How do I get a referral for an ADHD or autism assessment?

There is no single UK form or professional who opens every ADHD and autism assessment pathway. A GP may refer in one area, a school or health visitor in another, and a local single point of access may coordinate several services. Start by finding the current route for your child's age, postcode and assessment question.

Find the service before writing the referral

Ask the GP, school additional-needs lead, health visitor or local health service:

• Which team assesses ADHD, autism or combined neurodevelopmental questions?
• What ages and locations does it cover?
• Who is allowed to refer?
• Is self-referral available?
• What forms and evidence are required?
• What happens at triage?
• How are families told the decision?
• What support is available during the wait?

The NHS says families can speak to a GP or SENCO about requesting an ADHD assessment ^[1]. For autism, a GP can often refer, but children's routes may require school or a health visitor ^[2]. These are starting points, not a guarantee that the same referrer applies everywhere.

Use the service's current website or written pathway. Local names and criteria change, and England, Wales, Scotland and Northern Ireland organise services differently.

State the question clearly

Avoid opening only with "please assess for ADHD" or "we think she is autistic." Explain what needs understanding:

We are asking for assessment of a persistent pattern of attention regulation, impulsivity and task access across home and school, including its effect on learning, safety and relationships. We also want other possible explanations and coexisting needs considered.

Or:

We are concerned about a long-standing developmental pattern involving social communication, sensory experience, flexibility and daily functioning. We would like the appropriate service to consider whether an autism assessment is indicated.

The referral requests assessment; it does not need to write the conclusion in advance.

Use examples, not a copied checklist

For each main concern, include:

• a specific example;
• source of the information;
• setting and timing;
• frequency or duration;
• effect on the child's life;
• support tried and what changed;
• an easier occasion and its conditions.

For example:

During independent written work, T begins after repeated individual prompts and completes less than they can explain verbally. School recorded this in four subjects over six weeks. A three-step written instruction reduced prompts but did not resolve task completion.

A screening questionnaire may help organise features. NICE says ADHD diagnosis must not be based solely on rating scales or observation ^[1], and autism identification tools must not be used to make or rule out diagnosis ^[3]. Include scores as one source, not proof.

Bring several accounts without manufacturing agreement

The referrer may need information from the child, family, school or nursery and health records. Differences are expected. Ask each source to describe what it directly observes.

If school sees fewer difficulties, write that accurately and add the conditions:

School reports that R follows whole-class routines and achieves expected work. R says they copy peers when unsure and cannot eat in the dining hall. At home, the family records three hours of recovery after school. We ask the assessment to consider the difference rather than assuming either account is complete.

Do not claim that a difference proves masking. NICE autism guidance says that where reported signs and clinic observation differ, clinicians should consider more information or observation in another setting ^[3]. That is an assessment response to discrepancy, not a rule that one explanation must be true.

Include relevant health and development

Give the referrer proportionate information about:

• pregnancy, birth and early development where known;
• language, movement, learning and self-care;
• sleep, eating, hearing, vision and physical health;
• mental health, significant events and current stress;
• medication;
• family history where relevant and known;
• earlier assessments and reports.

Mark uncertain dates as approximate. Adopted, looked-after or estranged families may not have a complete early history. Say what is unavailable and provide present-day evidence; do not invent milestones.

Check consent and information sharing

Ask who will receive the referral, school report and health information. The referrer should explain the local consent process and how your child is involved according to age and understanding. Do not copy a wide group of professionals into sensitive developmental information without a purpose.

Tell your child what is being requested in language they can use. Ask what they want the service to understand and whether they would like to contribute in writing. A referral about them should not arrive as a secret project conducted entirely between adults.

If parents with responsibility disagree or the family situation is complex, ask the service for its consent and communication policy rather than assuming one parent's signature resolves every question. Keep safeguarding and confidentiality concerns on the appropriate professional route.

Show what support has already happened

Some services ask what has been tried before referral. Summarise the support, duration, delivery and effect. "SEN support in place" is too broad. State the change and what happened.

Support history can help the team understand need and differential explanations. It should not be presented as a test the child must fail before any concern is legitimate. Ask the service to explain any prerequisite and how urgent or complex cases are handled.

Continue needs-led support during referral. A diagnostic pathway is not a waiting room for education or current health care.

Use the appointment efficiently

Take a one-page summary and your top questions. The GP and NHS Prep Pack helps organise current concern, impact, relevant history and requested next step.

Ask the referrer to confirm:

• the service selected and why;
• the question in the referral;
• documents attached;
• submission date;
• how acknowledgement and triage decisions arrive;
• what you should do if symptoms change.

Request a copy where the system permits. Correct factual errors promptly rather than rewriting a professional's opinion as your own.

If the referral is returned or declined

First identify the decision:

Missing information: ask exactly what is needed, who can provide it and whether the existing referral can be completed.

Wrong pathway: ask which service answers the question and whether the referral will be redirected or must be resubmitted.

Criteria not met: request the reasons, information considered and support or alternative assessment recommended.

Capacity or commissioning issue: ask for the responsible service's written position and available patient-choice or complaints information.

A triage decision is not a diagnostic assessment result. The handling a no guide helps map the decision-maker, reasons and relevant new information.

Patient choice in England

NHS England guidance says some remotely delivered ADHD and autism assessment services may be subject to the legal right to choice of provider and team. The referrer remains responsible for deciding whether the referral is clinically appropriate ^[4]. Eligibility depends on the service and circumstances.

Ask the GP or referrer whether patient choice applies, whether the provider holds the relevant NHS contract, what age and pathway it covers, and what follow-up is included. Do not confuse an NHS-funded choice provider with paying privately.

Routes outside England

Wales, Scotland and Northern Ireland use their own health and education structures. The professional who can refer, the name of the team and the role of school may differ. An England Right to Choose provider list is not a UK referral directory.

Ask the local health board, NHS board, Health and Social Care Trust or Education Authority service to identify the current route. Record the source and date. If a website gives only adult information, confirm the children's pathway rather than adapting the age range yourself.

Where education and health share a referral form, check which organisation makes the clinical triage decision and where the family sends updates. A school contribution can be required without making school the diagnostic authority.

Prepare for triage, not a verdict

Triage may decide whether the referral fits the service, whether information is missing or whether another route should respond first. It is not the full diagnostic assessment.

Ask how long the triage decision usually takes, how it is communicated and whether the child joins a waiting list from referral or acceptance. If the service requests more information, respond to the stated question instead of resending the entire file. Keep a dated copy of each version.

If the referral is accepted, confirm what the child is waiting for. Some pathways assess one condition; others may consider more than one. Acceptance into an autism pathway does not silently include ADHD assessment, medication or every developmental question.

Track without chasing blindly

Record the referral date, service, reference number, stated timescale and contact route. Follow up if acknowledgement or a decision does not arrive when promised. Update the service with significant new clinical or functional information, not weekly repetitions of the same file.

Ask who should manage new symptoms during the wait. The assessing team may not yet hold clinical responsibility.

If the family moves, the child changes school or contact details change, notify the service through its stated route and ask whether the referral transfers. Do not assume one waiting list follows automatically across commissioning areas or national borders.

Before closing the referral conversation, ask the child whether the summary represents what they want understood. They may add one priority the adult record has missed.

A good referral is not a performance of certainty. It gives the correct service enough clear, source-labelled information to decide the next assessment step and leaves current support moving.

Sources

1. NHS, ADHD in children and young people
2. NHS, Autism assessments
3. NICE, Autism spectrum disorder in under 19s: recognition, referral and diagnosis
4. NHS England, Patient choice guidance