If you think you might be autistic, the assessment itself can feel like the biggest unknown. Many adults put off booking simply because they do not know what will be asked, who they will see or whether they need to bring someone with them.
Here is what happens at an adult autism assessment, step by step, what you can do to prepare and what happens afterwards.
An autism assessment is a conversation about your life, not a test you can pass or fail.
Who an autism assessment is for
The national guideline for autism in adults, NICE CG142, suggests considering an assessment when someone has persistent difficulties with social interaction or communication, or rigid and repetitive behaviours, resistance to change or restricted interests.
That is usually alongside difficulties in work, education or relationships, contact with mental health services, or a history of another neurodevelopmental condition such as ADHD.
Step 1: Screening
Most assessments begin with a short screening questionnaire. NICE recommends the AQ-10 for adults without a moderate or severe learning disability. A score of 6 or above, or a clinician's judgement that autism is likely, is a reason to offer a full assessment.
A screening score is not a diagnosis. It simply helps decide whether a comprehensive assessment is the right next step.
Step 2: Questionnaires before your appointment
You will usually be asked to complete questionnaires before you meet the clinician. With us, these can include:
- The Autism Spectrum Quotient (AQ) and the Empathy Quotient (EQ)
- The Ritvo Autism Asperger Diagnostic Scale – Revised (RAADS-R)
- The GAD-7 for anxiety and the PHQ-9 for low mood
- A questionnaire for someone who knows you well
The anxiety and mood questionnaires are there because these often appear alongside autism, and the clinician needs the full picture.
Step 3: The diagnostic interview
The main appointment is a structured conversation with a specialist clinician. NICE says a comprehensive assessment should ask about:
- Social interaction and communication, and repetitive behaviour or restricted interests, from childhood into adulthood
- Your early development, where this is known
- How you manage at home, in education and at work
- Past and current physical and mental health
- Other neurodevelopmental conditions
- Sensory sensitivities and attention to detail
Our assessments draw on recognised tools such as the Autism Diagnostic Interview – Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS).
Step 4: Observation
NICE also recommends direct observation of how you communicate and interact. In practice this is part of the appointment itself: the clinician pays attention to how the conversation flows, as well as to what you say.
There is nothing to perform. If you usually mask, it helps to say so, because masking is one of the main reasons autism is missed in adults.
Step 5: Information from someone who knows you
NICE recommends involving a family member, partner or other informant, or using documents such as school reports, to understand your early development and behaviour.
If no one can describe your childhood, the assessment can still go ahead. Old school reports, a parent's recollections in writing, or a partner's view of you now can all help.
What an autism assessment does not involve
There are no blood tests, brain scans or genetic tests. NICE says these should not be used routinely to diagnose autism. The assessment is based on your history, your questionnaires and the clinician's observations.
Considering other explanations
A careful assessment also looks at what else might explain your difficulties, or sit alongside autism. That includes ADHD, anxiety, depression and social anxiety, among others.
ADHD and autism often overlap. Our guides to the difference between ADHD and autism and how the two overlap explain why both are sometimes assessed together, and our guide to a combined ADHD and autism assessment covers when that makes sense. Anxiety is also common, as covered in our article on ADHD and anxiety.
Adjustments to the assessment
NICE says assessments should be adapted where needed, including the setting, the length and the pacing. Our assessments are online, so you can take part from somewhere familiar. Tell us beforehand if you would like breaks, written questions or more time to answer.
How to prepare
- Write down examples from childhood and from now, at home, at school and at work
- Find any old school reports
- Ask a parent, sibling or partner whether they could help with the informant questionnaire
- Note any sensory things that bother you, such as noise, lighting or clothing
- List any mental health diagnoses or treatment you have had
After the assessment: your report and next steps
You will receive a written report setting out the outcome, your strengths and the areas where support may help, with recommendations. NICE recommends a follow-up appointment to talk through what the diagnosis means and any concerns you have.
We can also provide supporting letters for work or study. Our guides to adjustments at work and the Access to Work grant explain what you can ask your employer for, and our ADHD and autism therapy services offer support after diagnosis.
What an autism assessment costs with us
Our online adult autism assessment costs £1,900. That includes the full assessment with a specialist, a report with your diagnosis and support plan, and supporting letters for work or school.
You can read more and book on our adult autism assessment page. If you are also wondering about ADHD, our guide to what to expect at a private ADHD assessment covers that process.
If you need help now
An assessment is not an emergency service. If you are struggling to cope or feel unsafe, please see our urgent help and crisis support page.
Conclusion
An adult autism assessment usually involves screening, questionnaires, a structured interview, observation and, where possible, information from someone who knows you. It ends with a written report and a chance to talk the outcome through.
If you have questions before you book, contact our team and we will explain how it would work for you.
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