How do I get an Autism assessment for my child?

If you suspect your child may be Autistic, you may be feeling worried and stressed about what this might mean. You might also feel uncertain about how you might best support them. Here, you will find detailed, reliable information on how to get an Autism assessment for your child through both public and private routes.

If you are looking for more information on what it means to be Autistic, you may want to start with our articles on what Autism is and signs you may be Autistic.

In this factsheet, you will find information on:

• Public Autism assessment routes
• Private Autism assessments
• Qualifications to look for in a private psychologist conducting an Autism assessment
• How to determine if a private psychologist is neurodiversity-affirmative
• The diagnostic criteria a practitioner should use to meet quality standards
• What should be included in the formal report after assessment

To learn more about coping strategies for being Autistic in unaccommodating environments, check out our factsheets on how to cope with Autism stigma and how to cope with Autistic burnout and life stress.

Public Autism assessment

Private assessments are not affordable for everyone, and often cost €1,000-2,000. If you opt for a public assessment instead, you have three options:

• Apply for an Assessment of Need at your local Health Centre
• Self-refer to a Children’s Disability Network Team
• Request a psychological assessment through the National Educational Psychology Service (NEPS).

Information on each of these options is provided below.

Applying for an Assessment of Need

You do not need to apply for an assessment of need to access health services. You can self-refer your child directly to a Children’s Disability Network Team (CDNT), as explained in the next section.

However, the Disability Act 2005 lays out a separate process for seeking professional assessment if you suspect your child has a disability needing support. This process can help you identify whether your child is Autistic. The process can also indicate what level of support they might need.

Steps to follow when applying for an Assessment of Need

Here’s what you can expect during the process:

• Fill out the form: Complete an Assessment of Need application form and send it to the Assessment Officer at your Local Health Centre
• Confirmation letter: Your local Assessment Officer will send you a letter to confirm they have received your application form within two weeks
• Waiting period: You will wait up to three months for a referral. As part of a referral, the Assessment Officer may recommend you to see another professional specialist. During this time, you may be asked for more information about your child. This information can help to prove that your child would benefit from an assessment
• Assessment: A professional or team of professionals will carry out an assessment within three months of receiving this  referral. Seeing as this route is not specific to Autism assessment, the professionals will review your child’s overall needs. The assessment may identify Autism as one of several differences or types of neurodivergence
• Assessment report: You will receive an Assessment Report which outlines whether or not your child is Autistic or possibly is disabled and in need of support in other ways
• Service statement: If the team confirms that your child is disabled, you will receive a Service Statement from a Liaison Officer, along with the Assessment Report, within one month. The Service Statement will contain information about the types of services and supports your child might benefit from

Referral to a Children’s Disability Network Team (CDNT)

You can also go to your local GP or public health nurse (PHN) with your concerns. If your GP or PHN thinks that your child is possibly presenting with a disability, or is Autistic, they may refer you to your local primary care services.

You may prefer not to go through your GP. Perhaps you have had a negative experience with a GP who is not neurodiversity-affirmative. Under these circumstances, you can self-refer your child to a Children’s Disability Network Team (CDNT). A CDNT is a team of health and social care professionals who provide services to children and young people under 18 with complex needs. To self-refer your child to your local CDNT, fill out the Children’s Services Referral Form and send it by email to your local CDNT. You can find more information about your local CDNT and where to send the form on the HSE website.

Keep in mind that CDNT referrals are suitable for children with “complex needs.” A child suspected to have complex needs experiences more than one set of difficulties (e.g., challenges with speech, and movement/coordination) and usually requires the care of a multidisciplinary team of professionals. This team usually includes speech and language therapists, occupational therapists, and psychologists.

If your child does not have complex needs but you suspect they are Autistic or have needs arising from a disability, you can use the same referral form. This allows you to self-refer to primary care services.

Autism assessment through the National Educational Psychology Service (NEPS)

A third option for getting a public Autism assessment is to talk to your child’s teacher or school principal about applying for an educational psychological assessment. The National Educational Psychology Service (NEPS) offers psychological assessments for children in primary and secondary schools who are facing learning and behavioural challenges. This includes assessments for Autism and specific learning difficulties like dyslexia.

Further information on the types of school supports available for Autistic students can be found in the As I Am guides: Starting the Autism Journey (for Parents and Guardians) and Understanding Your Child’s Autism Diagnosis.

Private Autism assessment

There are several reasons you might choose a private Autism assessment over a public one for your child. The main advantage of a private assessment is avoiding long waiting lists.

Visit the As I Am website for a list of private clinics and professionals currently offering Autism assessments in Ireland. Before paying for a private assessment, there are several important factors to consider. Here are some questions you might want to ask before selecting a private professional:

What are their qualifications?

Psychologists and psychiatrists with the right knowledge and experience can conduct Autism assessments. However, in Ireland, psychologists are not currently regulated by the state. CORU, Ireland’s health and social care regulator, is working on introducing regulations for the psychology profession. In the next few years, you may be able to check a psychologist’s professional standards by seeing if they are registered with CORU.

In the meantime, to ensure a psychologist has the training, qualifications, and professional standards needed to carry out Autism assessments, check if they are a Chartered member of the Psychological Society of Ireland (PSI). The PSI is a professional body that upholds ethical standards and high training quality by offering chartered membership to those who meet specific requirements.

If you’re considering exploring if your child is Autistic with a psychologist, a good first step is to ask if they are a chartered member of the PSI. If you’re unsure, ask to see their PSI Chartered Membership Certificate.

It is important to be aware, however, that the law does not require fully qualified psychologists to be Chartered members of the PSI. There are many psychologists who are not Chartered members who are qualified to carry out Autism assessments.

Are they neurodiversity-affirmative?

Not all private psychologists and psychiatrists offering Autism assessments view Autism in the same way. You may feel more comfortable getting an Autism assessment for your child from a professional whose views on the Autistic experience align with your family’s view of what it means to be Autistic. It’s okay if you and your family are still figuring out what it means to be Autistic and don’t have firm views on it yet. Many people who suspect they have Autism prefer to go to a neurodiversity-affirmative professional. “Neurodiversity-affirmative” means recognising and valuing different ways of thinking and experiencing the world, rather than viewing them as problems that need fixing.

If you’re unsure about a professional’s views on neurodivergence or their approach to working with Autistic individuals, pay attention to the language they use. Neurodiversity-affirmative practitioners typically avoid terms that frame Autism as a “disorder” or illness. Instead, they highlight an Autistic person’s unique strengths and talk about “differences” rather than “impairments” or “deficits” that need treatment. While they acknowledge that Autistic people might need different levels of support, they view Autism and its traits as natural variations in how we think, learn, and experience the world.

If you choose a neurodiversity-affirmative professional for your child’s Autism assessment, expect someone who wants to hear about how your child experiences the world. In the end, they may or may not determine that your child is Autistic. However, they should be willing to collaborate with you and your child to find an explanation that fits with your child’s unique life experiences and differences.

What diagnostic criteria are they using?

Diagnostic criteria are a set of rules or guidelines that mental health professionals need to use in their work to identify specific forms of neurodivergence, such as Autism or ADHD (although they are referred to as “disorders” in the written criteria). These criteria help ensure that diagnoses are consistent and based on the same standards. In Ireland, qualified professionals use one of two standard sets of diagnostic criteria to assess and diagnose Autism:

• The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V): a widely accepted set of guidelines, developed by the American Psychiatric Association (APA), used by mental health professionals worldwide for diagnosing and treating mental health conditions and types of neurodivergence
• The International Classification of Diseases 11th Revision (ICD-11): a global standard for diagnosing and classifying health conditions, developed by the World Health Organisation

The DSM-V and ICD-11 list the core characteristics of the Autistic experience, although these characteristics are framed in ways that are not neurodiversity-affirmative (e.g., “behavioural, social, emotional, and learning deficits”). To identify someone as being Autistic, a psychologist or psychiatrist looks for similarities between the list of characteristics in the DSM-V or ICD-11 and the types of thinking, processing, and communication a person has displayed throughout their life.

Core characteristics leading to an Autism diagnosis

A person doesn’t need to show every single trait listed in the DSM-V or ICD-11 to be formally identified as Autistic. However, in general, they must show differences in these three core areas:

• Social-emotional reciprocity: This describes back-and-forth conversation between people, where they respond to each other’s words, actions, and emotions in a way that shows mutual understanding
• Language and non-verbal communication: This includes possible speech delays, as well as eye contact, gestures, facial expressions, and body movements
• Repetitive behaviours and restricted interests: Autistic children may engage in self-stimulatory behaviours (often referred to as “stimming”) such as flapping arms, hands or objects, finger-flicking, hair twirling, rocking, or spinning when they are feeling excited, anxious or over-stimulated. They may also have highly focused interests (often referred to as “special interests”) which they feel passionate about and spend a lot of their time absorbed in. Special interests can provide the opportunity to connect with other children who share the same passions. For more information on special interests and an A-Z glossary of similar terms, check out the As I Am Teenage Years Guide.

Eliminating other possible diagnoses:

Showing some Autistic traits over your lifetime does not necessarily mean you are Autistic. A mental health professional and the child or teen who suspects they may be Autistic (or their family, in the case of very young children) must also confirm that:

1. The child’s characteristics (referred to as “symptoms”) are not caused by another form of neurodivergence, such as intellectual disability. These other differences can produce traits similar to those seen in Autistic people. The thorough assessment process that ensures one form of neurodivergence is not mistaken for another is called differential diagnosis
2. These differences, even if well-masked or camouflaged, lead to a person having support needs in everyday life. Autism is a spectrum condition, meaning different Autistic children have different levels of support needs. However, all Autistic people will experience at least some social and/or communication differences. They will also have behaviours they like to repeat, or a preference for sameness

Deficit-focused language

Many neurodiversity-affirmative professionals acknowledge that being Autistic brings with it its own challenges and strengths (the same with any neurotypes). However, the language used in the DSM-V and ICD-11 is rejected by neurodiversity-affirmative clinicians and many in the Autistic community. Both standard classification systems describe Autism-related challenges as “deficits” rather than natural variations in thinking, feeling, moving, and processing. You may recognise the list of traits (referred to as “behaviours”) in the DSM-V or the ICD-11. However, you do not have to agree with a deficit-based view of these differences.

What diagnostic tools are they using?

Diagnostic tools are specific methods or tests which some mental health professionals use to gather information during the Autism assessment process. These tools can help professionals decide whether a person meets the diagnostic criteria for Autism. While diagnostic criteria like the DSM-V and ICD-11 provide the framework, professionals can use diagnostic tools to collect the detailed information needed for making a diagnosis.

However, there is no requirement to use any of the current diagnostic tools available for assessing autism. Many of these tools look at being Autistic through a very narrow and deficit-focused lens. While some professionals use these tools (e.g., a play-based assessment called the ADOS-2), best practice guidelines do not require professionals to use them. Best practice guidelines are recommendations on the best way to do something based on current knowledge, research, and experience.

Ensure that the professional you choose is fully qualified and experienced in working with Autistic children. The process should be thorough and include:

• Parent interviews
• A play-based assessment with your child (or interview)
• Information gathered about different environments

Do they offer a report formally identifying Autism and including support recommendations?

When a professional identifies someone as Autistic, they should always provide a formal report. This report includes information such as:

• How the professional carried out their assessment
• A summary of your child’s unique strengths and challenges
• Recommendations to help your child navigate individual challenges

The recommendations in the report should address your child’s specific needs. This may include supports that enable you or other family members to best care for them. These supports can include special needs and inclusion supports at school. They may also include entitlements to social welfare payments, like Carers’ Allowance and Domiciliary Care Allowance.

The ‘three levels’ of support needs

The Disability Act 2005 entitles Autistic people to additional support at work, school, or home. Whether an Autistic person will receive additional supports depends on their level of need as defined by the DMS-V. The DSM-V does not use the old terms “high functioning” and “low functioning.” Instead, Autistic children are assigned to one of three levels based on their support needs:

• Level 3. “Requiring very substantial support“:This includes individuals who speak very few words, rarely initiate social interactions, and have significant difficulties with changes in routine and shifting focus.
• Level 2. “Requiring substantial support”: This category includes individuals who can speak in simple sentences but have limited social interactions, often focused on their special interests. Their repetitive behaviours or stimming are noticeable to others.
• Level 1. “Requiring support”: This includes individuals who can speak and interact with others relatively easily but struggle with turn-taking and have more difficulty making and keeping friends.

Types of support

Below are examples of some Autism-specific supports your child might benefit from:

• Speech and language therapy: For children with language or speech delays. Make sure the Irish Association for Speech and Language Therapists has accredited any professional you choose
• Occupational therapy: For children with sensory processing difficulties and/or challenges with coordination and movement
• Psychological support: For those experiencing anxiety or depression due to multiple pressures. These pressures often include masking and managing differences in communication, social interaction, and sensory processing

The psychologist you choose should be trained to work with children and accredited by the Psychological Society of Ireland. Similarly, psychotherapists should have the relevant child experience and training. It is important that a professional is accredited by the Irish Association for Counselling and Psychotherapy, the Irish Association of Play Therapy and Psychotherapy, or an equivalent accreditation body.

Find more resources and information on supporting your Autistic child on the As I Am website.

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