What does a good assessment for autism or OCD actually look like? A parent’s guide

If you’re approaching a CAMHS assessment, or considering a private one, knowing what to expect can reduce anxiety and help you feel more confident in the process. A good assessment is a collaborative process — not a test your child can pass or fail, but a careful gathering of information from multiple sources to build the most accurate picture possible.

Here is what a thorough, NICE-compliant assessment for autism or OCD typically involves, and what questions it’s reasonable to ask at every stage.

For autism assessment

A comprehensive autism assessment should draw on information from multiple sources and use validated assessment tools. In the UK, NICE guidance recommends the following:

• A detailed developmental history — covering early development, communication, social interaction, and sensory experiences from as early as possible
• Direct observation of the child, usually using a structured tool such as the ADOS-2 (Autism Diagnostic Observation Schedule)
• A clinical interview with parents or carers, often using the ADI-R (Autism Diagnostic Interview — Revised)
• Information from school or other settings where the child spends significant time
• Assessment of any other conditions that might be present (such as ADHD, anxiety, or a learning disability)

An assessment that does not include school information or standardised tools may not be NICE-compliant, and the resulting report may not be accepted by local authorities or other services.

For OCD assessment

An OCD assessment is primarily a clinical interview. The clinician will want to understand the nature of the obsessions and compulsions — what the intrusive thoughts or fears are, what the child does in response to them, and how much time and distress is involved.

They will also want to understand how the OCD is affecting the child’s daily life, and whether other conditions might be present or contributing to the picture.

Standardised measures such as the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) may be used to assess severity.

Questions it’s reasonable to ask

At any point in the assessment process, it is entirely appropriate to ask:

• What are you looking for, and why?
• What tools are you using, and what are they designed to measure?
• What will the report include, and who will receive it?
• What are the next steps regardless of the outcome?
• If a diagnosis is made — what does that mean in practical terms for my child?
• If a diagnosis is not made — what does that mean, and what happens next?

You are a full participant in this process. Your observations are clinical data. Your questions are legitimate. A good clinician will welcome both.

After the assessment

A good assessment doesn’t end with a report. It should include a clear explanation of the clinician’s thinking, specific recommendations for support, and a pathway to whatever comes next.

If you don’t understand the conclusions, ask for them to be explained. If you disagree with them, say so. If the recommendations don’t feel right for your child, it is appropriate to seek a second opinion.

Understanding your child’s needs is a process, not a single event. The assessment is the beginning of that process, not the end.

This post is part of the Lumara guide series for parents. Lumara Screen is an evidence-informed online screening tool for parents concerned about repetitive behaviours, rituals, or routines in their child. Free to complete — full personalised report £7.99.

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