Getting an autism assessment for your child

Getting an autism assessment for your child can feel overwhelming – there are so many pathways and differences in professional approaches.  It can be hard to know how to start or where to go. To help, we’ve created this summary to guide parents and carers toward the right assessment for their child.

Why get an assessment for my child?

Assessments can be time-consuming and expensive so often the first question is why is it worth having one?

• Many parents seek assessments because their child is struggling—attending school, managing emotions, navigating friendships, or coping with sensory demands. Understanding these challenges can help identify the right support.
• Sometimes, an assessment is needed to access additional support or funding such as the NDIS.
• Most importantly, an assessment helps you understand your child’s unique way of thinking and connecting, making it easier to support and advocate for them. It also helps your child understand themselves and advocate as they grow.

I was told I shouldn’t “label” my child.

A lot of parents still hear this from well-meaning professionals but this view is outdated and current research tells us the opposite.

• Labels don’t change your child.  If they are autistic, then they’re autistic whether this has been recognised or not.
• A diagnosis protects your child from the labels that undiagnosed autistic kids almost always pick up or give to themselves – weird, dumb, broken, awkward.  These are the labels we should protect our kids from.
• Research shows us that early knowledge about being autistic is protective and beneficial for kids.
• We also know that not being recognised as autistic sets up children for a lifetime of masking and challenges without having an explanation – this increases the chances of later difficulties with anxiety, depression, and burnout.

What type of assessment should we get?

There’s a lot to cover here so we’ll try to break it down.

Who can provide an autism assessment?

• In Australia, the National Guidelines for the Assessment and Diagnosis of Autism state that the professionals who are appropriately trained and qualified to identify a child as autistic are psychologists, psychiatrists, or paediatricians.
• Other health professionals – such as occupational therapists, speech pathologists, dieticians, and physiotherapists – also play an important role in providing additional information that is used when identifying a child as autistic and working out what support they need.
• If your child is being assessed, you should get a clear answer at the end and not be told you have to go to another professional afterwards to have something confirmed.

Where can I get an assessment?

• Public/Free Services: Hospitals, community health centres, or specialist clinics. These often have long waitlists (12+ months).
• Paid Services: Private psychologists, psychiatrists, or paediatricians with varying costs.  Waitlists can also apply.

How much will it cost?  Are there options to help with the cost?

• Paid services can vary in cost but are typically around $1,500 – $3,000 with a psychologist.  Payment plans may be available. These prices are usually based on the time that goes into each assessment.  Although the face-to-face part may be about 3 hours, another 4-to 5 hours usually go into interpreting the information and preparing a comprehensive report.
• A paediatrician or psychiatrist usually completes a different diagnostic process, which may take 1 to 3 appointments. Medical specialists’ fees can range from $400 to $800 per appointment.
• Limited rebates are available via a specific Medicare program called Complex Neurodevelopmental Disorders if you have a paediatrician referral. It covers four appointments for diagnosis and is about $94 per appointment (this may be higher if you’ve reached the Medicare Safety Net Threshold).

What’s involved?

Most assessments include parent interviews, child sessions, and input from teachers or caregivers. Tools like cognitive assessments or sensory profiles may be used to gather more detailed insights. Assessments from speech pathologists and occupational therapists may also be included.

Are all assessments the same?

This is where things can get really confusing.  The biggest differences will not be what tools the professional uses but how well that person understands autism.  There are two main ways of doing this. They can look at your child from a medical-deficit perspective or a neurodivergent-affirming perspective.

The Medical or Deficit-Based Approach

This is the old way of understanding autism which describes it as a neurodevelopmental disorder that causes deficits in a child’s social, communication and emotional skills.

• The goal of assessment is to diagnose your child based on identifying enough ‘symptoms’ by listing your child’s deficits compared to how we expect non-autistic kids to think, feel, communicate, and behave.
• Tools like the Autism Diagnostic Interview (ADI-R) and the Autism Diagnostic Observational Schedule (ADOS-2) are commonly used.
• This approach says that the distress autistic kids experience is because of their deficits and therefore the focus is on ‘treating’ or changing them.

The Neurodivergent-Affirming Approach

This approach acknowledges that different brains mean different ways of processing, communicating, thinking, and connecting. These differences are not seen as disorders or deficits, so there is nothing to “treat” or “fix” about your child.

• The goal is to understand what it’s like to be your child—their sensory, social, and emotional experiences—and compare these to autistic experiences. This process can lead to a diagnosis but is equally focused on helping those around your child better understand and support them.
• The assessment is collaborative, involving professionals, parents, and the child, and avoids comparing them to non-autistic norms. Tools like the Monteiro Interview Guidelines for Diagnosing the Autism Spectrum (MIGDAS-2) may be used.
• This approach emphasises that distress often arises from a mismatch between autistic kids and environments designed for non-autistic norms. The focus is on adapting environments to suit the child, not changing the child to fit the environment.
• The Psychology Board of Australia recently changed the minimum standards of knowledge and training.  In 2025, all psychologists in Australia will need to incorporate neurodivergent-affirming practice into their assessment and therapy work.

So many acronyms!  I was told I had to get an ADOS for my child.

• The ADOS-2 (Autism Diagnostic Observation Schedule) is a widely used but outdated autism assessment tool. While often called the “gold standard,” this label is misleading.
• The ADOS-2 was designed based on a 2000 definition of autism published in 2000 which hasn’t been updated to reflect how much we’ve learned about autism over the past two decades. Its accuracy is limited, correctly identifying autism only about half the time—no better than flipping a coin.
• The National Guidelines emphasise that no single tool or questionnaire is sufficient for diagnosing autism. Instead, the best approach involves a thorough interview with a trained professional who is up-to-date with current research and understands how autistic individuals experience the world.

Ok, so what does a good assessment look like?

• A detailed parent/carer interview to get to know your child and understand their developmental history and how they are currently coping in all aspects of their life.
• A child interview to understand your child’s perspective and how they make sense of the world around them.
• Input from other sources – teachers or other professionals supporting your child – and questionnaires
• A good assessment should be collaborative – the professional, the parents, and the child working together to understand the child.
• The assessment should follow your child’s interests and sensory preferences rather than having a strict order or prescriptive tasks.
• The professional offering the assessment should be a psychologist, paediatrician, or psychiatrist who has additional training and experience in assessments and who has current, evidence-based knowledge about autism.

What questions should I ask when looking for an assessment?

To make sure you get an assessment like the one we just described, there are some questions you can ask.  The person offering to assess your child should always welcome  questions like these and be happy to answer them:

• Will you provide an official diagnosis at the end of this assessment (if my child meets criteria for autism)?
• What tools do you use and how do you combine them with other information?
• What if my child is not autistic?  Will the report still help us understand how to support them or will we need to get a different assessment?
• What is your understanding of the autistic brain?
• How do you use knowledge from autistic people with lived experience in your assessments?
• Do you consider ADHD or other types of neurodivergence at the same time?
• How will my child feel if they read their report as an adult?

Here are some things that may help you decide where to get an assessment for your child

Red Flags

• You pay for an “assessment” and then need to take those results to another professional for confirmation.
• Use of out-of-date assessment tools like ADOS-2 and ADI-R.
• Over-reliance on questionnaires rather than spending time getting to know you and your child.
• Terms such as “autism spectrum disorder” or “high functioning” and person-first language such as “children with autism”.
• Deficit-based language such as “difficulty with social skills”, “limited eye contact”, “rigid behaviours”, or “abnormal interests”.
• Recommended therapies like ABA or “social skills training”.

Green Flags

Here are some things to be aware of when looking for an assessment for your child:

• Consistent neurodivergent-affirming language across the website, social media, intake forms, consent forms, and conversations.
• The assessment process considers your child’s special interests and sensory needs.
• The assessment is child-centered which includes providing feedback about the assessment results to your child.
• Recommendations focus on changing the environment to support your child.
• Use of up-to-date tools such as the MIGDAS-2 along with information from multiple sources.
• The professional demonstrates a clear understanding of how autism presents differently in girls, non-speaking individuals, or those with co-occurring ADHD.

 

Getting an autism assessment can feel daunting, but it’s a vital step toward understanding your child and helping them understand themselves. A neurodivergent-affirming practitioner combines evidence-based practice with insights from the lived experiences of autistic individuals, ensuring a process that is both empowering and meaningful. With the right support, an assessment can provide a clear path to understanding your child’s needs and putting the best supports in place for them to thrive.