ENAn autism assessment in Germany is an evaluation by a child and adolescent psychiatrist, or for adults by a psychiatrist specialising in autism, built on an interview, observation and tests under the German clinical guideline. In plain terms, autism spectrum disorder (ASD) is a difference in development that makes social communication hard and comes with repetitive behaviour and narrow interests. It is called a “spectrum” because it ranges from a child without speech to an adult living independently.
Families travel to Germany for a report from specialists who work to the German clinical guideline and for a clear support plan. The assessment does not promise a “cure”: its purpose is to understand what is going on and what support is needed.
How the Assessment Works: Interview, Observation, Tests
The assessment combines an interview, observation and tests, led by a doctor: for children, a child and adolescent psychiatrist (Kinder- und Jugendpsychiater); for adults, a psychiatrist specialising in ASD. It starts with a detailed conversation with the parents about development since early childhood, usually following the ADI-R, a standard structured interview with a fixed set of questions.
Next, the specialist observes the child in play and conversation using the ADOS-2, a set of tasks in which communication and behaviour are rated. Speech and cognitive abilities are assessed with standard tests.
Other causes are ruled out in parallel: hearing is tested; a general and neurological examination, which the guideline recommends for everyone, is carried out; an EEG, a recording of the brain’s electrical activity, is done if seizures are suspected (see childhood epilepsy in Germany); and genetic counselling is offered when indicated. The doctor also looks at the overlap with ADHD, attention deficit hyperactivity disorder, which often occurs together with ASD. The procedure is set out in the German S3 guideline “Autismus-Spektrum-Störungen im Kindes-, Jugend- und Erwachsenenalter”, part 1 “Diagnostik”.
Language and Age: What a Family from Abroad Should Know
A family from abroad should settle the language question before the trip: tests run in German, and in some hospitals in English. If a child speaks only the family’s language, the team works through an interpreter, which reduces the accuracy of observation. Discuss this with the hospital in advance. Home videos and parent questionnaires completed in the family’s language help.
On age, the German guideline draws on research: a diagnosis on the autism spectrum made before the age of two, when the signs are clear, stays within the spectrum over time, so it should be made and named rather than postponed. If the picture is unclear, the child is observed and reassessed later. Teenagers and adults can be diagnosed too, including those who learn about ASD late.
What Support Is Needed After Diagnosis
Support after diagnosis rests on therapy and practice, because no medicine “treats autism”. The basis is behavioural and developmental programmes (see ABA therapy for children with autism), parent training so that practice continues at home, speech therapy and occupational therapy, which means practising everyday and motor skills.
Medication is prescribed by a psychiatrist, mainly for accompanying problems such as sleep difficulties, severe irritability or ADHD.
Methods without proven benefit, such as stem cells, chelation (drugs given to “remove metals” from the body) and special “autism diets” without a medical reason, are not supported by the German guideline (part 2 “Therapie”): it advises against them altogether, as they can harm health or are ethically questionable. See also stem cell therapy: what is proven. If you are offered such a procedure, calmly ask which studies support it and talk to the treating psychiatrist.
Families’ Reviews of Autism Care: How to Read Them
Other families’ reviews are useful when they answer three questions: who made the diagnosis, a psychiatrist or a “centre”; which methods were used; and whether the family received a written support plan.
A red flag is a promise to “cure” autism in one course of treatment, or paid procedures without a clear indication. More on how to read such accounts is in family reviews of autism care.
Frequently asked questions
Can an autism assessment be done online?
No, a diagnosis cannot be made from videos or messages alone: the German guideline requires direct observation and an in-person examination. Online contact helps around the trip: the hospital receives translated documents and home videos in advance, and later questions about the support plan can be discussed by video.
What should we bring to the assessment?
Bring anything that describes development since early childhood: doctors’ reports, earlier test results, reports from nursery and school, and home videos. The German guideline explicitly advises drawing on medical reports, test results and school reports, so that the picture of early development is as objective as possible.
Will a diagnosis made at home be confirmed in Germany?
That depends on the hospital’s own assessment: German specialists take earlier reports into account but repeat the interview, observation and tests. The result may match the previous diagnosis, refine it or not confirm it. The doctor then explains the findings and sets out recommendations for support that can be shared with professionals at home.
How is autism diagnosed in adults?
Along the same steps, but a psychiatrist leads the assessment, and parents or older siblings describe early childhood where possible. School reports and old medical records also help. If no one remembers the person’s childhood, or there are no documents, this does not necessarily prevent a diagnosis: the German guideline explicitly allows for it.
How AlenMed Organises an Autism Assessment in Germany
AlenMed starts before the trip: the developmental history, medical reports, earlier results and home videos are translated and sent to a university department of child and adolescent psychiatry, while an adult’s documents go to a department that assesses adults (see psychiatric care in Germany). Waiting times at such departments can be long, so it is best to start early.
One specialist in this field is Prof. Dr. Luise Poustka, Medical Director of the Department of Child and Adolescent Psychiatry at Heidelberg University Hospital. Her profile lists autism spectrum disorders, early detection and early intervention. She is also first vice chair of the Scientific Society Autism Spectrum (Wissenschaftliche Gesellschaft Autismus-Spektrum, WGAS).
An interpreter is present at every appointment. The report and support plan are translated for professionals at home, and a video consultation can be arranged for follow-up questions. The company’s office is in Munich.
This material is for reference only and is not an offer: the diagnosis and the support plan are decided by a doctor at an in-person appointment.