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Autism is a lifelong neurodevelopmental difference that shapes how a person perceives, experiences, and interacts with the world. It means your child may learn, communicate, and process information in ways that are unique to them. While autism can bring challenges, such as difficulties with social interaction or sensitivity to sensory input, it also brings individual strengths and perspectives. Understanding and celebrating these differences supports autistic children can thrive and be themselves.
For example, autistic people may:
Find communication and social interaction challenging
Have difficulty understanding how others think or feel
Become overstimulated more easily or need more stimulation
Become anxious or upset in unfamiliar situations or social events
Take longer to process information
Repeat certain actions or thoughts
Struggle with changes to routines or unexpected changes
These differences are part of what makes every autistic person unique.
The prevalence of autism in the general population in East Berkshire is estimated at 1% or 4441 people in 2020 rising to 1.5% by 2039 (6991 people).
Autism presents differently in every individual, but there are some common signs that can appear. Being aware of these indicators may help you seek the right support.
For younger children you might notice that your child:
Doesn’t always respond when you call their name
Tends to avoid eye contact
Rarely smiles back at you when you smile
Gets very upset by certain tastes, smells, or sounds
Shows repetitive movements, like hand-flapping, finger-flicking, or rocking
Speaks less than other children their age
Engages less in pretend play
Repeats the same words or phrases
Seem not to understand what others are thinking or feeling
Use unusual speech patterns, such as repeating phrases or talking “at” people
Prefer a strict routine and become very distressed by changes
Develop strong interests or hobbies and focus on them intensely
Get very upset if asked to do something they don’t want to do
Find making friends difficult, or prefer to spend time alone
Take things literally, for example, not understanding jokes or common expressions like “break a leg”
Struggle to put their feelings into words
Autism can look different in girls compared to boys. Due to this, autism can be harder to spot and diagnose in girls and women. Autistic girls may:
Hide signs of autism by copying how other children behave and play (masking)
Withdraw or become quiet in situations they find challenging
Seem to cope better socially, especially in structured environments
Display fewer repetitive behaviours.
Difficulty understanding what others are thinking or feeling
Feeling anxious in social situations
Preferring to be alone or finding friendships hard to maintain
Seeming blunt, uninterested, or awkward (often unintentionally)
Struggling to express emotions or describe how they feel
Taking language very literally, and not always understanding sarcasm or idioms
Needing a fixed daily routine and feeling anxious if it changes
There are additional behaviours or experiences that might suggest autism at any age:
Not picking up on social “rules” (such as not talking over someone)
Avoiding eye contact
Feeling uncomfortable with physical closeness, or needing more personal space
Noticing small details, patterns, or sensory stimulus that others may miss
Intensely focusing on specific interests or topics
Preferring to plan carefully before starting activities
Recognising these signs is a step towards understanding and supporting autistic people.
Please read the information from Berkshire Healthcare NHS Foundation Trust if you are wondering if a child or young person may benefit from an assessment for autism. This will guide you through the best way to help the child or young person.
Their team is made up of speech and language therapists, psychologists, community paediatricians (West Berkshire), specialist mental health practitioners, specialist nurses, assistant psychologists and administrators.
Initial questionnaires
Between questionnaire and assessment
What happens during an assessment
What happens after the assessment
For more information and advice please click on the following link :
https://cypf.berkshirehealthcare.nhs.uk/adhd-and-autism-neurodiversity/autism/
NICE guidance for autism in children and young people explains the process and standards expected. Click here
Nice guidance for adults can be found here
If you are registered with a GP surgery in England and your GP refers you to a specialist or consultant in mental health, you have the legal right to choose the NHS-qualified provider you wish to be referred to, as long as that provider offers the service elsewhere in England. This right exists for any provider with an NHS commissioning contract, regardless of whether your local Integrated Care Board (ICB) holds a direct contract with them. The provider must deliver services according to NHS-commissioned standards.
Key considerations when requesting a right to choose referral
Provider quality varies: Not all providers deliver the same standard of care.
Wait times may be misleading: The wait times advertised on provider websites are not always accurate or up to date.
Service scope differs: Not all RTC providers assess children or offer post-diagnosis care (such as ADHD medication). This could require a new referral and another wait to access local NHS support for ongoing treatment.
Do your research: Before approaching your GP, research providers to check their wait times, whether they accept new RTC referrals, appointment format (online or face-to-face), travel requirements, and whether post-diagnosis care like prescriptions stays with the provider or transfers to NHS services.
GP must agree to refer: GPs are not obliged to refer under RTC unless they consider it clinically appropriate. Your GP may recommend the local NHS service for consistent guidelines on prescribing, monitoring, and care sharing.
Limited online services: Most RTC providers offer online-only assessments, which may be unsuitable for complex needs, language barriers, or certain learning disabilities. Complex cases might require a broader assessment, and RTC providers may refer you back to local NHS services, leading to new wait times.
Assessment focus: Some providers only assess for ADHD or autism, not both. Uncertainty about the condition could result in incomplete assessments or misdiagnosis.
Ongoing monitoring and assessments: Online-only services for post-diagnostic medication often rely on self-reported measurements (height, weight, blood pressure) from families, which can be inaccurate-especially in children. Alternatively, you might be asked to visit your GP or pharmacy, but these services are not required to assist.
Face-to-face appointments: In-person appointments may require travel to distant locations specified by the provider’s NHS contract. Travel requirements should be discussed before requesting a referral.
Frequently Asked Questions (FAQs)
When does the right to choose apply?
You can exercise your right to choose when:
You receive an NHS referral for your initial or first appointment.
The referral is made by your GP.
The service is led by a consultant (for physical or mental health) or a mental health professional (for mental health).
The provider is commissioned by the NHS in England to deliver the required service.
When does the right to choose not apply?
The right to choose does not apply if:
You have self-referred.
You need urgent or emergency care.
You are already receiving care for the same condition.
The chosen provider or team does not offer the right service for your needs.
You are a prisoner or on temporary release from prison.
You are detained in a secure setting, hospital, or under the Mental Health Act 1983.
The service is commissioned by a local authority outside of a joint agreement or is delivered as primary care.
Can RTC be used for a second opinion after a previous assessment?
Any subsequent referral is at your GP’s discretion based on clinical need and new symptoms or evidence. Second referrals are generally considered only if there are substantial new reasons for re-evaluation.
Understanding your Right to Choose is vital for accessing timely and appropriate care. Doing thorough research, confirming with your GP, and knowing the limits and responsibilities involved helps ensure the best outcome for you or your child.
Deciding when to tell your child about their autism diagnosis is a personal decision. Some parents choose to share this information when their child is quite young (around primary school age), especially as the child becomes aware of differences and starts asking questions. Others wait until their child is older, believing they will better understand the diagnosis.
How should I tell my child?
There is no single “right” way to explain autism, but here are some helpful tips:
Choose the right person: The conversation is best led by someone your child trusts and feels comfortable with. This is often a parent, but sometimes other family members can help.
Pick a calm, familiar setting: Choose a quiet time when you’re both relaxed and in a place where your child feels safe. Avoid moments when your child is anxious or stressed, as new information may be harder to process then.
Minimise interruptions: Give your child time to absorb the information and ask questions without feeling rushed. It might take days for them to process what they want to know.
Start with strengths and differences: A good way to begin is by discussing everyone’s unique strengths and challenges in your family, including your child’s. You can then explain that the pattern your child has is known as autism.
Explain variability: Let your child know that autistic people share some common traits but are all different, and that it’s okay to be unique.
How might my child react?
Reactions will vary. Some children may feel relieved and happy to better understand themselves. Others might worry that something is seriously wrong, so it’s important to reassure them that autism is not a disease and does not affect health in that way. Speak positively about autism, but acknowledge any frustrations or upset.
You might explain that your child has particular strengths and that they may receive support at school, like help from a teaching assistant for things they find challenging.
Supporting ongoing conversations
Be available for questions and discussions. Some children may find it easier to communicate privately through a question box, diary, or texts. Try giving them space and time to process information.
What if my child wants to meet other autistic children?
Meeting others who share similar experiences can be very reassuring for many children. Support groups or local autistic communities can provide opportunities for social connections and understanding.
What if my child wants to tell their friends?
If your child wants to share their diagnosis at school, you can discuss with teachers about how to help foster inclusion and support among classmates. Work with them to practise conversations with their friends.
Your child’s school special educational needs coordinator will be able to advise as each school must follow national guidance on the inclusion of children and young people with Autism in schools and further educational settings.
Berkshire Healthcare Children, Young People and Family services website has some useful information regarding what support options schools can offer. Click here
The National Autistic Society (NAS) has created advice for parents and carers and teachers on a range of educational topics for children and young people who have been diagnosed with autism. Click here
Ambitious about Autism practical toolkit contains a wealth of straightforward information in one place to guide parents and carers through their child’s journey in the early years. From the autism assessment process to the first day of school, this toolkit is packed with practical tips and checklists to support parents during the earliest years of their child’s life. It also provides signposts to sources of support or additional information. Click here
IPSEA: Independent Provider of Special Education Advice: information and training on the support disabled children are legally entitled to at school, including Education Health and Care Plans (EHCPs). Click here
Transition plans are required only in special circumstances if a young person is transitioning into adult services. The plan will be co-created with stakeholders in children and adult services and take account of the young person’s wishes and needs.
This link may help a young person understand what a transition plan is Click Here
NICE guidance on transition can be found here Click Here
The Royal College of Paediatricians also provides guidance on what a good transition plan should contain here Click Here
Autism Berkshire: an autism charity delivering specialist services, training and social and leisure activities throughout the county Click Here
Berkshire Healthcare Foundation NHS Trust Autism assessment team for children and young people Click Here
Berkshire Healthcare Foundation NHS Trust Autism assessment team for adults Click Here
Parenting Special Children; provide specialist parenting support to parents and carers of children and young people with Special Needs, so that they can create positive change in their lives Click Here
The Autism Group is committed to supporting and enhancing the lives of young people on the spectrum, their parents, and carers. The group focuses on offering support and social opportunities primarily for those of secondary school age and over, together with parent support and training Click Here
Bracknell Forest Council SEND Local Offer: a guide to services available for children and young people in Bracknell Forest with special educational needs and/or disabilities aged from birth to 25. Click Here
Bracknell Forest Council Information, Advice and Support Service: provides confidential and impartial advice, information and support to parents or carers and children and young people who have, or may have, Special Educational Needs and Disabilities (SEND) in Bracknell Forest. Click here
Bracknell Forest Community Team for People with Autistic Spectrum Disorder support adults aged 18 and over with a primary diagnosis of autism Click Here
RBWM SEND Local Offer: provides information on local services and support available for families including children and young people aged 0 – 25 years with special educational needs or disabilities Click Here
RBWM Information, Advice and Support Service: free, impartial, and confidential information, advice and support to children and young people with Special Educational Needs and Disabilities (SEND) up to age 25, and their parents/carers. Click Here
Slough’s Local Offer provides information about services, support and activities for children and young people with special educational needs and disabilities (SEND) aged 0-25 The service covers early years and childcare, education, health and wellbeing, care and support for families and other services in Slough Click Here
Slough SENDIASS – Information Advice and Support Service: a confidential and impartial support and advice service for parents, carers and children and young people (aged up to 25 years) on issues to do with special educational needs and disabilities Click Here
Afasic: support for families of children who have Speech Language and Communication needs, including those resulting from autism Click Here
Ambitious About Autism they run specialist education services, an award-winning employment programme and children and young people are at the heart of our charity’s decision-making, policy work and campaigning. Click here
Autism Education Trust (part of the National Autistic Society): downloadable information for parents and carers as well as for schools and teachers Click Here
Autistica: is a charity which funds research into autism Click Here
Choice Support: social care charity working across England to provide the best possible support to people with learning disabilities, autism and mental health needs Click Here
Communication Matters: is a UK-wide organisation that supports people of all ages who find it hard to communicate because they have little or no clear speech Click Here
NHS Choices: Overview of Autism Click Here
National Autistic Society: the UK’s leading charity for people on the autism spectrum and their families, providing support, guidance and advice Click Here
National Autistic Taskforce: established to give autistic adults a stronger voice, especially those with the highest support needs Click Here
Neuro Diverse Self Advocacy: a not-for-profit organisation by autistic volunteers, offering an online forum and community of neurodivergent people who support each other Click Here
The Curly Hair Project: supports people on the autistic spectrum and the people around them, founded by autistic author Alis Rowe, using animated films, comic strips and diagrams Click Here
National links for disability
Cerebra: children with a brain condition: advice and support on subjects including education, Disability Living Allowance (DLA), toilet training and sleep Click Here
Choice Support: social care charity working across much of England to provide the best possible support to people with learning disabilities, autism and mental health needs Click Here
Contact: for families with disabled children: supporting families with the best possible guidance and information Click Here
Disability Law Service:– free advice via information, factsheets, training courses and telephone and written advice in areas relevant to people with disabilities and their carers Click Here
IPSEA: Independent Provider of Special Education Advice: information and training on the support disabled children are legally entitled to at school, including Education Health and Care Plans (EHCPs) Click Here
Mencap: The Voice of Learning Disability: information about learning difficulties and learning disabilities related to autism, Down syndrome and other conditions Click Here
Sibs: for siblings of disabled people: Sibs aims to enhance the lives of siblings of disabled people by providing them with information and support, and by influencing service provision throughout the UK Click Here
Sunflower: Hidden Disabilities: information about Sunflower lanyards, increasingly used to discreetly indicate to people around you including staff, colleagues and health professionals that you have a hidden disability and you may need additional support, help or more time Click Here
ERIC: treatment, prevention, causes, types and living with continence issues Click Here
Ways Into Work: Supported Employment, Supported Internships, Recruitment and Workplace Support for disabled people Click Here
Childline: support for children’s metal health online and by telephone Click Here
ACAMH: Association for Child and Adult Mental Health: online portal with professional seminars on topics related to autism and ADHD Click Here
Anxiety UK: supporting people with anxiety, stress, anxiety-based depression or a phobia with downloadable guides and online or helpline support Click Here
CALM: Campaign Against Living Miserably (mental health support for men): a free and confidential helpline and webchat – 7 hours a day, 7 days a week for anyone who needs to talk about life’s problems Click Here
Family Lives: supporting parents and families in crisis: family support services offered through helpline, and offering tailored support around issues such as bullying, special educational needs, and support for specific communities Click Here
Mental Health Foundation: aims to find and address the sources of mental health problems so that people and communities can thrive, to help people understand, protect and sustain their mental health Click Here
The Samaritans: 24 hours a day suicide prevention support online or by telephone Click Here
Young Minds: fighting for children and young people’s mental and emotional health. Support for parents and carers as well as young people Click Here
Mind: mental health charity: provide advice and support to empower anyone experiencing a mental health problem Click Here
Harmless: Self Harm Support: a national voluntary organisation for people who self-harm, their friends, families and professionals Click Here
Emotionally Related School Avoidance (ERSA) sometimes called Emotional Based School Avoidance (EBSA) is when a child or young person finds it difficult to go to school because of strong emotions or worries. This isn’t just about “not wanting” to go to school. Instead, it’s usually because something feels overwhelming for your child, whether it’s things happening at school, at home, or in their wider life.
ERSA can sometimes be hard to notice at first. Some children might still go to school but feel very anxious and find it difficult to cope, while others might avoid school completely for a long time. The early signs are often small and easy to miss, but they show that a child might be vulnerable. If the early stages are missed, the problems can become worse. It’s important to remember that most children and young people with ERSA really want to go to school; they just struggle with feelings of anxiety and don’t always know how to handle them.
Rising Absence and the need for support
The 2022 Attendance Audit by the Children’s Commissioner revealed that in Autumn 2021, 1 in 4 children were identified as persistently absent from school. In comparison, the rate in 2018/2019 was 1 in 9—this shows a significant increase in persistent absence over a short period.
The ERSA Toolkit
To address these challenges, an ERSA guidance and toolkit has been created and distributed to all schools across the Royal Borough of Windsor and Maidenhead. This toolkit is designed to help schools provide early intervention and support for students experiencing ERSA.
Key features of the toolkit include:
A graduated response guide to determine the best resources, actions, and referrals at different stages and severity of ERSA.
Practical strategies for early recognition and support to help children re-engage with school.
A clear framework for communication between schools, families, and external professionals.
If you are a parent or carer concerned about school avoidance in your child, or a professional looking for resources, the guidance and ERSA toolkit can be invaluable aids in shaping the right support and ensuring every young person has the best possible chance to attend and thrive at school.
Here are some helpful links:
IPSEA- Click here
Not fine in school- Click here
Pookynight smith- click here
