Adult autism assessment in France: who carries it out, who pays?

An appointment with a doctor or a health professional trained in autism. The Maison de l'autisme names the family doctor (médecin traitant), the occupational physician, or a psychiatrist, psychologist or speech therapist. It adds that, whatever your situation, seeing a doctor remains an essential step.

This first professional does not reach a conclusion. After an initial examination, they may notice a neurodevelopmental difficulty and raise a suspicion. To follow it up, they either see you again or refer you to other professionals, who carry out more detailed assessments.

The Maison de l'autisme's pathway guide offers four types of structure for an adult assessment. The table reports what the source says about each, and what it leaves out.

The Maison de l'autisme presents private practice as a pragmatic answer to hospital waits. It also states that a resource centre complements local services without replacing them, and that it is mainly called on when a situation is complex.

Often, yes. The Maison de l'autisme writes that most centres ask for a psychiatric opinion before carrying out an assessment. The reason given is that many signs linked to autism also appear in other, more common difficulties, so those other explanations are explored first, before a specialist assessment.

"Most" does not mean "all". The source does not say which centres require it. The safest move is to ask the centre you have in mind before you build a file, so that this step does not come as a surprise after months of waiting.

In private practice, you pay for the consultations yourself and are reimbursed afterwards. The Maison de l'autisme writes that a complementary health insurer (mutuelle), if you have one, reimburses "in full or in part depending on the fees charged". What you end up paying therefore depends on your policy and on the professional's fees.

For hospitals, community mental health centres and autism resource centres, the pages we read say nothing about cost. We infer nothing from that. None of the three pages publishes a price, so we quote none, rather than repeat a figure that circulates without a source.

• Before starting, ask the professional how many sessions are planned and what the total cost will be.
• Ask your insurer what it reimburses for this kind of assessment, and on which documents.

Not entirely. The Maison de l'autisme considers that observing someone in person remains necessary to judge communication strategies, and that tests must be carried out face to face. A video consultation can help, for example, to gather information from family and friends.

At the end, the coordinating doctor (médecin référent) goes through the conclusions and writes a final report and a medical certificate. That certificate allows, where relevant, an application for rights to the MDPH. The report describes a situation at one point in time, and the source recommends updating it regularly.