frequently asked questions

• what is different about pebble?

  Pebble emerged from a desire to make things better. We set up Pebble in early 2020. At that time most diagnostic services were using an outdated medical-model that ignored the emerging research into real life autistic experiences. People were telling us that their experiences of assessment were often very clinical and the language used made them feel worse about themselves. We combined our experiences of having worked within those systems with an understanding of new developments in the understanding of neurodiversity to create a service that was fully accessible and sensitive to the needs of our clients and one they could trust to provide outcomes and reports that were accepted by schools, local authorities, the NHS and other agencies. We want people to leave us having had a positive experience and feeling better about themselves and the future.

• will I have to travel for my assessment?

  Wherever possible we like to meet everyone we assess face to face in the rooms we rent in Leamington Spa. Home and/or school visits can be arranged if required depending on geographical location and individual need. In some circumstances, for adults and older teens, we will conduct an assessment online if this is the client’s preference.

• does pebble autism follow nice guidelines for autism and adhd assessments?

  Yes, absolutely. Our autism and ADHD assessments are provided by fully qualified and registered professionals. We have a Chartered Clinical Psychologist and a Specialist Speech and Language Therapist in our multidisciplinary team because each of us brings a different professional specialism, as per the guidelines. Both Chris and Sue have worked in NHS assessment services earlier in their careers and understand the requirements well. As well as using NICE recommended assessment tools such as the ADOS-2 for autism assessments and the QbCheck (a computer-based assessment tool) for ADHD assessments, we take a detailed developmental history to ensure any features of autism/ADHD have been present throughout the life span and are alert to the possible presence of other co-occurring conditions or alternative diagnoses.

• does pebble autism use the DSM V criteria?

  Yes. We acknowledge that the current requirements of the medical and educational establishment require us to use the DSM V. We are however, mindful of the criticisms that have been levelled at the negative framing of the criteria and the emphasis it has on observable behaviours rather than lived-experience. We therefore also draw on new research and innovations in the understanding that are currently helping to reframe the understanding of autism and ADHD such as the work by Damian Milton on Double Empathy and the theory of Monotropism. This emphasis on understanding rather than simply labelling behaviour, puts the individual at the centre of what we do. This is one of the things that makes Pebble different and one of the reasons that many of our clients choose us.

• can you prescribe ADHD medication if required following a diagnosis?

  No. We do not have any prescribing clinicians at Pebble. If you feel you may want to try medication we recommend that you seek an assessment with a Psychiatrist (or Paediatrician for a child or young person) who can prescribe medication.

• why should I consider an assessment for my child?

  The decision about whether to have an autism or ADHD assessment is highly personal. Having a diagnosis can help children and young people in many ways but it can make a big difference how this is done. If a child or young person is able to learn about their neurodivergence in a way that helps them to feel more comfortable in their identity and be better able to advocate for themselves it can be a very positive experience. People who learn at a younger age about their sensory needs, how to manage their energy levels, what their communication style is and how they can work with, rather than against their neurology are more likely to develop into adults who are able to be compassionate with themselves and create ways of living, learning and working that work for them.

  Often it is the child or young person who wants the assessment because they know they are ‘different’ but don’t know why. Having a diagnosis can be very validating and provide a sense of belonging to a wider community. A diagnosis with a robust description of the child/young person can also help schools, colleges and universities to put in place accommodations that make life easier, safer and more enjoyable.

• i am an adult. what should i consider before deciding whether to have an assessment?

  This can be a hard decision. Many of the adults we have assessed have described how validating the experience was. However, the process and the outcome of an assessment can sometimes throw up difficult questions and emotions. During the assessment process we will need to learn about your childhood and teens as well as exploring how life is for you now. We try to guide these conversations in a way that keeps you feeling safe while helping you to make sense of those experiences in the context of possible neurodivergence. You can discover more about how receiving a diagnosis might feel on the Embrace Autism blog.

• i don’t want my parents involved, or they cannot be. can I still have an assessment?

  Yes. Families can be complex and many people seeking an assessment choose not to involve their parents in the assessment process for a variety of reasons.

• i have had some very difficult experiences in my life. will I have to talk about them?

  No. Your mental and emotional safety is a priority to us. Both Chris and Sue will be sensitive to any trauma you have experienced and you will not be asked about any subjects that you would prefer not to talk about.

• will the diagnosis and report be accepted by schools, NHS services and local authorities?

  Yes. Sue and Chris are both members of their respective professional bodies and are registered with the Health and Care Professions Council. NHS clinicians belong to these same bodies which have robust codes of professional conduct. We have both worked in diagnostic services in the NHS. All our autism and ADHD assessments follow NICE Guidelines. We have never had any professionals or organisations challenge our conclusions or refuse to accept our reports and recommendations. We have consistently received positive feedback from other professionals working within the NHS.

• what if my child is too anxious to attend the face to face meeting?

  This is rare but it can happen. Many of the children we see experience high levels of anxiety and that can impact on their ability to attend appointments. If we are aware that a child may struggle we can offer a video call before the face to face meeting to introduce ourselves and help the young person get to know us better. In the past we have also met young people in the park across from the clinic rooms initially to help them with the transition to the clinic. Some families bring their dogs or important attachment objects. On other occasions we have seen children remotely and have conducted home visits where necessary. If the person being assessed needs support communicating we will take whatever steps are necessary to facilitate this.

• can I stay with my child during the assessment?

  If your child would prefer you to stay in the room with them this can be accommodated. We generally ask that parents sit quietly and passively and do not get involved in the assessment process. There is always flexibility around how we carry out the assessments though and we will work with you on the day to make sure that everyone feels as safe and happy as possible.

• will I get any support following the assessment?

  We offer everyone a free follow-up meeting to discuss the report and recommendations and next steps. For children, young people and families this is tailored to your needs and can be for the young person, for parents or for you all together. When you take this is your choice. Some people want to meet again soon after their assessment. Other people might want to wait a few months. You can have this session with Chris or Sue. Many people prefer to use video calling for their follow-up session to avoid the need to travel. For adults this meeting can be a good opportunity to discuss the feelings that came up during the assessment process.

• what is included in my reports?

  Each report includes a summary of the assessment, a profile of the person being assessed and is accompanied by a set of recommendations tailored to the individual, this might include links to various websites, recommended reading, podcasts to listen to etc. We pride ourselves on the fact that all of the material we signpost individuals and families to is created by autistic/ADHD creators. We can help you access really good quality up to date information and advice that is hard to find from a simple internet search.

• do we have to share all of the information in the report with the school or our GP?

  No. We always provide a summary report that just contains the outcome of the assessment and any recommendations. There is no additional fee for this.