Show the full module text
Module 3 — Choosing a Service, and What to Ask
The routes that actually exist, what genuinely differs between them, what is known about waiting and cost, and the questions to put to a service before you give anyone money.
The Assessment · Part One — Before you book
The big idea
Short on capacity today? The big idea: Module 2 ended with a finding that sounds like an obstacle and is really an instruction: what predicts a sound assessment is specific experience and structure, not the profession on the letterhead. Neither of those is printed on a website. Both of them are answerable by asking.
So this module does two things. It sets out the routes that exist and what is actually known about them — which turns out to be less than you would hope, and the gaps are worth knowing about in advance. Then it gives you the questions.
One thing said before anything else, because it should colour how you read the rest.
This course makes no referrals and receives nothing. New Path Family is a nonprofit. It employs no clinicians, provides no assessment, and takes no commission, revenue share or fee of any kind if you go anywhere named or unnamed on this page. Nothing below is a recommendation. It is a description of a landscape and a list of questions.
Step 1 — The lesson
A. The four routes
1. A public health service. Where a country has one, this is usually the first route and usually free at the point of use. In England, the NHS describes the path plainly: speak to a GP, who can refer adults to a local autism team; you may also be referred when you are already being helped with something else, if a mental health professional notices signs and recommends it. The NHS’s own page says that once a referral is accepted “it can take a few months or longer” to get an assessment, and — usefully — that if you cannot get a referral you can ask to speak to another GP, which it names as getting a second opinion.
England has one additional mechanism worth knowing by name. Right to Choose: the NHS states that in England you can choose which NHS service does the assessment, and that you may be able to find a clinic with shorter waiting times this way. The assessment is still NHS-funded. This is the single most under-used option in the English system.
2. Private or independent practice. Fastest, most variable, and the one you pay for. In England this category overlaps confusingly with the public one, because independent-sector providers also deliver NHS-funded assessments under patient choice — so “private clinic” and “NHS assessment” are not opposites, and it is worth asking which basis yours is on.
3. A university or teaching clinic. Assessments carried out by supervised trainees inside a department that teaches this work. Usually cheaper, sometimes free, waiting lists often shorter than public services. The supervision is real and the structure is often unusually good, because teaching clinics run to protocol. The trade is scheduling: they work to academic terms, and they are not available everywhere.
4. An integrated practice — one that assesses and then continues to work with you therapeutically, rather than assessing and discharging. This is one model, not the norm, and it is neither better nor worse in the abstract. What it changes is what happens on the day after the answer. If continuity matters to you, ask about it directly; if you want assessment only, ask whether they take people who want assessment only, because some integrated services do not.
Diagram — A · Four routes, and the difference is not which. One: a public health service. Where a country has one, this is usually the first route and usually free at the point of use. In England the NHS describes the path plainly: speak to a GP, who can refer adults to a local autism team, and you may also be referred when you are already being helped with something else, if a mental health professional notices signs and recommends it. The NHS's own page says that once a referral is accepted it can take a few months or longer to get an assessment, and that if you cannot get a referral you can ask to speak to another GP, which it names as getting a second opinion. England has one additional mechanism worth knowing by name: Right to Choose. The NHS states that in England you can choose which NHS service does the assessment, and that you may be able to find a clinic with shorter waiting times this way; the assessment is still NHS-funded. It is the single most under-used option in the English system. Two: private or independent practice — fastest, most variable, and the one you pay for. In England this category overlaps confusingly with the public one, because independent-sector providers also deliver NHS-funded assessments under patient choice, so private clinic and NHS assessment are not opposites and it is worth asking which basis yours is on. Three: a university or teaching clinic, where assessments are carried out by supervised trainees inside a department that teaches this work. Usually cheaper, sometimes free, waiting lists often shorter; the supervision is real and the structure is often unusually good, because teaching clinics run to protocol. The trade is scheduling: they work to academic terms, and they are not available everywhere. Four: an integrated practice, one that assesses and then continues to work with you therapeutically rather than assessing and discharging. This is one model, not the norm, and it is neither better nor worse in the abstract; what it changes is what happens on the day after the answer. If continuity matters to you, ask about it directly, and if you want assessment only, ask whether they take people who want assessment only, because some integrated services do not.
B. What actually differs between them
Not the criteria. Everyone is working from the same diagnostic manual. What differs is everything around it, and four differences matter enough to ask about.
Who assesses, and how much structure they work inside. Module 2’s whole argument. This varies far more between individual services than between the four categories above.
Whether the resulting document is portable. This is the difference people discover last and regret most. The report you receive is not automatically accepted everywhere. NHS England’s own independent ADHD Taskforce names the problem directly: people with ADHD “encounter challenges when a provider diagnosis of ADHD is not recognised or accepted or when they move geographical area”, with duplication of work and difficulty negotiating different systems. That is a national body describing a national problem, not a rare mishap.
What is included, and what is extra. Sessions, instruments, informant involvement, the written report, an accommodation or adjustment letter, a follow-up conversation, onward treatment. Two services quoting similar totals can be selling substantially different things.
Whether anyone is checking the quality. The same taskforce report recommends introducing “more transparent and clear regulation of ADHD service providers as well as auditable quality control for commissioners” — a recommendation that only makes sense if that transparency is not currently there. It goes further, and this is the sentence to remember when a website tells you its clinicians are appropriately qualified: the report states there is “an urgent need for NHS England/DHSC to collaborate with NICE to explicitly define what is meant by an appropriately ADHD qualified healthcare professional.”
Read that twice. In the system that requires an appropriately qualified professional, the phrase is not yet defined. Which is exactly why section E is a list of questions rather than a list of credentials to look for.
Diagram — B · The same brick, two walls. Not the criteria: everyone is working from the same diagnostic manual. What differs is everything around it, and four differences matter enough to ask about. Who assesses, and how much structure they work inside — Module 2's whole argument — varies far more between individual services than between the four route categories. Whether the resulting document is portable is the difference people discover last and regret most: the report you receive is not automatically accepted everywhere, and NHS England's own independent ADHD Taskforce names the problem directly, saying that people with ADHD encounter challenges when a provider diagnosis of ADHD is not recognised or accepted or when they move geographical area, with duplication of work and difficulty negotiating different systems. That is a national body describing a national problem, not a rare mishap. What is included and what is extra covers sessions, instruments, informant involvement, the written report, an accommodation or adjustment letter, a follow-up conversation and onward treatment — two services quoting similar totals can be selling substantially different things. And whether anyone is checking the quality: the same taskforce report recommends introducing more transparent and clear regulation of ADHD service providers as well as auditable quality control for commissioners, a recommendation that only makes sense if that transparency is not currently there. It goes further, and this is the sentence to remember when a website tells you its clinicians are appropriately qualified: the report states there is an urgent need for NHS England and the Department of Health and Social Care to collaborate with NICE to explicitly define what is meant by an appropriately ADHD qualified healthcare professional. In the system that requires an appropriately qualified professional, the phrase is not yet defined — which is exactly why the module ends in a list of questions rather than a list of credentials to look for.
C. Waiting — what is known, and what is not
Here the honest answer is uncomfortable, and the discomfort is the finding.
For adult ADHD in England, there is no national waiting-time statistic at all. The independent ADHD Taskforce’s second report states it in five words: “There are no national reports on waiting times for adults.” What exists instead is survey evidence, which the report cites: in a national survey of commissioners, primary care clinicians and people with lived experience, 40 per cent reported waiting times of two years or more.
The report also passes on a more extreme claim — that waiting lists “are reported to have increased to 10–15 years in some areas of the UK.” Treat that one differently from the 40 per cent, and here is why: the taskforce tags every claim it makes with its own two-part quality grading, and for both sources behind the 10-to-15-year figure the first of those two tags reads “low”. It is in this module because a national body thought it worth reporting, and it is labelled here because the same body labelled it. It is a report of the extreme, not a national average.
For autism in England there is a national count, and it is large. In June 2026, 294,792 people had an open referral for suspected autism, and 86.8 per cent of them — 256,017 — had been waiting at least thirteen weeks. That figure is carried from Module 1 rather than re-read for this one; the verification note explains exactly why, and the honest reading is that it describes referrals of all ages, not adults specifically.
Diagram — C · Four claims about waiting, one of them blank. Here the honest answer is uncomfortable, and the discomfort is the finding. For adult ADHD in England there is no national waiting-time statistic at all: the independent ADHD Taskforce's second report states it in five words — there are no national reports on waiting times for adults. What exists instead is survey evidence, which the report cites: in a national survey of commissioners, primary care clinicians and people with lived experience, 40 per cent reported waiting times of two years or more. The report also passes on a more extreme claim, that waiting lists are reported to have increased to 10 to 15 years in some areas of the UK. Treat that one differently from the 40 per cent, and here is why: the taskforce tags every claim it makes with its own two-part quality grading, and for both sources behind the 10-to-15-year figure the first of those two tags reads low. It is in this module because a national body thought it worth reporting, and it is labelled here because the same body labelled it. It is a report of the extreme, not a national average. For autism in England there is a national count, and it is large: in June 2026, 294,792 people had an open referral for suspected autism, and 86.8 per cent of them, 256,017, had been waiting at least thirteen weeks. The honest reading is that it describes referrals of all ages, not adults specifically. Three things follow for you personally. Ask the service for its own current waiting time, in writing, and ask what it measures from — referral received, referral accepted, first appointment, report issued? Services quote different clocks and the difference can be a year. A national figure is not your figure, because waits vary enormously by area, and in England Right to Choose exists precisely because they do. And get on a list while you decide: being on a waiting list costs nothing and commits you to nothing, while deciding first and joining later costs you the whole wait.
Three things follow for you personally:
- Ask the service for its own current waiting time, in writing, and ask what it measures from. Referral received? Referral accepted? First appointment? Report issued? Services quote different clocks and the difference can be a year.
- A national figure is not your figure. Waits vary enormously by area, and in England Right to Choose exists precisely because they do.
- Get on a list while you decide. Being on a waiting list costs nothing and commits you to nothing. Deciding first and joining later costs you the whole wait.
D. Cost — what published sources actually show
Almost nobody publishes what an assessment costs. What governments publish is what they will pay, which is a different number and a more useful benchmark than it first appears.
Australia’s Medicare Benefits Schedule is the clearest published example, and it is the government’s own list. Three items, all with schedule fees updated on 1 July 2026:
Item. 291. What it covers. Consultant psychiatrist attendance over 45 minutes on GP referral, including a comprehensive diagnostic assessment and a mental state examination. Schedule fee. AUD 549.90. Medicare benefit. 85 per cent — AUD 467.45.
Item. 289. What it covers. Consultant psychiatrist attendance of at least 45 minutes, patient under 25, where a comprehensive assessment leads to a diagnosis of a complex neurodevelopmental disorder such as autism, plus a written treatment and management plan. Schedule fee. AUD 320.55. Medicare benefit. 75 per cent — AUD 240.45; 85 per cent — AUD 272.50.
Item. 82000. What it covers. Eligible psychologist assisting the referring doctor with diagnostic formulation, patient under 25. Schedule fee. AUD 119.45. Medicare benefit. 85 per cent — AUD 101.55.
Two things to take from that table, neither of which is the numbers themselves.
First, a schedule fee is not a price. It is what a government sets as the benchmark against which it pays a benefit. Practitioners are generally free to charge more, and the difference between the fee charged and the benefit paid is the patient’s. Any published fee schedule anywhere works this way. It tells you what a system thinks the work is worth, not what you will be invoiced.
Second, look at what the items are attached to. The psychiatrist item is priced for one attendance of forty-five minutes or more. The psychologist item is priced as a contribution to someone else’s diagnostic formulation. Neither is priced as “an autism assessment”, because an assessment is not one billable act — it is several, from possibly more than one person. When a private service quotes you a single figure, the useful question is which of these components it contains.
And what is not published anywhere: private assessment prices. No health authority collects them, no regulator publishes them, and a range assembled from provider websites is a range assembled from advertising. This course therefore quotes no private price, in any country. What it can tell you is what NHS England’s taskforce observed about the consequence: very long public waits create “a two-tier system” in which the most disadvantaged groups are the least likely to be able to afford private assessment and treatment. Whatever you are quoted, you are participating in that, and knowing it is better than not.
Diagram — D · A schedule fee is not a price. Almost nobody publishes what an assessment costs. What governments publish is what they will pay, which is a different number and a more useful benchmark than it first appears. Australia's Medicare Benefits Schedule is the clearest published example, and it is the government's own list: three items, all with schedule fees updated on 1 July 2026. There are two things to take from that table, and neither of them is the numbers themselves. First, a schedule fee is not a price. It is what a government sets as the benchmark against which it pays a benefit; practitioners are generally free to charge more, and the difference between the fee charged and the benefit paid is the patient's. Any published fee schedule anywhere works this way. It tells you what a system thinks the work is worth, not what you will be invoiced. Second, look at what the items are attached to. The psychiatrist item is priced for one attendance of forty-five minutes or more. The psychologist item is priced as a contribution to someone else's diagnostic formulation. Neither is priced as an autism assessment, because an assessment is not one billable act — it is several, from possibly more than one person. When a private service quotes you a single figure, the useful question is which of these components it contains. And what is not published anywhere is private assessment prices: no health authority collects them, no regulator publishes them, and a range assembled from provider websites is a range assembled from advertising. This course therefore quotes no private price, in any country. What it can tell you is what NHS England's taskforce observed about the consequence: very long public waits create a two-tier system in which the most disadvantaged groups are the least likely to be able to afford private assessment and treatment. Whatever you are quoted, you are participating in that, and knowing it is better than not.
E. Finding an assessor, without anyone selling you one
The nonprofit position, stated once and in full: we make no referrals and receive nothing. Not a commission, not a revenue share, not a fee, not an arrangement of any kind, wherever you go.
Independent routes to a qualified assessor:
- Your primary care doctor. In systems with a public route this is usually the door, and it is free. In England the NHS’s own guidance is that a GP can refer adults to a local autism team.
- The public system’s own choice mechanism. In England, Right to Choose. Ask your GP to make the referral to a named NHS-funded provider. The NHS page on autism assessments describes this option directly.
- The statutory register. Every regulated profession has one and every one of them is publicly searchable. Ask any assessor which register they are on and under what number, then look them up yourself. It takes two minutes and it is the only credential check that does not rely on the service’s own description of itself.
- National autism and ADHD organisations. The NHS’s own assessment page points readers to the National Autistic Society for how to request an assessment and what to do while waiting. Charities and advocacy bodies in most countries maintain similar guidance, and they take no fee from providers.
- University and teaching clinics. Contact the psychology or psychiatry department of a university near you and ask whether its clinic assesses adults.
- A separate organisation related to this one. New Path Family of Therapy Centers, Inc. is a separate company that provides adult autism and ADHD assessment. Naming it is a connection, not a referral: nothing is received here if you go, and it belongs on this list on exactly the same terms as every other item — to be compared, questioned and rejected like any of them.
Whichever route you take, the questions below are the same.
Diagram — E · Nine questions, before you step in. Send them by email: you want the answers in writing, and a service's willingness to put them in writing is itself one of the answers. One, who will assess me, what is their registration, and which register is it on? Then check the register yourself, and also ask who signs the report if it is someone else. Two, roughly how many adult assessments does that person complete in a year? That is Module 2's evidence in one question: volume with your population, not years in practice. Three, what structured interviews and rating scales do you use, and is an informant involved? You are asking what holds the assessment together, and a service that can name its structure has one. Four, how long is the wait, and what does that measure from and to — referral received, referral accepted, first appointment, or report issued? Ask which, and ask for the current figure rather than the typical one. Five, what exactly is included in the price and what is extra: number of sessions, the written report, an adjustments or accommodation letter, a follow-up conversation, any add-on assessments, and what a copy or a reissue costs later. Six, what document do I receive, and will the specific place I need it accept it? Name the employer, university, insurer or benefits process, then ask that institution the same question independently — the taskforce's finding about diagnoses not being recognised is what this question exists to prevent. Seven, what happens if the answer is no, and what happens if it is something else? Do you still get a report, is there a follow-up conversation, is any of the fee refundable? A service that has thought about this will answer immediately. Eight, if I want to try medication, who prescribes, and do they accept your diagnosis? Ask before booking, because two-step routes are normal and discovering one late is expensive. Nine, what are your adjustments for the assessment itself — written questions in advance, breaks, lighting, cameras off, a support person present, a non-verbal way to answer? Every one of these is a reasonable request, and the answer tells you what kind of service you are dealing with.
F. What helps — the questions to ask before you book
Send them by email. You want the answers in writing, and a service’s willingness to put them in writing is itself one of the answers.
1. Who will assess me, what is their registration, and which register is it on?
Then check the register yourself. Also ask who signs the report, if it is someone else.
2. Roughly how many adult assessments does that person complete in a year?
Module 2’s evidence in one question. Volume with your population, not years in practice.
3. What structured interviews and rating scales do you use, and is an informant involved?
You are asking what holds the assessment together. Module 5 goes through the instruments; for now, a service that can name its structure has one.
4. How long is the wait, and what does that measure from and to?
Referral received, referral accepted, first appointment, or report issued. Ask which. Ask for the current figure, not the typical one.
5. What exactly is included in the price, and what is extra?
Number of sessions, the written report, an adjustments or accommodation letter, a follow-up conversation, any add-on assessments, and what a copy or a reissue costs later.
6. What document do I receive, and will [the specific place I need it] accept it?
Name the employer, university, insurer or benefits process. Then ask that institution the same question independently. The taskforce’s finding about diagnoses not being recognised is what this question exists to prevent.
7. What happens if the answer is no — and what happens if it is something else?
Do you still get a report? Is there a follow-up conversation? Is any of the fee refundable? A service that has thought about this will answer immediately.
8. If I want to try medication, who prescribes, and do they accept your diagnosis?
Ask before booking. Two-step routes are normal; discovering one late is expensive.
9. What are your adjustments for the assessment itself?
Written questions in advance, breaks, lighting, cameras off, a support person present, a non-verbal way to answer. Every one of these is a reasonable request and the answer tells you what kind of service you are dealing with.
Module 4 turns to the other side of the table: what you will actually be asked, what to gather before you go, and how to prepare without rehearsing.
Up next
Module 4 — What You Will Be Asked, and How to Prepare