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Autism in young children

Signs of autism in young children include:

  • not responding to their name
  • avoiding eye contact
  • not smiling when you smile at them
  • getting very upset if they do not like a certain taste, smell or sound
  • repetitive movements, such as flapping their hands, flicking their fingers or rocking their body
  • not talking as much as other children
  • repeating the same phrases

Autism in older children

Signs of autism in older children include:

  • not seeming to understand what others are thinking or feeling
  • finding it hard to say how they feel
  • liking a strict daily routine and getting very upset if it changes
  • having a very keen interest in certain subjects or activities
  • getting very upset if you ask them to do something
  • finding it hard to make friends or preferring to be on their own
  • taking things very literally – for example, they may not understand phrases like "break a leg"

Autism in girls and boys

Autism can sometimes be different in girls and boys.

For example, autistic girls may be quieter, may hide their feelings and may appear to cope better with social situations.

This means autism can be harder to spot in girls.

Criteria for a diagnosis of an Autism Spectrum Disorder

  1. Deficits in social communication & social interaction
  2. Restricted, repetitive patterns of behaviour, interests, or activities.
  3. Symptoms must be present in early childhood
  4. Symptoms together limit and impair everyday functioning – across the different settings your child is in.

Children need to meet all these criteria to get a diagnosis.

How to get an assessment

You need to be referred to the Community Paediatricians for an assessment by your GP or special educational needs (SENCO) staff at your child's school. It is usually best if a referral comes from your child’s school (where applicable). Bromley Schools have access to a ‘Social Communication Toolkit’ which helps a school to explore the difficulties your child is showing in school, with the aim that they can provide them with appropriate support. The toolkit provides the school with a referral form to refer directly to our service and ensures we have the information we need. If a referral comes from your GP it is important they enclose information from your child’s school regarding the difficulties your child is showing in this setting.

Where a child is not in school, or parents do not feel a school are recognising their child’s difficulties, then it is very helpful if information from other professionals who know your child is enclosed, such as from a Speech Therapist, or Behavioural therapist, who has assessed your child and worked with them.

You may have to wait a few months to get an appointment.

Further information on how to get diagnosed

What you can do while you wait for an assessment

If you think your child needs support at school, you can start getting help before having an assessment.

You can:

  • look at the local offer for children and young people with social communication difficulties, who provide information on what support is available in the Bromley area:
  • find a local support group using the National Autistic Society services directory
  • talk to teachers or special educational needs (SENCO) staff at your child's school. Your child does not need a diagnosis to receive support in school for their dificulties.  If you are having difficulties getting support for your child you can contact the Information Advice and Support Service (IASS) for advice, on tel 0208 461 7630 or via email at
  • speak to student support services at college

What happens during an autism assessment

You will have an initial assessment with a doctor from the Community Paediatric team. As part of their assessment they will:

  • ask you about your child's development, such as when they started talking
  • watch how you and your child interact, and how your child plays
  • read any reports sent by the GP and the nursery or school

Based on the assessment it may be appropriate to refer to other services e.g. Speech Therapy, Occupational Therapy, Physiotherapy, etc. or to arrange investigations such as blood tests. We may need to request information from your child’s school/pre-school, or from the other services your child is known to, such as Speech therapy.

Once all the information has been collected, the doctor will then decide if your child needs further assessment of their social communication difficulties. If so, they will then refer them to the Complex Communication Diagnostic Service (CCDS). If the doctor does not feel a referral is needed at that time they will explain the reasons why they do not. Some children’s difficulties will become more significant as they get older, and if a referral to the CCDS is not made then your child can be referred back to our service at a later point, if there continue to be concerns.

If your child is referred to the CCDS, the referral will be discussed in the monthly CCDS referrals meeting by the CCDS team, where it will be decided if we go ahead with an assessment. The CCDS team is made up of the senior doctors on our team, as well as a senior speech and language therapist and member of the CAMHS team. It may be that further information, treatment or support is needed before a referral would be considered. Parents/Carers will be notified of the outcome of this meeting by post.

If the referral is accepted to the CCDS all children will be assessed with a structured observation, by either, a Speech Therapist or Psychologist. Where the Paediatricians need more information about the child’s difficulties they will meet with parents/carers for a structured interview.

Your doctor should inform you of the likely waiting time for the CCDS assessment when you are referred to the CCDS. If you have any questions about the waiting time then you can contact the CCDS administrator on 0208 315 4673, for any updates on this. The waiting time for an assessment can seem very long and in view of this it is important that your child gets the support they need. Not having a diagnosis should not stop your child getting this support. Further information on local support can be found at:

Getting the result

Following these assessments a feedback meeting will be organised which parents/carers and the child’s school would be invited to. At this feedback meeting we will discuss the outcome of the assessments and decide the following:

  • if your child meets the criteria for a diagnosis of an autism spectrum disorder.
  • what kind of support your child requires and who should be providing this

After the feedback meeting we will provide you with a hand written outcome of the meeting, including the plan. A written report will be sent to you within 4-6 weeks. Sometimes the report can be hard to understand as it can be full of terms used by health care professionals.

If you have questions or concerns please ask the assessment team at the feedback meeting, or contact them afterwards via the CCDS administrator on 0208 315 4673.

Autism is a lifelong condition, so the report will be used throughout childhood and into adulthood.

Find out more: