If you have been referred for an adult autism assessment, you may wonder how clinicians decide whether someone meets the criteria for a diagnosis. At Psychiatry UK, we use pre-assessment questionnaires, a detailed clinical conversation and observation during your appointment to build a complete picture of your experiences. 

Our questionnaires are informed by recognised autism assessment approaches and gather useful information before your appointment. 

Your clinician will consider this information alongside the appointment to decide whether your experiences meet the DSM-5 criteria for autism. 

 

What if I mask my difficulties? 

Many autistic people, particularly adults, describe masking or camouflaging their differences in social situations. This means developing strategies to fit in, avoid standing out, or manage social expectations. 

Clinicians are aware that masking can influence how autism presents during an assessment. This is one reason why the assessment considers your developmental history, questionnaire responses and lived experiences, rather than relying only on what is observed during the appointment. 

 

What questionnaires will I be asked to complete? 

Before your assessment, we’ll ask you to complete three questionnaires: 

  • ASD Self-Report Questionnaire, Parts 1 and 2 
  • AQ-10, also known as the Autism Spectrum Quotient-10 
  • ASD Informant Report Questionnaire 

Together, these questionnaires look at your experiences from different perspectives, helping your clinician to understand both your own experiences and, where possible, how they may have been observed by someone who knows you well. 

 

ASD Self-Report Questionnaire, Parts 1 and 2 

The ASD Self-Report Questionnaire asks about your own experiences. 

It helps your clinician understand how you experience communication, social situations, routines, change, sensory information, interests and everyday life. 

It will also ask about your development, childhood, education, work, relationships and mental health. These details show whether your experiences have been present over time and how they affect different areas of your life. 

There are no right or wrong answers; the aim is simply to understand what life is like for you. 

AQ-10 

The AQ-10 is designed as a screening questionnaire rather than a diagnostic test. 

It can help highlight areas that may be relevant to your assessment, but it does not diagnose autism by itself. A higher score does not automatically mean you are autistic, and a lower score does not automatically rule autism out. 

Your clinician will consider your AQ-10 score alongside all the other information gathered during your assessment. 

 

ASD Informant Report Questionnaire 

The ASD Informant Report is completed by someone who knows you well, preferably someone who has known you since before the age of 12. 

This could be a parent, partner, relative, close friend or another person who can comment on your development, communication, relationships, routines, interests or daily life. 

Information from someone else can be helpful because autism is a neurodevelopmental condition. This means autistic differences are usually present from early life, even if they were not recognised at the time. 

If you do not have someone who can complete this questionnaire, please let us know.  

 

Why do you ask about childhood? 

Autistic differences begin during development, although they may become more noticeable at different stages of life. 

Your clinician may ask about what you were like as a child, including your communication, play, friendships, routines, interests, sensory experiences and how you managed change. 

Some people remember lots of detail from childhood. Others remember very little. Both are common. School reports, family memories or examples from earlier life may be helpful, but you do not need to have perfect recall. 

 

What happens during the assessment? 

During your assessment, your clinician will talk with you about your current experiences and your developmental history. 

As part of the assessment, your clinician will naturally observe how you communicate and interact throughout the appointment.  

This observation is not about judging you or expecting you to behave in a particular way. It helps your clinician understand how you experience and navigate communication, social situations, change, sensory demands and everyday life. 

Your clinician may ask about: 

  • social communication and interaction 
  • routines, repetition and change 
  • sensory differences 
  • focused interests 
  • childhood and development 
  • education, work and relationships 
  • mental health and wellbeing 
  • strengths, challenges and support needs 

You do not need to prepare or perform in a certain way. The most helpful thing is to be yourself as much as you can. 

 

How is the diagnosis considered? 

No single questionnaire, score or observation determines whether someone is diagnosed with autism. 

Your clinician will consider the full picture, including: 

  • your completed questionnaires 
  • information from your informant questionnaire, if available 
  • your developmental history 
  • your current experiences 
  • clinical observation during the appointment 
  • how your experiences affect everyday life 
  • whether your experiences meet the DSM-5 criteria for autism 

DSM-5 is a diagnostic framework used by clinicians. It sets out the areas that need to be considered when making an autism diagnosis. 

Your clinician will also consider whether there may be other explanations for your experiences, or whether you may have additional needs alongside autism. 

 

Will the assessment look at other conditions too? 

Yes. Some people who are assessed for autism may also have ADHD, anxiety, depression, trauma-related difficulties, sleep problems or other mental health or neurodevelopmental needs. 

Experiences such as difficulties with concentration, social interaction, emotional regulation or sensory processing can overlap with other conditions. 

This is why your clinician will ask broader questions about your development, mental health and daily life. The aim is to understand your needs as fully as possible. 

 

What if I am not diagnosed with autism? 

Not everyone who is assessed will receive an autism diagnosis. If your experiences do not meet the diagnostic criteria for autism, your clinician will explain their reasoning and discuss any other factors that may help explain your difficulties. 

In some cases, other mental health, neurodevelopmental or life experiences may better account for the challenges someone is experiencing. 

 

Is this process only used for autism? 

The autism questionnaires and observation process are designed to support autism assessments. 

They are not used to diagnose ADHD or other conditions, although another condition may be present alongside autism or better explain your experiences. 

 

Do I need to prepare? 

You do not need to revise or practise answers for your autism assessment. 

It may help to think about examples from your everyday life, such as: 

  • situations you find easy or difficult 
  • how you communicate with other people 
  • how you manage change or uncertainty 
  • sensory experiences that affect you 
  • routines, interests or patterns that are important to you 
  • what school, work or relationships have been like for you 

If you feel nervous, need something to be repeated or need a question explained in a different way, it is okay to say so. Your clinician will guide you through the appointment and explain what is happening. 

The assessment is not about passing or failing. It’s designed to establish whether autism may explain your experiences and what support may be helpful for you.