Frequently Asked Questions
General
.svg){kind=icon}
We understand that receiving prompt support for your child is the most important thing. Our wait times by service are as follows:
Autism Assessments
The current wait times from NHS GP referral to first autism assessment appointment is below:
- Remote Pathway (8-18 years) : 12 weeks
- Hybrid Norwich Pathway (6-18 years): 12 weeks
- Hybrid Exeter Pathway (5-18 years): 14 weeks
- Hybrid Exeter Pathway (2-4 year): 15 weeks
Please note that the current wait times do not apply if your child is registered to a GP practice in one of the NHS ICB regions below. Due to NHS imposed funding restrictions, we have been told to pause the delivery of assessments in these NHS ICB regions until at least the 31st of March 2027:
Hampshire and Isle of Wight ICB
Greater Manchester ICB
North East and North Cumbria ICB
Thames Valley ICB
ADHD Assessments
The current wait time from NHS GP referral to ADHD assessment is four to eight weeks, though as this is a new service this wait time will change. We will keep families updated on our website.
Autism and ADHD Assessment
The current wait time from NHS GP referral to have an autism and ADHD assessment is four to eight weeks, though as this is a new service this wait time will change. We will keep families updated on our website.
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. Please book an appointment with them and direct them to complete our referral form. The following pathways are available:
Autism Assessments
- Remote (online), if the child is aged 8–18.
- Hybrid, with a in-person child observation in Exeter, if the child is aged 5–18.
- Hybrid, with a in-person child observation in Exeter, if the child is aged 2-4. Note, we can only accept referrals for children 2-4 if they have seen a community paediatrician who has recommended an autism assessment
- Hybrid, with an in-person child observation in Norwich, if the child is aged 6-18.
Click here to read useful tips for the conversation with your NHS GP about an autism assessment.
ADHD Assessments
- Remote (online), if the child is aged 8-18
Click here to read useful tips for the conversation with your NHS GP.
Click here to read useful tips for the conversation with your NHS GP about an ADHD assessment.
If you are unsure if your child needs an autism or ADHD assessment, talk to your GP. Your child can be referred to Paloma for an autism assessment, ADHD assessment, or for both an autism or ADHD assessment.
Charities are very helpful in providing more information about these conditions, for example:
The National Autistic Society on 'what is autism'
As soon as we've received your NHS GPs referral via our online referral form, you will receive an email to confirm this. Keep an eye out in your spam folder t
If we receive an NHS GP referral to our NHSmail address, we will confirm your referral within 2-3 working days.
Haven't received this email yet? Please first check with your NHS GP practice admin team to ask if they have sent us the referral. If they have, wait 2-3 days in case they sent it via NHSmail. If you still haven't received confirmation from Paloma, then contact us via our website
If your child is home-schooled we will ask for additional information from another suitable professional, or an adult from 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.
Importantly, we can only book in an ADHD assessment when we have received social context information from an adult from outside of the home who knows your child well.
Paloma will only get in touch if we need additional information before progressing, or if your child has not been accepted for an assessment.
Once you have completed your onboarding questionnaire and your nominated social context source (generally your childs school or nursery) have completed their questionnaire our multi disciplinary team will review the information supplied.
All being well, your child is then assigned to our booking team who book in the next available assessment. You should receive this confirmation within 12 weeks of being referred.
If our team determines that we are not the right service for your child, a member of our team will be in contact with advice on next steps.
Autism 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.
For our in-person appointments, there is nothing you need to bring.
For remote appointments, it is important that you:
- Join this call on a laptop or desktop computer, or on a tablet with a 10 inch screen or greater
- Bring five small hand held objects. Two of them need to have a clear purpose, e.g. a pen, and three need to be able to be used in different ways, e.g. a block. Please ensure none of these objects are characters or action figures.
Please do not join a remote appointment on a mobile phone, or on a tablet with a screen smaller than 10 inches, as it will not be possible to continue the appointment.
ADHD Screening
Within our 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.
If it is identified your child needs an ADHD assessment, you can ask your NHS GP for a referral for an ADHD assessment to Paloma. We will use all of the information gathered in our autism assessment to support the ADHD assessment, so you don't have to repeat the same information.
PDA screening
We do not assess for PDA as it is not a recognised diagnosis in the DSM-5 diagnostic criteria.
We do not use any measures that specifically screen for 'demand avoidance'. 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 present differently in females
- Potential masking and camouflaging.
Our team is highly 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, our assessors will do their very best to put your child (and the whole family) at ease and engage even the most shy and anxious children.
After your two appointments are completed (the parent interview and child observation), we will send you an outcome appointment date which is typically within two to three weeks.
We aim for your outcome report to be available before your outcome appointment. You will receive an email notification when your report is ready, and you can access it in your Paloma Portal (you login to this when your child is first referred to Paloma).
After an autism assessment
The NHS GP that referred your child to us will receive the assessment outcome report within a few days of your outcome appointment. 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.
ADHD Assessment
Our ADHD assessments are thorough and evidence-based, strictly adhering to NICE and NHS guidelines. The process involves a social context questionnaire as well as a detailed discussion in an appointment with the assessor, the parent, and the young person.
Yes. It is very common for ADHD and Autism to co-occur. If you or your GP suspect your child shows traits of both conditions, they can refer your child to both an autism and ADHD assessment through the referral form on our website.
If your child receives an ADHD diagnosis, you will receive a comprehensive report detailing their strengths, challenges, and tailored recommendations for school and home. We will also discuss evidence-based management options, which may include psychoeducation, behavioral strategies, lifestyle adjustments, and medication if it is recommended.
Yes, we offer medication to children who have received an ADHD diagnosis from us, as it is one of the most common and effective ways to treat the condition. If medication is recommended, there will be an eligibility screening followed by a clinically led "titration" process to find the right type and dose. We will continue to support your child's prescription and medication moving forward, even after they turn 18 if needed.
NHS Right to Choose
Right to Choose is a legal framework that allows you to select your preferred healthcare provider for specialist consultations and mental health assessments.
If your GP agrees that your child is showing signs of autism or ADHD and is willing to make a referral to an NHS assessment service, you have the legal right to choose which NHS provider you are referred to. You must explicitly choose Paloma Health to be referred to our service.
We have heard that come GPs are saying they cannot refer to Paloma Health either because they can only refer to a local approved list, or that the school needs to refer. This is not the case. Here is some information to help you if this happens:
- If your GP refers you for elective care or mental health treatment in England, you have a legal right under the NHS Constitution to choose your provider.
- That right is not limited to a local list — you can choose any provider holding an NHS contract with any ICB in England, including independent sector providers.
- Some ICBs are telling patients and GPs that choice is restricted to a local approved list. It is not.
- What you can say to your GP: "Under the NHS Choice Framework and the NHS Constitution, patients in England have the right to choose any provider holding an NHS standard contract with any ICB in England for the service they need. This applies to elective referrals and mental health services. Choice cannot be restricted to an ICB-approved list."
Here are some resources which may help:
https://www.england.nhs.uk/wp-content/uploads/2017/03/patient-leaflet-digital.pdf
https://www.nhs.uk/using-the-nhs/about-the-nhs/your-choices-in-the-nhs/
If the GP still refuses, the next step is to make a complaint to your GP Practice Manager.
Yes. If your child is currently on a waiting list with another NHS autism or ADHD service and has been waiting longer than 18 weeks (or if you have been told the wait will exceed this), you have a legal right to switch your NHS provider. Speak to your NHS GP about transferring your referral to us.
Yes. Our reports are fully compliant with all guidelines set out by the NHS and NICE (National Institute for Health and Care Excellence). Because we are an official NHS Right to Choose provider, our diagnostic assessments must be legally recognised by local authorities, schools, and other NHS trusts.
Because we meet all strict NHS England standards, local bodies should accept our findings. If you face pushback (for example, during an EHCP process), you have the right to request a written explanation for their challenge. If they cannot resolve it, you can file a formal complaint or escalate it to the Local Government Ombudsman. If they require clarification, they can contact us directly, and our clinical team will assist.
