How do therapists assess baseline skills before therapy for autism? 

Before therapy begins, clinicians build a detailed picture of an autistic person’s strengths, needs and everyday experiences. According to NICE guidance for children and young people and NICE guidance for adults, this baseline assessment should be comprehensive, person-centred and led by a multidisciplinary team. It helps ensure that therapy is tailored to how the individual communicates, processes sensory information, learns, manages daily life, and interacts with others. 

This article explains how therapists assess baseline communication, sensory, functional, emotional and behavioural skills before therapy begins, laying out the groundwork for a personalised and effective support plan. 

1. Understanding the whole person 

NICE recommends a holistic assessment that includes personal, educational, social, and communication functioning, behaviour, and co-existing conditions. NHS England autism assessment framework describes this process as person-centred and multidisciplinary, spanning developmental history, strengths, sensory needs, mental and physical health and daily living skills. The National Autistic Society notes that families can expect interviews, observation and structured tools to inform recommendations. 

This baseline picture is essential for choosing the right interventions, identifying reasonable adjustments and avoiding assumptions about what the autistic person needs. 

2. Communication assessment (Speech & Language Therapy) 

Speech and language therapists assess how someone understands and uses language, communicates socially, and interacts with others. The Royal College of Speech and Language Therapists highlights that SLTs use observation, standardised tools, and family input to create a communication profile. 

If augmentative and alternative communication AAC may help, SLTs carry out detailed assessments of comprehension, expression, motor and sensory skills, and communication environments, as described in RCSLT AAC guidance. 

NICE recommends that social-communication interventions be based on the child’s specific strengths and needs, often using structured play or video-feedback approaches. 

3. Sensory and functional assessment (Occupational Therapy) 

Occupational therapists assess how sensory processing and motor skills affect daily life. The RCOT Sensory Integration Evidence Spotlight states that OTs use parent/teacher reports, observation and sensory tools to understand how sensations affect participation at home, school, and in the community. 

An NHS sensory processing position statement emphasises examining environmental factors: noise, lighting, layout alongside functional tasks such as dressing, eating and personal care. 

NICE expects assessment of adaptive skills for children and adults, with findings guiding interventions that promote independence, daily-living skills and participation. Adults may also need structured life-skills assessment to plan occupational support. 

4. Emotional and behavioural assessment (Psychology & PBS) 

When behaviour that challenges is present, NICE recommends a functional assessment exploring triggers, consequences, communication needs, sensory factors and mental or physical health. NICE CG142 advises that adults receive the same functional analysis, forming the basis of positive behaviour support. 

UK Positive Behaviour Support guidance describes using ABC charts, structured interviews and observation to identify why behaviours occur. Psychologists also assess anxiety, depression, and other conditions using autism-adapted tools. 

5. Developmental history and co-occurring needs 

Developmental history is a core component of baseline assessment, as described in NICE CG128, helping clinicians understand early communication, play, learning and behaviours. Screening for ADHD, learning disabilities, epilepsy, and mental health needs is required under NICE and NHS England guidance. 

6. Person-centred planning and adjustments 

NICE emphasises collaboration with the person and family when setting goals. The SEND Code of Practice requires assessment and planning to reflect the child’s views, preferences and outcomes. Reasonable adjustments such as preferred communication methods, sensory considerations, and flexible session structures are expected as part of baseline planning, highlighted by NHS England and the National Autistic Society. 

Key takeaway 

Baseline assessment is the foundation of high-quality autism support. By understanding communication, sensory needs, daily living skills, emotional wellbeing, developmental history and personal preferences, therapists can design therapy that is tailored, meaningful, and effective. This article offers general information only and is not a substitute for personalised clinical advice.