Paloma Health | NHS Autism assessment

Frequently asked questions

Practical information

We can offer first appointments within 6 weeks

Once we have received your referral, you immediately get access to our Patient Portal. You can complete your questionnaires and book your appointments in there.

How long is the wait?

First appointments are available within 3-6 months. We're expanding capacity to reduce wait times to under 4 weeks.
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Once we have received your referral, you immediately get access to our Patient Portal. You can complete your questionnaires and book your appointments in there.
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Why are your wait times for an autism assessment so much shorter than with the NHS?

The Government is dedicated to giving patients in England more choice and control over their healthcare. With the 'NHS Choice Framework', you have the freedom to choose your assessment provider. As an independent NHS provider, we are able to quickly adapt and keep waiting times to a minimum.

How fast is the assessment?

The speed of the assessment depends on how quickly we receive responses from you and your child’s school, and appointment availability for appointments.

At this moment this will be likely around 6 months.

How much does the assessment cost?

There are no costs for our service for parents. People in England are able to ask for a referral at an NHS registered GP. Our partnership and funding from the NHS allow us to provide this service at no charge to you.

The assessment

What will my clinician ask me?

The clinician and parent appointment will cover your child's strengths, needs, preferences, dislikes, and developmental history.

The observation appointment is with you and your child, and the clinician observes your child’s behaviours and mannerisms.

Using this information, we will review the DSM-5 criteria to determine if a diagnosis is appropriate.

Once completed, the results and any recommendations for further support or treatment will be shared with you.

Who will conduct the assessment?

Each assessment is completed by two trained clinicians, specialising in diagnosing autism in children and young people.

Where will my child’s observation appointment take place?

The in-person observation will take place at our clinic in Devon or remotely. The rest of the assessment will be done remotely via video call (or phone if needed).

Is a remote autism assessment as accurate as in-person assessment?

Yes, research shows that remote autism assessments can be just as accurate as in-person assessments when carried out by an experienced professional.

A study by the National Autistic Society found that the move to remote assessments during the pandemic didn’t affect the accuracy of diagnoses. In fact, a study published in the Archives of Disease in Childhood showed that remote assessments not only maintain diagnostic accuracy but also have high levels of parental satisfaction.
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For remote assessments, we use an adapted observation that draws on the Autism Diagnostic Observation Schedule (ADOS). This is the same adapted observation that our children who are seen face to face complete for consistency in assessment.

I booked my child’s observation before the video interview. Will that make a difference?

Don’t worry, that’s absolutely fine. The order of the interview and the observation are not important, and won’t affect the outcome or the quality of the assessment of your child.

What if the clinicians don’t observe the same behaviours I do?

Our clinicians are experienced in, and trained on, recognising the diverse ways autism can present. Our assessments are carefully designed to identify more subtle traits and symptoms, how autism can be different in females, and to look out for masking and camouflaging.

What happens if my child is too anxious in the assessment?

Our team are very experienced in working with young people and understand that sometimes an assessment can be a stressful experience for the family. As experts in the field and trained in working with children, we will do our very best to put your child (and the whole family) at ease and are very skilled at engaging even the most shy and anxious children.

Getting access

How can I get a referral from my NHS GP?

Your NHS GP will need to refer your child to Paloma Health for an autism assessment. Please book an appointment with them and direct them to complete our referral form.

The following services are available:
- Autism assessment with remote observation (for children aged 7–18).
- Assessment with in-person observation in Devon (for children aged 0–18).

We recommend answering a a few quick questions in our "Service Finder" to get personalised advice on which service is best for your child, and what to ask your NHS GP.

Click here to read useful tips for the conversation with your NHS GP.

Why do you recommend asking for a “Devon” referral for the remote service? Do I need to travel to Devon?

We understand this might be confusing. Don’t worry, as it’s a remote service, you won’t have to travel to Devon.

As an NHS Right to Choose provider, we partner with different NHS Integrated Care Boards (ICBs). Each partnership enables us to offer different services. Our partnership with the Devon ICB allows us to offer the remote service.

We recommend asking for this specific service, as your GP needs to select this option when referring your child.

Do you have any other questions about this? Feel free to email us at support@paloma.health.

Click here to read useful tips for the conversation with your NHS GP.

I'm not in Devon, is my child still eligible for the assessment?

Your child is eligible for the assessment if you have a referral from your NHS GP in England and can attend the observation session in Devon, or remotely.

To decide which service is right for you, we recommend answering a few quick questions in the "Service Finder" to get personalised advice for your child. You will also find what to ask your NHS GP for.

I'm in the Norfolk area, which service would you recommend?

Families with an NHS GP in Norfolk and Waveney (N&W) can get a referral to our N&W autism assessment service. This service is available for children aged 6–18 and includes a child observation in Norwich, Norfolk. If this applies to you, you can talk to your NHS GP in N&W about getting a referral.

All other families in England, outside of Norfolk and Waveney, are welcome for a remote assessment or an assessment with in-person assessment in Exeter, Devon. Answer a few quick questions in the Service Finder on our website to find out what is the right service for you - and what to ask your NHS GP for.

For now, we are unable to accept referrals from outside of N&W into the Norfolk service. If you’re already referred into the N&W service, rest assured that your assessment will go ahead as planned with the same high-quality care and clinical focus.

My child is home-schooled, can I still follow this assessment?

Don’t worry, this won’t affect the assessment. We will ask for a report from another suitable professional, or someone outside of the home who knows your child well.

My GP is hesitant to provide a referral because they are not familiar with Paloma Health. What should I do?

If your GP has any questions they can speak to Dr Kate Bennett, our Lead Clinical Psychologist. Please ask them to email support@paloma.health directed at Kate, and we will answer all their questions.

What if I am on a waiting list for another provider?

If you are waiting for more than 18 weeks, you also have a legal right to change your NHS provider. You can speak to your NHS GP about getting a new referral to Paloma Health, if that's the case.

After the assessment

Our assessments fully comply with NICE guidelines and we are NHS-approved. We use the highest quality and well-regarded clinical model within our service. Importantly, your child will be seen by a doctor as part of the assessment, which isn't always the case with private assessments. This means a diagnosis made by our service will be accepted by the NHS, schools/colleges, and any other governmental support entities.

Will my GP get the outcome report and will it be entered into the NHS medical record for my child?

The NHS GP that referred your child to us, will receive a full assessment report. They should ensure the report is included in your child’s NHS medical record. As an NHS Right to Choose provider, our assessments should be accepted by any local authority, as we meet the standards of the NHS.

What happens if my child is not diagnosed with autism?

Behaviours seen in autism can also be seen in other neurodevelopmental or mental health conditions. And, a child's experience can affect how they develop and sometimes this can look like autism.

We will consider all these factors in your child's assessment and provide you with our understanding of what the possible causes of your child's difficulties are, so the best support and understanding can be offered.

All children assessed will receive recommendations and a strengths and needs profile, whether they get an autism diagnosis or not.

Is the outcome reports compliant with NHS and local authority standards?

Yes, the outcome reports are in line with regulations, set out by the NHS.

We are a Right to Choose provider of the NHS. That means that the NHS appointed (commissioned) us to assess children and young people for autism.

To become a Right to Choose provider, we were assessed to meet high standards, including that our assessments are compliant with NICE guidelines and the NHS England Operational Framework. An example of these guidelines is that all assessments are done by trained and experienced professionals, and include all criteria as set out by guidelines of NICE called “CG128: Autism spectrum disorder in under 19s”. These guidelines focus on recognition, referral and diagnosis.

We always take the school’s observations into account, as this is an integral part of the assessment. To diagnose autism, it must be clear in multiple environments. As school is very structured, it is often a great place to be able to see it. However, if school does not report any observations of autistic traits, it does not mean there will be no diagnosis, as there can be other reasons for this. Autistic children can be ‘model’ students as they follow rules very well and quietly get on with their work. They can mask and make it seem like all is well but then have a ‘meltdown’ as soon as they get home. Our team are very familiar with this and will take everything into account when assessing.

What are my rights if my local authority is challenging the outcome report?

You have the following rights if your local authority is challenging an outcome report:

- Request clarity: You can write to them and ask them to explain their challenge.

- File a complaint: If you're dissatisfied with their response, you have the right to file a formal complaint.

- Escalate: If their response is unsatisfactory, you could take the complaint to the Local Government Ombudsman and to your local MP.

- Appeal: If the challenge to a report influences the EHCP decision process, you may have a case to appeal.

What happens if a local authority needs more information on an outcome report?

If this happens, you can ask them to contact us on support@paloma.health. Our Clinical Lead will work with them to ensure a swift resolution.

Autism in girls

Is autism different in girls?

Whilst the assessment process and diagnostic criteria are the same across the gender spectrum, it is true that autistic girls can present very differently to autistic boys.

The criteria on which a diagnosis is made is largely known to be associated with symptoms in boys and men, and this can mean that girls who are autistic may go undiagnosed.

Boys often present their symptoms in a more obvious or ‘stereotypical’ way, whereas girls may have more subtle traits. This is because they often learn how to hide their symptoms (also known as ‘masking’) in order to fit in with their peers.

As clinical experts in ASD, we are used to seeing it present in many different ways. Our assessments are designed to take masking and camouflaging into account – especially in girls. Our team are very well trained in understanding the female presentation of autism.

Why is my daughter masking?

Your daughter might be masking as a way to feel accepted and avoid being judged or misunderstood for her atypical behaviour. Masking can help her navigate social and cultural expectations, providing a sense of safety in environments where neurodivergent behaviours may not be fully accepted. In the end, masking is a way to feel safe and protected.

It should be noted that neurotypical people can mask too. However, neurodivergent masking is different to neurotypical masking in that it is a continuous strategy that comes with a cost. While masking might help with fitting in or avoiding conflict in the short term, it can cause emotional exhaustion etc.

Support

I have an urgency with my child. Can Paloma Health support me?

Paloma Health is not an emergency service and we are unable to provide out of hours support.

If you or your child need urgent help, please either dial 999, go to your closest Accident and Emergency (A&E) service or contact your GP depending on the urgency of the need. You can also get advice from 111 or using 111 online.

I still have some questions. How can I get in touch?

If you have any questions that weren’t answered here, please reach out to us via our contact form. We’re available Monday to Friday during working hours and aim to respond within two working days.

Find the right service for you

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