If you are not happy with the outcome of an autism diagnostic assessment, you can consider requesting a second opinion. Here, we outline when a second opinion may be beneficial and how you can access one.

When to seek a second opinion autism assessment

If an autism assessment has been completed to a robust standard by experienced clinicians and has considered a broad range of information, it is unlikely that a second autism assessment will yield a different outcome.

However, if an initial assessment was not thorough or has been influenced by a particular behaviour, a more detailed assessment could well produce a different outcome.

Some situations where a second opinion may be beneficial include:

• When the assessment was completed by a single professional
• If standardised assessment tools were not used during the first assessment
• If the diagnostic outcome was made by a panel of professionals who have not met the child
• The person being assessed is a high-masking female
• The diagnostic outcome was based on information reported by the school
• An informant was not available, and the person being assessed cannot accurately recall childhood experiences

What to do if you do not agree with your NHS assessment outcome

The NHS website states that if you are not happy with the outcome of your NHS assessment, you should ask the assessment team why they reached that outcome; they suggest that the assessment team might arrange for a second opinion from a different team.

If this does not happen, the NHS advise that your alternative options are to ask your GP to refer you to another team for a second opinion or to pay for a second opinion from a private provider like us.

How to access a private autism assessment

You can self-refer for a private autism assessment, or as a parent, you can refer your child; you do not need a GP or NHS professional to refer for a private autism assessment.

Deciding whether to access a second assessment

You may suspect that your autism assessment was not completed as thoroughly as it should have been. Before seeking a new autism assessment, you should seek a professional opinion about the quality of the initial autism assessment.

If you were provided with the outcome of your NHS autism assessment verbally, you will need to wait until you receive the assessment report before seeking a professional view about the quality of the assessment and the diagnostic outcome.

When you have received your assessment report, a professional experienced in the diagnostic assessment of autism will be able to review the report, taking your concerns and observations into account. An experienced clinician will be able to determine whether:

• The information gathered indicates whether the DSM-5 criteria for autism are met or not
• The process adhered to NICE guidelines
• Standardised assessment tools were used and utilised properly
• Relevant information has not been considered
• Possible masking and camouflaging behaviours have been missed

They will be able to provide you with a professionally informed opinion about the quality of the assessment and the likelihood of a different conclusion being reached following a second assessment.

You can reach out to a private service and request a review of an assessment report. An ethical service will not charge you for this advice.

What happens during a second opinion autism assessment?

When we undertake an autism assessment for someone who has already been assessed, we follow the entire autism assessment process as we would for someone who has never had an assessment. When providing a second opinion, we are aware that the client will have already seen the support materials and been asked some of the same questions and take this into account.

After we have gathered the information we require, we meet as a diagnostic team to discuss our observations and review whether the information indicates that DSM-5 criteria are met; we do this in an unbiased way and do not take the details gathered in the initial assessment or the opinion of the initial team into account at this point.

If our diagnostic conclusion differs from the outcome of the NHS assessment, we then arrange a second multi-disciplinary meeting to compare the information gathered during both assessments and to try to understand the reason for the difference in opinion.

We then document our rationale, evidence and reasoning for overturning the NHS outcome. This will help your GP and other professionals you wish to share the diagnosis with to understand that the initial assessment was not accurate.

How is a private autism assessment different?

Autism assessments should follow the National guidelines outlined by the National Institute for Clinical Excellence; this applies to both NHS and private assessments. NICE guidelines outline components that are essential to an autism assessment and suggest additional aspects that should be considered, such as the use of assessment tools. We use these tools as standard in our assessments, which means that we gather more in-depth information than the NHS typically does.

A private autism assessment usually takes a more personalised approach, and clinicians will take your concerns into account and plan your assessment accordingly. We can utilise a range of evidence-based tools, screening questionnaires, and tests to gather a broader range of information.

Our clinicians are highly experienced in a variety of presentations of autism, including those with complex or nuanced presentations.

Discuss a second opinion autism assessment with us

If you are not happy with the outcome of an NHS autism assessment, please reach out to us. We will be more than happy to review your assessment report and offer advice about whether a re-assessment would be worthwhile.