Assessment for people with autism

When I get to see someone ... I don’t always understand what they are asking me. I don’t give complete answers to their questions and they don’t press for additional information. I get upset and often cry, then I feel stupid and they think I’m overemotional or exaggerating my symptoms.

(Autistic person)[13]

Offering an assessment to someone who has autism is a proactive duty for local authorities [20] and health and social care trusts.[31] In the past, many adults with autism, particularly those with Asperger syndrome or high-functioning autism, did not have assessments,[37] and often those assessments that were carried out were in areas with limited training in how to assess people with autism.[38]

The new guidance for the Care Act 2014 [15] stresses the duty to have suitably-trained people conducting assessments. Because many people with autism might have other conditions, as well as physical health issues, assessments must ensure that any underlying support needs related to a person’s autism are considered.[39] This is part of the Care Act 2014’s priority to ensure that people’s wellbeing is reflected in the assessment.[15]


People with autism can find assessments perplexing. While this in part relates to the nature of autism, many carers also report finding assessment processes confusing, so the issue is one that services should address.[40] The Care Act 2014 states that in England people have the right to independent advocacy if they need someone to help them have their say about their care needs, though this role might be carried out by a family member or friend. The Act also states that assessments need to be carried out in a way that is appropriate for the person being assessed.[15] At this time, there is no statutory requirement in place in Northern Ireland, however access to advocacy is recognised as good practice.

Assessing someone with autism can be difficult, because people with autism:

Successful assessment

Preparing in advance and flexibility towards the person with autism may help the assessment capture the right information, and the assessment must be proportionate to the complex nature of autism.[15] If you are conducting an assessment with someone with autism:

You might also want to ask yourself:[42]

While some of these examples are of specific relevance to people with autism, others are simply good practice in any social work or social care assessment.

There are also a number of issues, often connected to autism, which an assessor should consider:[42]

Consider risk factors that may arise from people’s obsessions, dietary problems, social isolation, self-neglect, running/absconding, mental health problems, inappropriate sexual behaviour, self-harm and other factors. Consider too whether the person with autism is also a parent or carer and, if so, how their autism affects how they care for the other person.

The impact of autism should be considered when assessing under the Mental Capacity Act 2005 or the Mental Health Act 2007. For example, someone with autism may have good theoretical knowledge about an issue and appear to have capacity, but in fact are not able to retain or weigh up the information.

The Care Act 2014 requires local authorities in England to consider the strengths and capabilities of people being assessed. This approach emphasises that through building on individuals’ strengths – personal, community, and in social networks – assessments are more likely to support the outcomes that those using services want.[41] There is more about the strengths-based approach in the section on ‘Personalising services’.

For more tips on communicating generally with people with autism, see the ‘Frontline staff’ subsection.

Further reading