Assessments – Warrington Neurodevelopment Assessment Pathway Service
Who is involved in the assessment?
The neurodevelopment assessment pathway team includes qualified and non‑qualified staff who are experienced in the assessment and diagnosis of neurodevelopmental conditions. All assessments follow national guidelines and local pathways.
If you are attending for an autism assessment, you may see one or both of the following clinicians:
- a community paediatrician
- a speech and language therapist
If you are attending for an ADHD assessment, you may see one or both of the following clinicians:
- a community paediatrician
- a healthcare assistant for QB testing, if required
The NDP team may also request information from other services involved with your child or young person, including early years practitioners, health visitors, school nurses, teachers, educational psychologists and child and young person mental health services (CYPMHS).
Speech and language therapy
During the assessment process, your child may be referred for an assessment with our colleagues in speech and language therapy.
You may feel this is not necessary, especially if you have never had concerns about your child’s speech or language. However, the speech and language therapist provides essential information about social communication, attention and listening skills. If we request this assessment, we cannot complete our overall assessment without it.
It is important that you opt in to this service and attend any appointments offered.
QB tests
If your child is being assessed for ADHD, the assessment pathway team will refer them for a QB test.
This assessment is completed by the specialist nursing team at the Child Development Centre and usually takes place early in the assessment journey.
Once the test is completed, there will be a wait for an appointment with the paediatrics team, who will interpret the results and provide feedback.
The QB testing team and neurodevelopment assessment team are unable to give results directly, so please avoid calling to request them.
Additional learning needs
In some cases, a child’s school may also have referred them to an educational psychologist. If so, we will request their opinion when we discuss the assessment findings as a team.
What does the assessment journey look like?
Autism pathway
Stage 1: Referral Referrals arrive by email from education (bchft.neurodevelopmentpathwayreferrals@nhs.net) and include a completed CAST (Childhood Autism Spectrum Test) and a graduated response.
Stage 2: Screening / triage The team reviews referrals and questionnaires to decide whether an assessment is appropriate, using NICE guidelines. Triage involves specialist paediatricians and speech and language therapists.
Stage 3: Assessment Assessment includes parent interviews, social communication evaluations (including ADOS if needed), education reports and AQ questionnaires. Paediatricians and speech and language therapists are involved, and a paediatrician always reviews the case.
Stage 4: Outcome The NDP team reviews all information against DSM‑5 criteria for autism. Possible outcomes include:
- diagnosis of autism
- no diagnosis of autism
- inconclusive – more assessment or updated information needed
- ongoing ADHD assessment
A report summarises findings and the rationale. Children may be discharged unless further review is needed.
Stage 5: Post‑assessment support Children diagnosed with autism are referred to specialist nurses for ongoing support (opt‑in). If not diagnosed, the report includes guidance on relevant services.
ADHD pathway
Stage 1: Referral Referrals are received from schools via email (bchft.neurodevelopmentpathwayreferrals@nhs.net) and include a SNAP‑IV questionnaire and a graduated response.
Stage 2: Screening / triage The team reviews referrals and questionnaires using NICE guidelines. Triage involves specialist paediatricians and speech and language therapists.
Stage 3: Assessment Assessment includes:
- QB test
- nursery/school/college reports
- SNAP‑IV questionnaires from school and home
Stage 4: Outcome A face‑to‑face paediatric assessment and developmental history are completed. Outcomes may be:
- ADHD diagnosis and medication initiation
- no ADHD diagnosis
- inconclusive – further assessment or updated information needed
Stage 5: Post‑assessment support Parents may choose medication after diagnosis. Progress is reviewed by phone, and dosage is adjusted as needed. Those diagnosed are referred to specialist nurses for ongoing support (opt‑in). If criteria are not met, the report lists other services for advice or support.
Combined referrals
We receive referrals for both autism and ADHD from educational staff. If the referrer is unsure which assessment is needed, they may request both with parental consent. During screening, our practitioners decide which assessments are appropriate.
If a child is accepted for both assessments, we begin with the ADHD assessment. Once this is underway, we determine whether an autism assessment is still required.
What else can you do while you are waiting?
Parents and carers often want to understand the reasons behind their child’s difficulties. Practical support is available locally while you wait for assessment. You can find this on our useful information section.
Potential assessment outcomes
Our focus is always to identify your child’s strengths and difficulties so they can access the right support.
Sometimes we are able to give a diagnosis of a neurodevelopmental condition such as ADHD or autism.
Sometimes a child’s difficulties do not follow the pattern of these conditions. In these cases, we may not be able to give a specific diagnosis, but we will still signpost you to appropriate support.
What will happen after the assessment?
When your child’s assessment is complete, you will usually be offered a choice:
- a face‑to‑face appointment to discuss the results
- receiving the assessment report by post
If you choose a face‑to‑face appointment, you will still receive the report, but there may be a wait for the appointment.
Most parents choose to receive the report first so they can access the outcome sooner. You should choose whichever option feels right for you.
Sometimes the doctor may request an appointment to discuss the results further, for example if medication needs to be considered.
Once a decision is made, your child’s involvement with the neurodevelopment assessment pathway ends, and you will be given information about the most appropriate support services. In many cases, children are discharged at this point.
What if you don’t agree with the outcome?
Sometimes parents and carers may disagree with the assessment results.
After a full assessment, we do not accept re‑referrals until two years have passed, unless new, significant information becomes available that could have affected the outcome.
In some situations, we may be asked to review the assessment outcome. This involves looking at the existing assessment information and any new details provided, rather than starting a new assessment.
Last updated: Wednesday 01 April 2026