Folate Receptor Autoantibody Testing (FRAT)
Home >If you’re looking into a FRAT test in the UK, it’s usually because you’re trying to make sense of ongoing developmental or behavioural concerns. You may have heard about folate and how important it is for brain development, with deficiencies leading to problems with speech and language, emotional regulation, seizures, and motor skills.
You may also have heard about the link between FRAT and autism spectrum traits, and be wondering whether folate supplementation can help your child.
How We Can Help
At Midland Health, you can book a private, consultant-led appointment directly with no referral needed and no waiting lists. You’ll have time to talk through what you’ve noticed, what you’ve already tried, and what you’re hoping this testing might clarify. Our consultant paediatrician will assess your child’s development and clarify whether a FRAT test fits your child’s overall picture, and the clinical question we’re trying to answer.
FRAT tests are only available in the UK as a research trial, and usually takes up to two months to receive the results.
What is a FRAT Test Used For?
The Folate Receptor Autoantibody Test (FRAT) looks for autoantibodies that may interfere with how folate (vitamin B9) is transported into the brain and central nervous system.
Autoantibodies are immune system proteins that mistakenly attack the body. Some people develop autoantibodies that block folate from entering the brain, where it's needed for brain development, nerve cell communication, and mood regulation.
Cerebral Folate Deficiency (CFD) happens when the brain does not have access to enough folate, and has been linked to developmental delays, speech and language difficulties, seizures, motor coordination problems, autism spectrum traits, and regressive symptoms, or losing skills.
What Folate supports:
- Brain development and growth
- Neurotransmitter pathways
- DNA methylation processes
- Cognitive and behavioural regulation
What the test measures:
- Blocking antibodies (may reduce folate binding at the receptor)
- Binding antibodies (may affect receptor function)
Please note that FRAT testing is not a diagnostic test for autism, and it doesn’t replace an ASD assessment.
Who Might Benefit From This Testing?
FRAT testing may be considered in appropriate clinical contexts, when a child has an Autism diagnosis or suspected ASD, and features of suspected cerebral folate deficiency syndrome, such as:
- Developmental delay (speech, learning, behaviour)
- Unexplained neurological, cognitive, or fatigue-type symptoms
- Limited response to standard nutritional approaches
- Family history of autoimmune conditions
- Clinical concern about folate transport or related pathways
After our consultant has assessed your child, they may recommend them for a FRAT test.
What to Expect From Your Appointments
We’ll keep the process clear, so you know what’s happening and why at each step.
FRAT testing is arranged as a consultation-led pathway, with results reviewed in context rather than sent without explanation.
The first appointment will be an initial consultation, at which our consultant paediatrician will listen to your concerns and assess your child. After this consultation, they may recommend a FRAT test.
At the testing appointment, your child will have a small amount of blood taken, which will be sent for laboratory testing. Then we’ll book a third appointment to review the results together and make recommendations for next steps.
Preparing for Your Test
There is nothing needed to prepare for the test. It can be helpful on the day for the child to wear short sleeves and comfortable clothing, and to bring a comfort item if this is helpful for your child.
It can also help to bring a list of any medications your child takes and any relevant clinic letters to give our team a clear overview.
Results
Turnaround time is typically around 50 days, as samples are processed by an external laboratory.
What happens next:
- Results are reviewed with you in your follow-up appointment
- A summary letter can be provided for sharing with your medical team (where appropriate)
How FRAT Testing Can Help
A positive result can help your clinician decide whether targeted folate-pathway support is worth discussing.
Because this is an evolving area, decisions are always individual and based on your child’s full presentation, not the test result in isolation.
If FRAT is positive, your clinician may discuss:
- Research options (including clinical trials), where suitable and available
- A monitored trial of folinic acid, also called calcium folinate
About folinic acid (calcium folinate)
In the USA, this is marketed as Leucovorin, while UK prescribing commonly uses Refolinon.
- Prescription form of folate support
- Used in selected cases under clinician guidance
- Generally well-tolerated; possible temporary irritability or sleep changes in some children
- Responses vary, and progress is reviewed using structured monitoring
Pricing
Consultation
£450
45 minutes
FRAT Blood Test
£350
With HCA plus centrifuge
Results Review
£250
30 minutes
Meet Our Consultant Paediatrician
Dr Prandeep Naganna, Consultant Neurodevelopmental and Community Paediatrician
Dr Pradeep is a highly experienced Consultant Paediatrician with over 20 years of clinical experience in children's health and more than 15 years dedicated to Neurodevelopmental Paediatrics. He has worked across both the United Kingdom and Australia, helping children, young people, and families navigate concerns relating to autism, ADHD, developmental differences, learning difficulties, and behavioural challenges.
Throughout his career, he has trained and worked in leading children's hospitals and tertiary centres, including Birmingham Children's Hospital, University Hospital of Wales (Cardiff), University Hospitals of Leicester, Royal Aberdeen Children's Hospital, and Perth Children's Hospital in Western Australia.
His specialist interest is Neurodevelopmental Paediatrics, a field in which he has worked since 2007. He has extensive expertise in assessing and managing Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), developmental delay, learning difficulties, tic disorders, sleep problems, developmental coordination disorder (DCD), and a wide range of behavioural and community paediatric conditions.
Visit Our Clinic
Appointments for FRAT testing take place at our Francis Road clinic in Edgbaston, Birmingham, with easy access by car and public transport.
Next Steps & Booking
If you’d like to explore whether a FRAT test UK pathway is appropriate for your child, the first step is a consultant appointment. You can book directly with no referral needed, and we’ll guide you to the right appointment type.
FAQs
Does folate help with speech delays or support speech development in non-verbal children?
Folate supplementation is currently under research for supporting developmental delays. It is considered that folate may support communication progress in some children, but it isn’t predictable, and it isn’t a “cure”. Your clinician will help you set realistic expectations based on your child’s profile.
How does a positive or negative FRAT result affect the treatment plan (e.g. folinic acid/leucovorin dosing)?
Where folinic acid is prescribed, dosing is typically based on a standard weight-based protocol, not the antibody level itself.
Does the laboratory test assess both blocking and binding antibodies?
Yes, FRAT measures both blocking and binding antibodies.
What is the typical turnaround time for results?
Currently, turnaround is typically around 1.5 to 2 months, though it can vary. This is because we use an external laboratory.
What outcomes are typically tracked, and how soon is progress reviewed?
We track language, behaviour, sleep, and gastrointestinal function, among other outcomes, using a validated rating scale alongside clinical review, and progress is discussed at each follow-up.
Is a summary letter provided for sharing with NHS clinicians, and can ongoing treatment be supported via shared care?
A summary letter can be provided, but shared care is not usually available for this testing.
If Leucovorin is expensive, are alternative products available?
We’ll prescribe the most appropriate available option. Refolinon is a commonly used UK brand of calcium folinate.
Can a FRAT test be performed if a child hasn’t been officially diagnosed with ASD?
Yes; where clinically appropriate, we can assess and consider testing based on symptoms and development, even if a diagnostic pathway is still in progress.
Are there any assessments or monitoring procedures that accompany this therapy?
Yes; there is structured monitoring using a validated rating scale; blood monitoring isn’t usually needed unless your child has pre-existing liver or kidney disease.
Do your practitioners have experience prescribing folate supplements for children with ASD?
Yes, your clinician can discuss when it may be considered and how it is monitored.
Is this a lifelong treatment?
Not always. Duration is individual and based on ongoing review of benefit, tolerability, and your child’s needs over time.
Is this the same as folic acid?
No; folinic acid, or calcium folinate, is a prescription form used in specific situations, and it is different from over-the-counter folic acid or methylfolate.
We have translators available for your appointment.
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Medically Verified
This content has been medically reviewed and verified by Dr Rupa Parmar.
Medical note: This page provides general information and is not a substitute for urgent medical care. If you have severe symptoms, seek urgent help.
Last updated: Jul 2026
