Across the UK, long NHS waiting times have led to a surge in private neurodevelopmental assessment services. New clinics appear every month, many offering fast, online assessments with little local knowledge and limited clinical experience. On the surface, this looks like increased choice. In reality, it has created a landscape where families must work harder than ever to identify safe, high‑quality providers.
A common pattern has emerged: services advertise the ADI‑R and ADOS‑2 as “gold standard” tools, implying that simply completing these assessments is enough to diagnose autism or ADHD. What many people understandably do not realise is that these tools require years of specialist experience to interpret accurately. They are not stand‑alone tests. They are complex, nuanced instruments that must be integrated with developmental history, behavioural observation, contextual understanding and clinical judgement.
The new market for ADI/ADOS training
Alongside the growth of rapid assessment clinics, a parallel industry has emerged offering short courses in ADI‑R and ADOS‑2 administration. These training programmes are often marketed to clinicians moving quickly into the private sector, hoping to meet demand. The difficulty is that these tools were never intended to be mastered through brief workshops or online modules. They require extensive supervised practice, deep familiarity with neurodevelopmental conditions and an understanding of how autism and ADHD present across different ages and contexts.
When training becomes a commercial product rather than a professional competency, clinicians can be left believing that completing the ADI‑R and ADOS‑2 alone constitutes a full assessment. This misunderstanding contributes to the rise in inaccurate or premature diagnoses now seen across the private sector.
The ADHD training landscape — an even more worrying trend
While autism assessment shortcuts are concerning, the ADHD training landscape is arguably even more alarming. ADHD is a complex neurodevelopmental condition with a wide differential diagnosis. It overlaps with trauma, anxiety, sleep disorders, learning needs, attachment difficulties, sensory profiles, and environmental stressors. It cannot be reliably diagnosed through a single questionnaire, a brief interview or a one‑day training course.
Yet this is exactly what is happening.
Many clinicians — some with no previous neurodevelopmental experience — are now attending a single ADHD training day and then immediately offering ADHD assessments. Some are diagnosing after short online appointments. Others rely solely on rating scales without exploring developmental history, context, masking, co‑occurring conditions or environmental factors.
This is not safe practice. It is not clinically defensible. And it is contributing to a rise in inaccurate ADHD diagnoses across the private sector.
ADHD assessment requires deep experience in:
• developmental trajectories • differential diagnosis • behavioural patterns across settings • co‑occurring neurodevelopmental conditions • environmental influences • family context • school‑based presentation • formulation, not score‑based decision‑making
These skills cannot be acquired in a day. They cannot be acquired through a webinar. They require years of supervised practice, exposure to diverse presentations and a strong understanding of how ADHD interacts with other developmental profiles.
The result of shortcut training is predictable: people being diagnosed with ADHD who do not meet criteria, while others with complex presentations are missed entirely.
A changing landscape — and why families feel overwhelmed
The private neurodevelopmental sector has changed dramatically. Long waiting times have led to an explosion of new clinics offering autism and ADHD assessments. Families now face a crowded, confusing market filled with services claiming to be “gold standard”, “specialist”, or “multidisciplinary”. It must be incredibly difficult to navigate.
After working in neurodevelopmental services for many years, it is striking how many of the names now presenting themselves as experts are people I have never encountered in the field. Some were not permitted to carry out assessments within NHS teams because they could not demonstrate the necessary skills, even under supervision. Yet they are now able to set up their own clinics, advertise themselves as specialists and offer diagnoses without the depth of experience required to do this work safely.
Large corporations have also entered the sector, recognising that long waiting lists create a profitable market. Their business models often rely on shortcuts: splitting assessments between multiple clinicians, conducting key components remotely, or insisting that staff complete ADI‑R, ADOS‑2 or ADHD training days as tick‑box requirements rather than developing genuine expertise. These approaches can make services look multidisciplinary or efficient, but they undermine the quality of the assessment. When no single clinician holds the full picture, formulation suffers — and when formulation suffers, misdiagnosis becomes far more likely.
Families are already feeling the impact. I know people personally who have been diagnosed with autism or ADHD through Right to Choose pathways delivered by private companies contracted by the NHS. They do not recognise the profile, their families do not recognise it, and their original referral was simply an exploration of wider developmental questions. Yet they have been given diagnoses of “mild autism” or “mild ADHD”. This is not because these conditions are being better recognised — it is because inexperienced clinicians, fragmented assessment models and commercial pressures are creating an environment where unnecessary diagnoses are becoming increasingly common.
Why experience and continuity matter
A high‑quality autism or ADHD assessment requires continuity, context and clinical depth. It is not simply a matter of completing the ADI‑R, ADOS‑2 or an ADHD rating scale. It involves understanding developmental history, observing subtle patterns, recognising differential diagnoses and integrating information carefully. These skills take years to develop.
Cerebro was built deliberately to be different. We do not offer quick online assessments with minimal contact. We do not rely on inexperienced clinicians. We do not reduce complex developmental profiles to a pair of standardised tools.
Instead, we offer assessments grounded in experience, clinical skill and a commitment to understanding each individual’s unique context. Our clinicians have worked in neurodevelopmental services for many years. We have seen the complexity of autism, ADHD and related conditions across ages, settings and presentations. We know how subtle these profiles can be, and how important it is to integrate information carefully rather than rely on isolated tools.
Cerebro’s values: personalised, ethical and transparent practice
Cerebro was founded with a clear purpose: to offer high‑quality, personalised neurodevelopmental assessments at a time when families had almost no alternative to long NHS waiting lists. When we began, private autism and ADHD assessment was rare. There were no local options in Sheffield and only a handful of clinicians nationally working independently. We created Cerebro because families needed thoughtful, experienced assessment — not because the market was profitable. Our business grew from values, not opportunity.
Those values remain at the centre of everything we do. We prioritise quality over speed. We prioritise accuracy over convenience. We prioritise people over processes.
Families come to us because they want clarity, not shortcuts. They want recommendations that make sense to schools, GPs and other professionals. They want assessments that stand up to scrutiny and genuinely support long‑term wellbeing.
In a crowded and increasingly commercialised market, our values set us apart. Cerebro remains focused on personalised care, clinical integrity and meaningful outcomes. We believe the sector needs stronger regulation, clearer standards and greater transparency. Until that happens, our commitment is to continue offering assessments that are ethical, thorough and rooted in genuine expertise.
Cerebro 