about the child or adult’s current experiences and also observe their social communication and interaction. We use the Autism Diagnostic Observational Schedule, 2nd Edition (ADOS-2) as standard during our autism assessments.
What is the ADOS-2?
The ADOS-2 is semi-structured observation and interview that is internationally recognised as a gold standard assessment tool.
The ADOS-2 has 5 different modules:
- Toddler module (Pre verbal/single words)
- Module 1 (Pre verbal/single words)
- Module 2 (Phrase speech)
- Module 3 (Fluent speech)
- Module 4 (Fluent speech)
The administering clinician chooses which module to use based on the individuals’ age and language level.
Each of the modules has set activities, and in the higher modules, it also has set questions. Modules T to 3 of the ADOS-2 all contain play-based activities. Children usually find the ADOS-2 an enjoyable experience.
Accompanying the observation schedule and set activities is a scoring system and a scoring algorithm for interpreting the scoring system.
Whilst administering the session, the clinician will be observing for social interaction and communicative behaviours, as well as repetitive behaviours, which they will score at the end of the session.
The ADOS-2 algorithm is then used to evaluate whether the individual is presenting within the same range as an individual with autism.
The observation and scoring cannot give a diagnostic outcome, but they are extremely useful part of the broader autism assessment process.
Online assessment sessions
As part of the overall autism assessment, we complete a diagnostic history interview utilising the Autism Diagnostic Interview – revised (ADI-r), the Autism Clinical Interview for Adults (ACIA) or the Ritvo Autism Asperger Diagnostic Scale–Revised (RAADS‑R).
We always complete these sessions via videoconferencing, or if preferred, over the telephone.
This means that the session can be completed from the comfort of home and also enables two parents to join from different locations if helpful.
The ADOS-2 can also be completed online for older children, adolescents and adults. This is because we can administer the Module 4 of the ADOS-2 via a video call, as long as this is set up correctly. As Module 4 is suitable for those with fluent language who are past the age where play is appropriate, we can offer a fully online autism assessment from the age of 10 upwards.
We do not offer fully online assessments for children aged 9 and under, even though some other services do. This is because there is no evidence to say that the Module 3 of the ADOS-2 has the same validity when undertaken online, and the play-based activities cannot be administered via a screen.
Is an online-administered ADOS-2 as valid as an in-person session?
The COVID-19 pandemic drove the NHS and private providers to have to offer online healthcare, including autism assessments.
As more people needed to be seen online, clinicians began to develop strategies that enabled the administration of the ADOS-2 via video call.
Subsequently, there were some small-scale research articles published that supported the validity of an online observation. In 2023, a larger-scale piece of research was published by Cambridge University Press on behalf of the Royal College of Psychiatrists. This study compared the outcome of 163 online ADOS-2 assessments with 198 in-person ADOS-2 assessments. The findings supported the use of an online observation, as the researchers found that there was no difference in the total scores between those who had undertaken the assessment online and those who had the assessment face to face. Both the online and in-person groups showed similar communication scores, and there was clear differentiation in scores for autistic people versus neurotypical people. This research also showed that an online ADOS-2 is equally valid for female and male presentations.
The research looked at the Module-4 schedule and algorithm; therefore, the findings do not apply to other ADOS-2 modules.
All of the compulsory activities in the ADOS-2 can be delivered online. When administering the session, the clinician will be observing the individual’s communication and interaction. As long as the session has been set up correctly (we will send you a guide on how to do this), all aspects of communication, interaction and repetitive behaviours can be scored, except eye contact.
In summary, in relation to Module 4, an online-administered ADOS-2 as valid as an in-person session.
Should I choose an online or in-person private autism assessment?
For verbal individuals over the age of 10 there is no clinical difference or benefit in choosing an in-person assessment. You can be assured that whichever option you choose, you will receive a robust, professional assessment with us.
Some people find attending a new clinic environment very stressful, and if this is the case, you may feel more relaxed online. Conversely, some people do not like being on camera, in which case a clinic session may be more comfortable.
Location may be an issue, and if you live a distance from one of our clinics, an online autism assessment may be more convenient.
With this in mind, you should choose how to access your assessment based on your own personal preferences.
Arranging an online private autism assessment
If you would like to arrange or discuss a private autism assessment that is administered online or in person, contact us. We can usually arrange your assessment to start within 2 weeks and our friendly team will be more than happy to discuss your assessment options with you.
