If you’re considering or awaiting a private autism assessment as an adult, it’s natural to feel uncertain about what to expect . Autism assessments are designed to help you and your healthcare provider better understand how certain behaviours, communication patterns, and sensory sensitivities may be impacting your daily life. The goal of the assessment is to gather a comprehensive picture of your experiences, both in childhood and adulthood, so that an accurate diagnosis can be made.
At Oxford CBT, private autism assessments for London, Oxford and surrounding areas involves a series of structured questions about various aspects of your life, including how you interact with others, how you process sensory information, and how you handle changes in routine. These questions are used by all reputable Autism Assessment clinics as they are key for successfully identifying traits associated with autism, which can sometimes manifest differently in adults than in children.
This article will focus on the questions asked during an adult autism assessment, but if you would also like a more general overview of the assessment process, take a look at our article on How Do They Test for Autism?
Asking the right questions helps the clinician understand your unique experiences, so being open and honest during the evaluation is key. The more accurately the assessment reflects your day-to-day challenges, the more helpful the diagnosis will be in finding the right support and strategies to manage symptoms effectively.
Key Areas Explored in an Adult Autism Assessment
In an adult autism assessment, the clinician will focus on several key areas of your life to understand how autism may be affecting you. Each area is carefully explored to identify patterns and behaviours that align with autism traits. Here are the main subjects that will be examined and why they are essential:
Social Interaction
The clinician will explore how you engage with others in social settings, with a particular focus on relationships, understanding social norms, and social behaviour. The goal is to assess how you navigate the nuances of human interaction. This may include questions about your comfort level in social situations, your ability to make and maintain friendships, and how well you understand social cues like facial expressions or tone of voice.
The reason for focusing on social interaction is that many adults with autism experience difficulties in this area. They may struggle to interpret social rules, find it challenging to develop meaningful relationships, or avoid social situations altogether due to feelings of discomfort or confusion. These challenges can significantly impact daily life, making this a significant aspect of the assessment.
Communication
Another important focus is how you communicate, both verbally and non-verbally. The assessment will explore whether you have difficulty understanding or using body language, facial expressions, or gestures. They will also look at how well you can follow conversations, especially in group settings, and whether you tend to misunderstand sarcasm, humour, or abstract language.
Communication is a key area in the assessment because individuals with autism often find it challenging to interpret subtle forms of communication, which can lead to misunderstandings in social interactions. Additionally, some may have a unique communication style, such as speaking in a more formal tone or struggling with back-and-forth conversations. These characteristics help the clinician build a better understanding of how autism might be affecting communication skills.
Behaviour and Routines
The assessment will also examine your behavioural patterns and how you handle daily routines. The clinician will explore whether you have a strong preference for consistency and routine and whether you become distressed when routines are disrupted. Repetitive behaviours, such as engaging in specific rituals or movements, will also be explored.
This focus on behaviour and routines is important because many adults with autism find comfort in repetition and predictability. Changes to routine can cause significant anxiety or frustration, and repetitive behaviours (sometimes called “stimming”) can be a coping mechanism to manage sensory overload or stress. Understanding your relationship with routine and repetition helps the clinician determine how autism may manifest in your daily habits.
Sensory Sensitivities
Sensory processing is another critical area of exploration. The clinician will want to understand how you react to sensory stimuli, such as light, sound, touch, or textures. They may explore whether certain environments feel overwhelming, whether you actively avoid particular sensory experiences, or if you become easily overstimulated.
Sensory sensitivities are a common trait among individuals with autism, and they can deeply affect how someone interacts with their surroundings. For instance, some people may feel overwhelmed in loud, crowded places, while others might be hyper-sensitive to certain textures in clothing or food. Sensory sensitivities can have a significant impact on quality of life, so exploring this area is essential for understanding how autism affects you.
Emotional and Cognitive Processing
Finally, the assessment will look at how you process emotions and how you understand and regulate them. This may include exploring whether you experience difficulty identifying or expressing emotions, or whether certain emotions feel overwhelming. Additionally, the clinician may look at your cognitive processing style, such as how you approach problem-solving or handle abstract thinking.
Emotional and cognitive processing are key areas of focus because many individuals with autism process emotions and thoughts differently. For example, some may experience “emotional flooding” where feelings become too intense to manage, or they may have a very logical, literal way of thinking that makes abstract concepts difficult to grasp. Understanding these patterns provides the clinician with a more complete picture of how autism affects your mental and emotional life.
Each of these areas is explored during the assessment to build a comprehensive understanding of how autism may manifest in your behaviours, communication, and daily experiences. Identifying these patterns helps clinicians provide a more accurate diagnosis and tailor support strategies to your individual needs.
H2: Typical Questions Asked in an Autism Assessment for Adults
During an adult autism assessment, clinicians use diagnostic tools like the Autism Diagnostic Observation Schedule (ADOS) and the Autism-Spectrum Quotient (AQ) to explore complex aspects of social interaction, communication, behaviour, and sensory processing. Below are real examples of the types of questions asked:
Social and Communication Skills
The clinician will explore how you manage and perceive social interactions, as autism often affects communication and social understanding:
- “How do you typically feel when interacting with others in social situations?”
This question helps assess whether you experience social anxiety, discomfort, or misunderstandings, which are common traits in adults with autism. - “Do you find it hard to start or maintain conversations?”
This is aimed at uncovering difficulties with conversational flow, turn-taking, and understanding the perspectives of others [1]. - “Have you been told by others that you misinterpret or miss social cues?”
This explores challenges in reading non-verbal communication, such as body language or tone of voice, which are commonly reported in autistic individuals [2].
Daily Life and Routine
To understand how autism impacts daily life, the clinician will ask about routines and repetitive behaviours:
- “Do you rely on a fixed routine, and how do you handle changes to that routine?”
Many adults with autism have a strong preference for consistency and may experience distress when routines are disrupted [3]. - “Do you engage in repetitive behaviours, such as tapping or organising objects?”
This question assesses whether repetitive behaviours or rituals (known as stimming) are used to manage sensory or emotional stress [4].
Sensory Experiences
Sensory processing difficulties are common in individuals with autism. The clinician will ask about how you respond to sensory stimuli:
- “Do certain sounds, lights, or textures bother you more than others?”
This helps identify sensory sensitivities, such as aversions to bright lights or loud noises, which can cause significant discomfort in daily life [5]. - “How do you manage environments with a lot of sensory input, like crowded or noisy places?”
This question explores whether sensory overload occurs in certain situations and how it affects your ability to cope [6].
By exploring these key areas through specific questions, clinicians gain insight into how autism may be impacting your social, emotional, and sensory experiences, ultimately helping them to provide a clear diagnosis and recommend appropriate support strategies.
What Do They Ask About Childhood Development?
An important part of any adult autism assessment involves exploring your early developmental history. Autism is a lifelong condition, and many of the traits that appear in adulthood may have been present during childhood, even if they went unrecognised. Clinicians will ask questions to understand how certain behaviours, communication patterns, and sensory sensitivities might have manifested in your early years.
Questions to Understand Childhood Behaviours
- “Were there any challenges with social interactions when you were a child?”
This helps assess whether difficulties in understanding social cues, making friends, or playing cooperatively with peers were present early on. In many cases, adults with autism report being socially withdrawn or struggling to form close friendships as children, which can be an important indicator in the diagnostic process [7]. - “Did you exhibit repetitive behaviours or an intense focus on specific interests as a child?”
Repetitive behaviours or fixations on particular subjects—like an intense interest in trains or animals—are often signs of autism that appear in childhood. Understanding these early patterns helps build a clearer picture of how autism may have impacted your development [8]. - “Were there any developmental delays, such as speaking later than usual?”
Some children with autism experience delays in language development or unusual speech patterns, such as echolalia (repeating others’ words). Clinicians ask about these to identify early signs of autism [9].
Importance of Early Developmental History
Exploring childhood development is crucial because it helps clinicians distinguish between autism and conditions that may emerge later in life, such as anxiety or social difficulties unrelated to autism. A consistent pattern of autistic traits from childhood through adulthood strengthens the likelihood of an autism diagnosis. Even if you were not diagnosed as a child, understanding your developmental history provides valuable insight into lifelong traits and behaviours associated with autism.
Family members or caregivers often play an important role in this part of the assessment. They can offer details about early behaviours that you might not remember, especially regarding social interactions, language development, and sensory sensitivities. For example, parents or close family members may have observed how you interacted with peers, whether you engaged in repetitive play, or if there were any delays in language development. Their input can help fill in gaps and provide a fuller picture of your early life.
H2: How to Prepare for an Autism Assessment for an Adult
Preparing for an adult autism assessment can help you feel more confident and ensure that you provide comprehensive, accurate information during the evaluation. Since autism assessments are designed to explore various aspects of your behaviour, communication, and daily routines, preparing personal examples in advance can help you articulate your experiences more clearly. Below are key areas to focus on and how to prepare relevant examples:
1. Social Challenges
One of the main areas explored in an autism assessment is how you interact with others and navigate social situations. To prepare, think about specific social challenges you’ve faced:
- Examples: Consider situations where you found it difficult to read social cues, struggled to maintain conversations, or felt uncomfortable in group settings. You might recall times when you misunderstood someone’s intentions or felt anxious in social environments. For instance, you could note, “In large social gatherings, I often find it overwhelming to keep up with conversations, and I sometimes miss non-verbal signals like facial expressions.”
- Reflection: Reflect on how these challenges have affected your relationships or daily life, whether it has led to social withdrawal or difficulty making and maintaining friendships.
2. Communication Difficulties
The assessment will also explore how you communicate, both verbally and non-verbally. Think about instances where you’ve had trouble with communication:
- Examples: You might remember times when you’ve had difficulty interpreting body language, tone of voice, or sarcasm. You could note, “I often take things literally and struggle with understanding when people are joking or being sarcastic.”
- Reflection: Consider whether you’ve found it challenging to engage in conversations, express your thoughts, or understand what others are communicating, particularly in group settings or with new people.
3. Daily Routines and Repetitive Behaviours
Autism assessments frequently explore how you handle routines and whether you engage in repetitive behaviours:
- Examples: Think about your daily routines and how important they are to you. Are you uncomfortable with changes to your routine? Do you have repetitive actions or specific rituals you follow? For example, you might write down, “I always follow the same routine in the morning, and I feel anxious when something disrupts it, like if I’m running late or if plans change unexpectedly.”
- Reflection: Reflect on how these behaviours help you manage stress or anxiety and how you react when your routines are disrupted. This can help illustrate the extent to which routines or repetitive behaviours play a role in your life.
4. Sensory Sensitivities
Many people with autism experience heightened sensitivity to sensory stimuli, such as light, sound, or touch. Think about your sensory experiences:
- Examples: You might note, “I am very sensitive to loud noises, and I often need to leave noisy environments because they make me feel overwhelmed.”
- Reflection: Consider how sensory sensitivities impact your daily life, such as avoiding certain places or feeling anxious in specific environments. These examples can help the clinician understand how sensory processing issues affect your ability to function.
5. Emotional Regulation
Many individuals with autism experience difficulties in emotional regulation. Think about situations where you’ve had strong emotional reactions or struggled to manage your emotions:
- Examples: “I often feel overwhelmed by emotions in stressful situations and find it difficult to calm down once I become upset.”
- Reflection: Consider whether these challenges affect your relationships or work environment, and how they have shaped your ability to cope with stress.
Gathering Information from Others
If possible, reach out to family members or close friends who may be able to provide insights about your early childhood development or how they have observed your behaviours over the years. This can help complete the picture and provide the clinician with additional perspectives.
By preparing these personal examples in advance, you will be able to provide detailed and accurate information during the assessment, helping the clinician make a thorough and informed evaluation. It also allows you to reflect on how autism may have impacted your life and helps ensure that nothing important is overlooked during the assessment.
How to Ask Family Members for Input
If you’re seeking input from family members, it’s helpful to approach the conversation openly and explain why their perspective is valuable. You might say something like:
- “I’m undergoing an autism assessment, and part of the process involves understanding my early development. Since you were around during that time, I would really appreciate it if you could share any memories or observations about how I interacted with others, my behaviour, or anything else that stands out from my childhood.”
You can also provide specific questions to guide them, such as:
- “Do you remember if I had trouble making friends or playing with other kids?”
- “Were there any particular routines or behaviours I followed that seemed unusual?”
- “Did I show any strong reactions to certain sounds, lights, or textures?”
These conversations can be invaluable in piecing together a comprehensive developmental history, which is crucial for clinicians to make an accurate diagnosis.
Looking into your childhood development and gathering input from family members allows clinicians to gain a comprehensive view of how autism traits have shaped your life from an early age, ensuring that the assessment captures the full scope of your experiences.
How Oxford CBT Supports Adults During Autism Assessments
At Oxford CBT, we understand that undergoing an autism assessment can be an unfamiliar and sometimes overwhelming experience for many adults. That’s why we prioritise guiding you through the process with care and professionalism, ensuring you feel supported every step of the way. Our goal is to provide a comprehensive and accurate assessment while maintaining a comfortable and welcoming environment where you can openly discuss your symptoms and experiences.
Step-by-Step Guidance Through the Assessment Process
At Oxford CBT, we follow a structured approach to autism assessments to ensure all aspects of your life and experiences are carefully considered:
Initial Consultation: During your first meeting, our clinicians will explain the assessment process in detail, answering any questions or concerns you may have. This consultation is designed to ease any anxieties and set clear expectations for what will follow.
Personalised Assessment: Each autism assessment is tailored to the individual, as we recognise that everyone’s experiences with autism are unique. We use a range of diagnostic tools, including interviews and questionnaires, to gain a thorough understanding of your social interactions, communication skills, behaviours, and sensory sensitivities.
Collaborative Approach: Our team works collaboratively with you to gather relevant information from various stages of your life, including childhood, if possible. We also encourage you to involve family members or close friends who may offer additional insights.
A Comfortable and Supportive Environment
At Oxford CBT, we believe that a comfortable environment is essential for an accurate and thorough assessment. We take great care in creating a space where you feel at ease discussing personal experiences and challenges without judgment.
Building Trust: Our clinicians focus on establishing a trusting relationship with you, ensuring that you feel heard and respected throughout the process. We know that discussing sensitive topics like social difficulties or sensory overload can be challenging, so we approach each conversation with empathy.
Clear Communication: We take the time to explain each step of the assessment in straightforward terms, ensuring you’re comfortable with the process. Whether discussing diagnostic tools or reviewing the next steps, we’re committed to providing clarity and support.
Flexible Approach: Understanding that some individuals with autism may have heightened sensitivities or preferences, we offer flexibility in how we conduct assessments. This may include adjusting the pace of the session or adapting the environment to suit your needs, such as dimming lights or offering breaks when necessary.
Tailored Recommendations Post-Assessment
Once the assessment is complete, our clinicians will carefully review the findings with you. We provide clear, personalised recommendations to help you manage any challenges you may face and improve your quality of life. This may include therapeutic interventions, strategies for managing specific symptoms, or referrals to additional support services.
Oxford CBT’s commitment to providing a compassionate, thorough, and supportive environment ensures that the autism assessment process is as smooth and empowering as possible. We strive to help every individual gain a deeper understanding of their unique experiences, providing the tools needed to navigate life with greater confidence.
Conclusion
Undergoing an autism assessment as an adult can be an insightful and transformative experience, offering clarity and a better understanding of the challenges you may have faced throughout your life. At Oxford CBT, we are committed to providing a supportive and comfortable environment where you can openly discuss your experiences.
Through a structured and personalised assessment process, we carefully explore key areas such as social interaction, communication, daily routines, and sensory sensitivities to create a full picture of how autism may be affecting your life.
Our team guides you every step of the way, ensuring that the process is clear and empowering, with a focus on your comfort and wellbeing. Whether it’s through gathering personal examples or involving family members in understanding your developmental history, we work collaboratively to provide a comprehensive diagnosis.
Following the assessment, we offer tailored recommendations and support to help you move forward with confidence, knowing that you have the tools to manage your symptoms and improve your quality of life. At Oxford CBT, we’re here to help you through your assessment journey with understanding and care.
References
[1] Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The Autism-Spectrum Quotient (AQ): Evidence from Asperger Syndrome/High-Functioning Autism, Males and Females, Scientists and Mathematicians. Journal of Autism and Developmental Disorders. Available at: https://link.springer.com/article/10.1023/A:1005653411471
[2] Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (1999). Autism Diagnostic Observation Schedule (ADOS). Western Psychological Services. Available at: https://www.wpspublish.com/ados-2-autism-diagnostic-observation-schedule-second-edition
[3] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Available at: https://www.psychiatry.org/psychiatrists/practice/dsm
[4] Autism Speaks. (2021). Repetitive Behaviors and Restricted Interests. Available at: https://www.autismspeaks.org/repetitive-behaviors
[5] Bogdashina, O. (2003). Sensory Perceptual Issues in Autism and Asperger Syndrome: Different Sensory Experiences, Different Perceptual Worlds. Jessica Kingsley Publishers. Available at: https://us.jkp.com/products/sensory-perceptual-issues-in-autism-and-asperger-syndrome
[6] Crane, L., Goddard, L., & Pring, L. (2009). Sensory Processing in Adults with Autism Spectrum Disorders. Autism. Available at: https://journals.sagepub.com/doi/abs/10.1177/1362361309335713
[7] Baron-Cohen, S., et al. (2001). The Autism-Spectrum Quotient (AQ). Journal of Autism and Developmental Disorders. Available at: https://link.springer.com/article/10.1023/A:1005653411471
[8] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Available at: https://www.psychiatry.org/psychiatrists/practice/dsm
[9] Lord, C., et al. (1999). Autism Diagnostic Observation Schedule (ADOS). Western Psychological Services. Available at: https://www.wpspublish.com/ados-2-autism-diagnostic-observation-schedule-second-edition
Author – Tom Murfitt
With over a decade’s experience in providing Cognitive Behavioural Therapy, Tom has worked in both the NHS and private sector to help adults and children to overcome a range of difficulties and improve their mental wellbeing. In addition to being an experienced CBT therapist, Tom is also an accredited Mindfulness teacher, providing courses locally, in businesses and schools. You can read more about us here.
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