When your child doesn't get a diagnosis
You waited months for the assessment, and the answer was 'no diagnosis'. That can feel like being sent back to the start, as if the struggles you see every day have been ruled not to count. They count. A diagnosis is a threshold decision made on one afternoon's evidence, not a verdict on your child's needs, and support in the UK doesn't require one.
What to do, step by step
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Read what the report actually says
Even without a diagnosis, the report should describe what the team found, your child's strengths and the areas where they need help. Those findings don't expire because a diagnostic threshold diagnostic threshold The point at which an assessment team decides a child's difficulties match a recognised set of criteria. Being below it does not mean the difficulties are not real. Read the full definition of diagnostic threshold wasn't met. They're written, professional evidence of need, and you can use them with school and anyone else supporting your child.
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Ask the team to explain the decision
Ask which criteria weren't met and why, what they'd recommend instead, and whether reassessment later makes sense, the NHS notes that for some children the signs simply aren't clear yet, and you may be asked to wait until your child is older to be assessed again. Get the answers in writing if you can.
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Keep school support going
SEN support SEN support The everyday help a school in England puts in place for a child with special educational needs. It is based on what your child needs, not on having a diagnosis. Read the full definition of SEN support at school is based on your child's needs, and those haven't changed. Take the report's findings to the SENCO SENCO The teacher in your child's school who leads support for children with special educational needs. They are usually the quickest person for a parent to reach. Read the full definition of SENCO and ask for the support plan to be kept, or strengthened, around them. If your child's needs are significant, you can still ask your local authority for an EHC needs assessment: a diagnosis is not a requirement.
SEN support at school (GOV.UK) Extra SEN help and EHC plans (GOV.UK)
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If you disagree, you have options
You can ask the GP GP Your family doctor. For many families the GP is the first person to talk to, and the person who refers your child on to a specialist. Read the full definition of GP or the assessment team to refer your child to another team for a second opinion second opinion Asking to have your child seen by a different team when you do not agree with the outcome of an assessment. You can ask, and asking is normal. Read the full definition of second opinion . Some families pay for an independent assessment outside the NHS, if you're considering that, check first how a private report would be used by your NHS services and school, as recognition varies. And if you feel the process itself went wrong, PALS at the NHS trust can help you raise it.
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Keep your records alive
Needs change as children grow, and a 'no' now doesn't close the door: new evidence can support a re-referral re-referral Asking for your child to be referred again, later, when things have changed or new evidence has built up. A no now is not a no forever. Read the full definition of re-referral later. Keep dating your notes, keep copies of school reviews, and keep the assessment report Assessment report The written report you get at the end of an assessment. You are entitled to your own copy, and you can ask for factual mistakes to be put right. Read the full definition of Assessment report with them, the next conversation starts further forward than the last one did.
Worth gathering
- The assessment report and the written reasons given
- Dated notes of new or changing difficulties since the assessment
- School reviews, reports and SEN support plans
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Keep supporting the needs you can see
You didn't imagine any of it, and the day-to-day work of supporting your child never depended on the label. Strategies target needs, not diagnoses: understanding exactly where your child struggles and where they shine is the foundation, with or without a diagnosis.
Common questions
Can my child be referred again?
Yes. If difficulties persist or new evidence emerges, ask your GP or school about a re-referral. Assessment teams expect some children to come back as they get older and the picture becomes clearer.
Was I wrong to push for an assessment?
No. 'Below the diagnostic threshold' does not mean 'fine'. You saw something real, the assessment report almost certainly confirms parts of it, and acting early is exactly what you're supposed to do.
Should we pay for a private assessment?
It's an option some families take. Before spending the money, check with your GP and your child's school how a private diagnosis would be recognised locally, acceptance varies between NHS services and local authorities.
Who can help us challenge decisions about school support?
IPSEA and your local SENDIASS both give free advice on SEN support, EHC needs assessments and appeals. Search your council's name plus 'SENDIASS' to find your local service.
Where next on the journey
Your child doesn't need a diagnosis to get support
Start with a profile of your child. See what we find. Go from there.
Sources
- How to get an autism assessment (if you do not agree with the result) , NHS
- Children with special educational needs and disabilities (SEND): SEN support , GOV.UK
- Children with special educational needs and disabilities (SEND): Extra help , GOV.UK
- What is PALS (Patient Advice and Liaison Service)? , NHS