If a child in your class or school is possibly autistic, getting a diagnosis can be a very positive thing. It can help their parents to get a better understanding of their child’s needs, and help school staff to understand more about how to support them.  

Screening tests are available but should not be seen as an alternative to proper assessment and diagnosis. 

This guide explains how a child is referred for an autism diagnosis. 

Is it autism? 

The characteristics of autism vary from one person to another, but for a diagnosis to be made, a person will usually be assessed as having had persistent difficulties with social communication and social interaction and restricted and repetitive patterns of behaviours, activities or interests. These difficulties will have been present since early childhood and will have affected and limited their everyday life. 

Children can be diagnosed as autistic when they’re quite young, in some cases from the age of two. But not everyone is diagnosed early in life. It’s quite common for a child to not get their diagnosis until they are older, or even an adult, particularly if they don’t have accompanying learning disabilities. 

Some of the main signs that a child may be autistic include: 

• not drawing their parents’ or others’ attention to objects or events, for example not pointing at a toy or a book, or at something that is happening nearby (or a child may eventually do this, but later than expected)

• carrying out activities in a repetitive way, for example always playing the same game in the same way, or repeatedly lining toys up in a particular order

• resistance to change or doing things differently

• emerging difficulties with social interaction and social communication

• behaviour such as biting, pinching, kicking, pica (putting inedible items in the mouth), or self-injurious behaviour. 

Read more about  diagnostic criteria. 

Getting a referral 

Parents may have reservations about pursuing a diagnosis for their child. This is their personal choice, but often a diagnosis can bring a sense of relief and help both parents and school staff to better understand the child’s needs and how to meet them. It can also help the child by enabling them to identify with their autistic peers. 
 
If parents are unsure about pursuing a diagnosis, it can still be a good idea to advise them to ask for a referral as they may have a long time to wait for an appointment. This will mean that they are not delaying the process while allowing them time to give it more thought. 

Read more about broaching the subject of autism with a parent.  

How a child is referred for an autism diagnosis 

Parents should speak to their GP or health visitor. Parents should make an appointment with your GP (or health visitor in the case of young children). They should take along a list of behaviours and characteristics that make them think their child might be autistic. You could advise them to keep a behaviour diary leading up to any appointments after the referral. 

Screening 

If the child is pre-school age, their health visitor or GP may carry out a ‘screening interview’ called M-CHAT (Modified Checklist for Autism in Toddlers). This will not give them a diagnosis, but it is a way of indicating whether a child may be autistic. 

Other tools, sometimes available online or as smartphone apps, also claim to be able to screen for autism. The use of screening or testing tools is potentially problematic as there are many factors affecting a child’s development and many other sensory, physical and mental health conditions that will require specialist investigation. The use of such a tool should not be seen as an alternative to proper assessment and diagnosis. 

Referral for a diagnosis 

Once the family’s GP or health visitor is convinced of their child’s difficulties, the child should be referred for a formal assessment (diagnosis). The family may have to wait some time before they actually go for the assessment. In the meantime, you can mention to parents that their child can be referred to other teams for support such as a speech and language therapy, occupational therapy, or education support services.  

A child should have a multi-disciplinary diagnostic assessment – that is, an assessment by a team of professionals. The team might include, for example, a paediatrician, a speech and language therapist and a specialist psychologist. 

If the child is referred to an individual professional, it’s important that they are experienced in diagnosing autism. 

Private assessments 

Private diagnosis is an option, if parents can pay for one, and can reduce the waiting time. The costs of private assessments can vary, so it’s a good idea for parents to phone several services to ask about costs, what this pays for and whether any follow-up service is offered. 

Some local authorities may not accept the results of private diagnoses. They might insist upon an NHS diagnosis before they will provide services to the child. For this reason, we suggest that parents stay on the waiting list for an NHS assessment even if they also decide to go privately. 

Parents can find  diagnostic services in our Autism Services Directory. 

Next steps 

Read our  diagnostic assessment guide.