How to get an autism assessment as an adult

More and more adults are wondering whether they might be autistic, often after reading about autism, recognising themselves in someone else's story, or taking an online test. But how do you actually get assessed as an adult? In this guide, we go through the usual steps, what an assessment involves, and how you can prepare.

Why get assessed?

Getting an assessment is a personal choice. Many people describe a diagnosis as giving them an explanation for experiences they have had all their life. It can also give you access to support and adjustments at work or in education, and help you and the people around you understand your needs better. Others choose not to be assessed, or find that self-knowledge is enough. Both are valid choices.

Step 1: Collect your experiences

Before you contact a doctor, it helps to write down what makes you think you might be autistic. Specific examples are more useful than general descriptions:

• Social situations: what do you find difficult or tiring, and how do you handle it?
• Routines and interests: how do you react to changes? What are you intensely interested in?
• Senses: are there sounds, lights, smells or textures that bother you a lot?
• Childhood: what were you like as a child? Did you have friends? What did teachers say about you?
• Consequences: how do these things affect your work, education, relationships and health?

Results from screening questionnaires such as the AQ-50 and the RAADS-R can also be useful to bring. They aren't a diagnosis, but they can show the doctor why you are asking.

Step 2: Talk to your doctor

In most countries, the first step is your regular doctor or another primary care service. Tell them you think you may be autistic and would like to be assessed. Explain how it affects your everyday life, and show them what you have written down. In many places, the doctor needs to refer you to a specialist service.

Some people are met with scepticism, especially if they have a job, a family or good social skills on the surface. If so, it may help to describe what it costs you to manage everyday life, or to ask what it would take to be referred. You can also ask for a second opinion.

Step 3: The assessment

An autism assessment for adults is usually done by a psychiatrist, a psychologist or a team with several professions. It often takes several appointments and may include:

• Interviews about your current life, your history and your difficulties.
• Information about your childhood, preferably from a parent or someone else who knew you as a child. Old school reports can also help.
• Questionnaires that you, and sometimes people close to you, fill in.
• Structured observation, where the professional sees how you communicate and interact in specific tasks.
• Assessment of other conditions such as ADHD, anxiety or depression, which can exist alongside autism or explain some of the same difficulties.

At the end, you get feedback on the conclusion, often with a written report. If you are diagnosed, the report usually describes your strengths and challenges, and what kind of support may help.

Waiting times and private assessments

In many countries, the waiting time for a publicly funded assessment for adults is long, sometimes several years. Some people choose a private assessment to get one sooner. If you do, check that the person assessing you is qualified and experienced with autism in adults, and find out whether the diagnosis will be accepted by your health service, school or employer.

Where to start in the UK and the US

In the UK, you usually start by talking to your GP, who can refer you to an NHS adult autism assessment service. In England, you can also have the right to choose which service you are referred to.

In the US, you can ask your primary care provider for a referral, or contact a psychologist, psychiatrist or neuropsychologist who assesses adults. Check with your insurance first, since coverage for adult autism assessments varies.

After the assessment

Whatever the conclusion, an assessment can give you a better understanding of yourself. If you are diagnosed, it can be helpful to read about autism, find other autistic adults to talk to, and think about what adjustments could make everyday life easier. If you aren't diagnosed, the assessment may still have pointed to other explanations for your difficulties, and to help that fits better.

Want to start with a screening? Take the AQ-50, the RAADS-R or the CAT-Q for free.