Frequently Asked Questions
General
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We understand that receiving support for your child is the most important thing, we want to help your child receive the support they need.
The current wait times from NHS GP referral to first appointment is below:
- Remote Pathway (7-18 years) : 11 weeks
- Hybrid Norwich Pathway (6-18 years): 14 weeks
- Hybrid Exeter Pathway (5-18 years): 14 weeks
- Hybrid Exeter Pathway (2-4 year): 13 weeks
Please note these waiting times are approximate and are subject to change depending on the amount of referrals we receive our assessor capacity.
If the current service you are on has a wait of more than 18 weeks, you have a legal right to change your NHS provider. You can speak to your NHS GP about getting a new referral to Paloma Health.
Referral process
Your NHS GP will need to refer your child to Paloma Health for an autism assessment. Please book an appointment with them and direct them to complete our referral form.
The following services are available:
- Autism assessment with remote observation, if the child is aged 7–18.
- Autism assessment with in-person child observation in Exeter, if the child is aged 5–18.
- Autism assessment with in-person child observation in Exeter, if the child is aged 2-4 and they have seen a community paediatrician who has recommended an autism assessment
- Autism assessment with in-person child observation in Norwich, if the child is aged 6-18.
We recommend answering a few quick questions in our "Service Finder" to get personalised advice on which service is best for your child, and what to ask your NHS GP.
Click here to read useful tips for the conversation with your NHS GP.
We recommend doing the Service Finder, to see which service is available for your child. If all options are available for you, it's up to you on whether you would like a fully remote or hybrid assessment.
As soon as we've received your NHS GPs referral, you receive an email to confirm this. Keep an eye out in your spam folder too.
Haven't received this email yet? Please reach out to your NHS GP to ask if they've processed the referral.
If your child is home-schooled we will ask for additional information from another suitable professional, or someone outside of the home who knows your child well. Ideally it would be someone who has seen your child in a social environment interacting with other children and has known them long enough to comment on their behaviour.
Paloma operates a bit differently to other providers, you will not receive an acceptance email.
Once you have completed your onboarding questionnaire and your nominated third party (generally your childs school or nursery) have completed their questionnaire our multi disciplinary team will review the information supplied. If our team reviews this information and determines that we are not the right service for your child, a member of our team will be in contact.
Otherwise we will contact you with the details of your parent interview and child observation appointment as soon as possible.
The assessment
Each assessment is completed by two trained assessors, specialising in diagnosing autism in children and young people.
Yes, research shows that remote autism assessments can be just as accurate as in-person assessments when carried out by an experienced professional.
A study by the National Autistic Society found that the move to remote assessments during the pandemic didn’t affect the accuracy of diagnoses. In fact, a study published in the Archives of Disease in Childhood showed that remote assessments not only maintain diagnostic accuracy but also have high levels of parental satisfaction.
For remote assessments, we use an adapted observation that draws on the Autism Diagnostic Observation Schedule (ADOS). This is the same adapted observation that our children who are seen face to face complete for consistency in assessment.
The order of the parent interview and the child observation are not important, and won’t affect the outcome or the quality of the assessment of your child.
The assessor and parent appointment will cover your child's strengths, needs, preferences, dislikes, and developmental history, particularly focusing on your child's early years.
The child observation appointment is between your child and one of our assessors who will observe your child’s behaviours and mannerisms.
If you have chosen our remote pathway you will need five small hand held objects for your child's observation appointment. Two of these objects need to have a clear purpose and the remaining three items need to be able to be used in many different ways. Please ensure none of these objects are characters or action figures.
ADHD Screening
Within NHS autism assessments, our qualified assessors will screen for signs of Attention Deficit Hyperactivity Disorder (ADHD).
This screening helps families understand whether a formal ADHD assessment may be necessary to ensure your child receives the appropriate support.
PDA screening
We do not assess for PDA as it is not a recognised condition in the DSM-5 diagnostic criteria.
We do not use any measures that specifically screen for 'demand avoidance' either. However, where demand avoidance is described (a persistent and marked resistance to the demands of everyday life, which may include essential activities such as eating or sleeping as well as expected demands such as school or work) we will record these characteristics and signpost to resources.
Resources will include those provided by the National Autistic Society and PDA society UK.
Our assessors are experienced in, and trained on, recognising the diverse ways autism can present.
Our assessments are carefully designed to identify more subtle traits and symptoms, how autism can be different in females, and to look out for masking and camouflaging.
Our team is very experienced in working with young people and understand that sometimes an assessment can be a stressful experience for the family. As experts in the field and trained in working with children, we will do our very best to put your child (and the whole family) at ease and are very skilled at engaging even the most shy and anxious children.
After your appointments, within a few weeks we will send an email with your outcome meeting date and time. We aim to provide your outcome report before this meeting. Once your report is ready you will receive an email notification and can access it in your Paloma Portal.
After the assessment
The NHS GP that referred your child to us, will receive a full assessment report. They should ensure the report is included in your child’s NHS medical record. As an NHS Right to Choose provider, our assessments should be accepted by any local authority, as we meet the standards of the NHS.
Behaviours seen in autism can also be seen in other neurodevelopmental or mental health conditions. And, a child's experience can affect how they develop and sometimes this can look like autism.
We will consider all these factors in your child's assessment and provide you with our understanding of what the possible causes of your child's difficulties are, so the best support and understanding can be offered.
All children assessed will receive recommendations and a strengths and needs profile, whether they get an autism diagnosis or not.
Yes, the outcome reports are in line with all guidance set out by the NHS and NICE.
We are a Right to Choose provider of the NHS. That means that the NHS appointed (commissioned) us to assess children and young people for autism.
To become a Right to Choose provider, we were assessed to meet high standards, including that our assessments are compliant with NICE guidelines and the NHS England Operational Framework. An example of these guidelines is that all assessments are done by trained and experienced professionals, and include all criteria as set out by guidelines of NICE called “CG128: Autism spectrum disorder in under 19s”. These guidelines focus on recognition, referral and diagnosis.
You have the following rights if your local authority is challenging an outcome report:
- Request clarity: You can write to them and ask them to explain their challenge.
- File a complaint: If you're dissatisfied with their response, you have the right to file a formal complaint.
- Escalate: If their response is unsatisfactory, you could take the complaint to the Local Government Ombudsman and to your local MP.
- Appeal: If the challenge to a report influences the EHCP decision process, you may have a case to appeal.
If this happens, you can ask them to contact us. Our assessor team will work with them to ensure a swift resolution.
