If you suspect that your child may be autistic, you may like to take a screening test. The results are not a diagnosis, but they may help with your decision to seek a formal assessment. Only a qualified clinician can diagnose your child.

Online tests leave out many things, including things that only a skilled diagnostician will be able to assess. All online tests can do is ask for your opinions about your child’s behaviour.

Below are some examples of autism screening tests:

ASDetect – autism detection for children aged 11-30 months.

Childhood Autism Spectrum Test (CAST) - autism detection for school-aged children (4-11 years).

Autism Quotient (AQ) - under the subheading: Versions and Translations, select the PDF version for adolescents aged 12-15 years.

If you would like to access a publicly funded assessment (i.e. free to access), you should book an appointment with your GP to request a referral. If you are already seeing a specialist for other reasons, you may wish to raise the matter with them first.

It would be helpful if the GP you see has an understanding of autism. Consider taking along a copy of the online screening test result, as it may be a helpful guide when discussing characteristics that you think apply to your child. Alternatively, you may like to refer to the characteristics of autism page of the Autism New Zealand website.

Your GP will be able to make a referral for an assessment in the public system.

GPs or specialists can refer to children for a publicly funded assessment. Depending on your area and the age of your child these referrals may go to Paediatrics, the Child Development Service or the Child and Adolescent Mental Health Service usually located in your nearest public hospital.

In some areas referrals for publicly funded assessments can also be made by other health services, such as Well Child/Tamariki Ora/Plunket and education services, such as an early childhood teacher at your child’s kindergarten or early childhood centre.

You will be contacted by the organisation you were referred to. You may be placed on a waiting list or provided with an assessment appointment date. Autism NZ research shows that in most parts of the country wait times to access a publicly funded assessment takes 6-12 months or longer in certain areas.

You may also be asked for further information before being offered an assessment appointment.

If the referral is accepted children and young people under the age of 19 years should access a Developmental Services/ASD Coordinator to help with coordination of the autism assessment process and post-diagnostic support services. Depending on your region, the Developmental Services/ASD Coordinator may help before, during, after or throughout the whole assessment process.

If the referral is not accepted, your GP or specialist may be able to refer you to an autism-experienced Paediatrician, Psychologist or Psychiatrist in the private system. You can also look on the Community Links page of the Autism New Zealand website to see a list of private diagnosticians in your area.

Some families choose to seek a diagnosis privately (with a personal cost for the assessment). Qualified professionals who can provide a diagnosis include Paediatricians, Psychologists and Psychiatrists with training and experience in autism assessments. You can look on the Community Links page of the Autism New Zealand website or ask your local Autism New Zealand Outreach Coordinator for a list of known professionals in your area.

Most private diagnostic services accept self-referrals and referrals from GPs or other health and education services. Once you have contacted the professional, they will arrange a time with you for the assessment. Wait times and costs for these assessments vary.

In order to access some publicly funded support services it is important to make sure that the assessment follows these recommendations.

4.1. Qualified professionals. It is recommended that a multidisciplinary team of professionals complete the assessment. This includes at least one of the following professionals with training and experience in autism assessments:

• Paediatrician
• Psychiatrist
• Psychologist

The team can also include a speech language therapist (SLT) or occupational therapist (OT).

When a multidisciplinary team is not available, the assessment can be completed by a Paediatrician, Psychiatrist, or Psychologist with training and experience in autism assessments.

4.2. Assessment process. The Guideline recommends professionals complete a thorough diagnostic assessment with the following components:

• Meet with parents/caregivers at least once to complete a developmental interview. This includes asking questions about your child’s development and gathering the information they need to form a diagnosis.
• Observe your child. This may be at the assessment appointment and/or your home or your child’s education setting.
• Speak to others, such as educators, about your child.
• Complete a standardised diagnostic assessment. This may include a play-based assessment with your child, such as the Autism Diagnostic Observation Schedule – ADOS-2. The Guideline provides more information about standardised assessments including specific assessments that can be used.
• Complete a differential assessment to identify or rule out other possible conditions, sensory needs, language and/or learning needs.
• Offer a feedback appointment to explain the outcomes of the assessment and next steps.
• Write a report that outlines their findings and the diagnosis. The diagnosis provided may confirm autism or provide an alternative explanation or guidance.
• To access some Government funded support services it is important for the diagnostic report to outline your child’s support needs, including what support they may need to live an independent life. This could include respite care; communication and behaviour support; home help (like housework); parent education courses; or other services.
• The assessment needs to occur in person. Assessments conducted online (virtual, telehealth) are not accepted for access to some Government funded support services.

The content of the report is generally discussed with you prior to being sent through to your GP. Reports prepared via a private diagnosis may not automatically be shared with your GP. You may like to ask who will have access to the report, and request they receive a copy.

It can be helpful to collect and bring notes with as much information as you can about your child starting from birth (e.g. medical history, when your child met key developmental milestones, friendships and social situations, communication skills, behaviours and interests, sensory processing). Include information about family members who have been diagnosed with autism.

Try to align notes under the DSM criteria where you can, which will also make your case for assessment even clearer.  The DSM criteria can seem a bit blunt and overwhelming, but this link may be helpful - https://neurodivergentinsights.com/blog/dsm-5-criteria-for-autism-explained-in-picture-form

During standardised assessments (for example, Autism Diagnostic Interview – ADI-R or Autism Diagnostic Observation Schedule – ADOS-2) some people might try to give the answer the professional is looking for. There are no right answers; you/your child are not failing (though it can feel like failing). It’s important for your child to be their authentic self.

It can also be helpful to bring snacks, drinks, fidgets, and comfort items to the assessment appointments.

Autism assessments often treat being autistic as a negative, and focus on things your child can’t do or things they find difficult. It can be helpful to find out whether the diagnostic team take a strengths-based approach where autism is treated as part of your child’s identity (a service calling itself ‘neuro-affirming’, using identity-first language like ‘autistic person’ rather than ‘person with autism’, and emphasising the positives as well as the negatives of being autistic are all good signs).

• Are they taking new clients at the moment, and what are the wait times?
• Do they require a GP or other referral?
• What does their assessment process involve? For example, gathering pre-assessment information/history from throughout your life, how many in-person sessions, any follow up sessions etc? (The number of sessions can vary, but generally there will be pre-assessment information to provide (often via forms), one or more appointments to conduct the assessment, and often a follow-up appointment to discuss the outcome of the assessment.)
• What assessment tools or criteria do they use?
• Do they offer in-person assessments and/or online options?
• How much does it cost? (This can typically vary anywhere from $1,000 - $4,000.)
• If appropriate, what is their experience in assessing and diagnosing autistic girls?
• How long does it take to receive their report and what is included in it (e.g. recommendations, further support options, etc.)?
• Can you go back to them for further information afterwards?

It can also be helpful to consider how responsive they've been to your enquiry:

• Did they get back to you in a reasonable timeframe?
• Have they offered you enough information about themselves, their service, and/or their processes?
• Have they been able to answer any questions or concerns you might have?
• And perhaps most of all - how comfortable do you feel with them?

These could include appointments with a Psychologist or Psychiatrist, speech language therapy, or behaviour support. In some cases you might be eligible for publicly funded services, outlined on the Understanding Autism page of the Autism New Zealand website.

You can also self-refer to an Outreach Coordinator at Autism New Zealand. This is a free service provided nationwide and available at any stage of the diagnosis journey. Outreach Coordinators can help you navigate information on autism, advise on educational options, and suggest services available for you and your child.

The results are not a diagnosis, but they may help with your decision to seek a formal assessment. Only a qualified clinician can diagnose you.

Online tests leave out many things, including things that only a skilled diagnostician will be able to assess. All online tests can do is ask for your opinions about your own behaviour.

Below is an example of an autism screening test:

Ritvo Autism Asperger Diagnostic Scale–Revised (RAADS–R)

For further screening tools and information about them see: https://embrace-autism.com/autism-tests/

If you would like to access a publicly funded assessment (i.e. free to access), you should book an appointment with your GP to request a referral. If you are already seeing a specialist for other reasons, you may wish to raise the matter with them first.

It would be helpful if the GP or specialist you see has an understanding of autism. Consider taking along a copy of the online screening test result, as it may be a helpful guide when discussing characteristics that you think apply to you. Alternatively, you may like to refer to the characteristics of autism page of the Autism New Zealand website.

While the Aotearoa New Zealand Autism Guideline recommends that specialist diagnostic assessment should be publicly available for all people who may be autistic, this is not currently the case for adults. It can be challenging for adults to access a publicly funded assessment for autism. In some cases, your GP or specialist can make a referral for an assessment in the public system.

Your GP or specialist may be able to refer to the Adult Mental Health Service, usually located at your nearest public hospital. Although autism is not a mental health condition, it can be diagnosed by Psychologists or Psychiatrists who work for the Adult Mental Health Service.

Usually, a referral is only accepted if you have a co-occurring intellectual disability or mental health condition. Occasionally a referral is accepted without any co-occurring conditions.

You will be contacted by the organisation you were referred to. You may be placed on a waiting list or provided with an assessment appointment date. Autism NZ research shows that in most parts of the country wait times to access a publicly funded assessment takes 6-12 months or longer in certain areas.

You may also be asked for further information before being offered an assessment appointment.

If the referral is not accepted, your GP or specialist may be able to refer you to an autism-experienced psychologist or psychiatrist in the private system. You can also look on the Community Links page of the Autism New Zealand website to see a list of private diagnosticians in your area.

Some people prefer to seek an assessment for diagnosis privately (with a personal cost for the assessment, usually between $1,000 and $3,000). Qualified clinicians who can provide diagnosis include psychologists and psychiatrists with training and experience in autism assessments. You can find links to local private diagnostic services on the Community Links page of the Autism New Zealand website or you may like to ask your local Autism New Zealand Outreach Coordinator for a list of known clinicians in your area.

Most private diagnostic services accept self-referrals and referrals from GPs or other health and education services. Once you have contacted the professional, they will arrange a time with you for the assessment. Wait times and costs for these assessments vary.

In order to access some publicly funded support services it is important to make sure that the assessment follows these recommendations.

4.1. Qualified professionals. It is recommended that a multidisciplinary team of professionals complete the assessment. This includes at least one of the following professionals with training and experience in autism assessments:

• Psychiatrist
• Psychologist

The team can also include a speech language therapist (SLT) or occupational therapist (OT).

When a multidisciplinary team is not available, the assessment can be completed by a psychiatrist, or psychologist with training and experience in autism assessments.

4.2. Assessment process. The Guideline recommends professionals complete a thorough diagnostic assessment with the following components:

• Meet with you at least once to complete a developmental interview. This includes asking questions about your development and gathering the information they need to form a diagnosis.
• Speak to others about you and your development, such a parent, other family member, or close friend that has known you since childhood.
• Complete a standardised diagnostic assessment. The Guideline provides more information about standardised assessments including specific assessments that can be used.
• Complete a differential assessment to identify or rule out other possible conditions, sensory needs, and/or learning needs.
• Offer a feedback appointment to explain the outcomes of the assessment and next steps.
• Write a report that outlines their findings and the diagnosis. The diagnosis provided may confirm autism or provide an alternative explanation or guidance.
• To access some Government funded support services it is important for the diagnostic report to outline your support needs, including what support you may need to live an independent . This could include a support worker to help with cooking, cleaning, or looking after yourself; mobility equipment; or other physical aids.
• The assessment needs to occur in person. Assessments conducted online (virtual, telehealth) are not accepted for access to some Government funded support services.

The content of the report is generally discussed with you prior to being sent through to your GP. Reports prepared via a private diagnosis may not automatically be shared with your GP. You may like to ask who will have access to the report, and request they receive a copy.

It can be helpful to collect and bring notes with as much information as you can about yourself starting from birth (e.g. medical history, when you met key developmental milestones, friendships and social situations, communication skills, behaviours and interests, sensory processing). Include information about family members who have been diagnosed with autism.

Try to align notes under the DSM criteria where you can, which will also make your case for assessment even clearer.  The DSM criteria can seem a bit blunt and overwhelming, but this link may be helpful - https://neurodivergentinsights.com/blog/dsm-5-criteria-for-autism-explained-in-picture-form

During standardised assessments (for example, Autism Diagnostic Observation Schedule – ADOS-2) some people might try to give the answer the professional is looking for. There are no right answers; you are not failing (though it can feel like failing). It’s important to be your authentic self.

It can also be helpful to bring snacks, drinks, fidgets, and comfort items to the assessment appointments.

Autism assessments often treat being autistic as a negative, and focus on things you can’t do or things you find difficult. It can be helpful to find out whether the diagnostic team take a strengths-based approach where autism is treated as part of your identity (a service calling itself ‘neuro-affirming’, using identity-first language like ‘autistic person’ rather than ‘person with autism’, and emphasising the positives as well as the negatives of being autistic are all good signs.

• Are they taking new clients at the moment, and what are the wait times?
• Do they require a GP or other referral?
• What does their assessment process involve? For example, gathering pre-assessment information/history from throughout your life, how many in-person sessions, any follow up sessions etc. (The number of sessions can vary, but generally there will be pre-assessment information to provide (often via forms), one or more appointments to conduct the assessment, and often a follow-up appointment to discuss the outcome of the assessment.)
• What assessment tools or criteria do they use?
• Do they offer in-person assessments and/or online options?
• How much does it cost? (This can typically vary anywhere from $1,000 - $4,000.)
• If appropriate, what is their experience in assessing and diagnosing autistic women or non-binary people?
• How long does it take to receive their report and what is included in it (e.g. recommendations, further support options etc.)?
• Can you go back to them for further information afterwards?

It can also be helpful to consider how responsive they've been to your enquiry:

• Did they get back to you in a reasonable timeframe?
• Have they offered you enough information about themselves, their service, and/or their processes?
• Have they been able to answer any questions or concerns you might have?
• And perhaps most of all - how comfortable do you feel with them?

Services that may be offered could include appointments with a psychologist or psychiatrist. In some cases you might also be eligible for publicly funded services outlined on the Understanding Autism page of the Autism New Zealand website.

You can also self-refer to a local Outreach Coordinator at Autism New Zealand. This is a free service provided nationwide and available at any stage of the diagnosis journey. Outreach Coordinators can help you navigate information on autism and suggest supports and services available for you and your support network.