How to get a child assessed for possible ADHD?

[kettleoffish]

Thinking of getting DD assessed privately for possible ADHD - inattentive type. Who should I go for? I was initially thinking of having her seen by am Ed Psych so I can get advice on how to help her educationally as she has been falling behind for some years now and even with one to one tuition, she is still finding academics so hard and takes ages to do her work or "get" concepts. School says she will catch up but she's been like this for years and is now a preteen.

But will Ed Psych be able to assess for ADHD? Or should I seek someone else? And are there any private doctors you can recommend? We live in Cambs and can travel quite a bit.

[kettleoffish]

She's a very placid child and tries to please so I know she's not being difficult. She also has speech problems since young, now very quiet compared to peers, almost invisible in school. Just want her to be seen by someone competent and suitable because the feeling I am getting from school is that because she is not a trouble maker, they don't really think it warrants any attention.

[streakybacon]

You'll need a consultant child psychiatrist to carry out the assessment and make the diagnosis. Ed Psych might be able to advise but they aren't qualified to diagnose, though their input can be helpful in formalising some of the difficulties your daughter has in school. Have you had any contact with the school's SENCo yet? I think that would be your best first port of call, class teacher too. Have there been any issues at school at all?

ADHD is diagnosed by Connors assessment. The psychiatrist needs to be sure that the child's presentation is the same in two settings - though this isn't essentially school and home, these are the two settings that are usually looked at. Parents and school (usually teacher) fill in the Connors forms and the psychiatrist compares them. If it looks as though the child presents similarly in both settings, they will diagnose.

I'm not sure how you'd go about finding a private psychiatrist - we found ours by word of mouth through a local ADHD support group, so perhaps that might be one way to go.

Incidentally, the way you have described her is quite typical of girls with ADD - they do tend to blend into the background and appear 'good' to teachers, so they don't see any reason for concern.

[Sootbird]

I don't have any advice on how (for DD Aspergers concerns we started with GP and gradually got referred on), but I will say please push. I'm 33 and just been diagnosed. So much makes more sense to me now, and I keep looking back wondering what I could have achieved if we'd known. She sounds a lot like child me. I always described myself as invisible. I was never trouble, just lost and forgot things so the teachers tended not to notice me.

[kettleoffish]

Well school teachers and headteachers not helpful. Expressed my concerns over the years but each time just got told she is fine and made to feel like I'm overreacting. But as DD grows older she is starting to hate school. Also she has always hated reading and maths. She will never read anything for pleasure. But will do it if told to by teacher. She has been struggling with making and keeping friends for years and often comes home from school grumpy.

[kettleoffish]

DS is almost 6.5 but he is much more a handful to deal with. Never sits still at home. Always jumping on couches and beds. Volatile temper at home, attacks people when upset. Oh and he has never slept through the night ever. When he was newborn, he woke every 1.5 hrs. Got a bit better since he was about 2 but still wakes up 3 times a night at least. Nowadays he wakes up anything between 1 to 3 times a night. He will wake up and throw a tantrum if he had been overexcited during the day.

In school he hides it and is quiet and shy. But teachers have told me when they ask him questions in class, he seems to be clueless and look dazed and say he doesn't know. I have let them know he doesn't sleep through the night so maybe he is tired.

As he's still so young so I guess still a matter of wait and see but I think his symptoms are worse than DD's. I believe it could be they both have a learning difficulty of some sort as both me and DH have siblings who did very badly at academic work despite all the support they had from parents and they really tried their best too. But back in the day, nobody knew about learning difficulties. My sister who is now 26 tells me she thinks she had dyslexia.

[ImBatDog]

ADHD is normally done via CAMHS... our referral was done by the school SENCO.

[kettleoffish]

And DS cannot play by himself it seems. Always bugging someone to play with him at home. Roomful of toys but he never touches them unless someone plays with him.

DD has the same problem she has never been able to occupy herself. Always needs someone to play with her or else she just sits there alone and aloof lookin miserable. Since we bought her a tablet and a Nintendo DS, she goes on them to play games non stop if she doesn't have anyone to play with.

Anyway yes I feel like both DCs need to be assessed, if not just to rule out conditions. I can't face dragging them through CAMHS and the long waits. I already feel a bit guilty I did not take DD for a private assessment earlier. Now it's gone on for so long. I just want to start the ball rolling.

Will have to contact some child psychiatrists then to see if they would assess privately. Or if anyone can recommend one.

[kettleoffish]

Imbatdog I cross posted. Yes my GP said CAMHS but he was reluctant to do it because he says it can take ages to be seen. He wants us to try getting school to see to it first but school says nothing is wrong.

[kettleoffish]

GP told me a wait of at least a year or something.

[kettleoffish]

So I'm prepared to do it privately to get the ball rolling otherwise it might be too late.

[constantlyconfused]

How old is your DD?

[ImBatDog]

it can take a while, but do keep pushing the school.

DS is in yr 3 and we've only just had CAMHS finally get to seeing him after me pushing and pushing!

It started with referral to the OT because he couldn't write/hold a pencil, and that happened in July 2013. Feb 2014 he was assessed and diagnosed with Dyspraxia/DCD. Then this last 12 months it all been about pushing for a CAMHS referral, which the new SENCO who took over in September agreed to do. he was seen in the last fortnight and they are happy to refer on to the consultant paeds for a full adhd/asd assessment.

[kettleoffish]

She's turning 12. Yes I do realise perhaps I need to be very pushy with the NHS. I intend to get her diagnosed on the NHS after I get her diagnosed privately. The private diagnosis is just to back up my claims if she does have anything. Of course she could just be a bit quirky or odd or whatever... I don't mind that. But recently I have gotten a few comments from other adults who see her regularly who also think something's not right and well, it gave me the impetus to pursue this. Many years ago I gave up pursuing this as nobody seemed to see my point of view. But as she grows older it is more obvious and she is starting to stick out in a group of peers and her behaviour cannot be explained simply as something she will grow out of.

[kettleoffish]

Poltergoose, the problem with ASD is that she did not display any of the symptoms when she was a toddler. She passed the m chat test (I found the test online and did the test on her when she was 2 and another time at 2.5). The only two problems she had though was that she really seemed to be struggling to say things, and that she was painfully reserved and shy in front of other children. I mean she babbled but she only said maybe 5 different words by 2.5. But after she went to nursery at 4, her speech became fine. But only at home. In school or nursery, she won't speak much at all. Her teacher told me she doesn't say anything to anyone at all some days. We decided to wait and see. As she was so chatty at home. Its just when she steps into a social or school setting outside, she goes almost mute and weird.

She did improve a little bit but by that I mean she maybe goes some days only speaking one or two sentences to someone there. She also answers teachers but never saying more than was necessary.

Nowadays it's not much better although one improvement is she will now join groups and clubs to meet others. And she genuinely enjoys the company of others but she still finds it hard to have the courage to speak spontaneously with them. She did not used to want that at all when she was a few years younger though. She would avoid talking or joining in activities at all.

I don't know what she has but a psychologist friend of mine said she sounds like she's got some kind of social anxiety problem. And if that's what she has, do you think it's worth seeing Daphne for it? I am still looking at who is the best doctor to see for her. I definitely think she needs to be seen but I want one who is good at telling the difference between ASD, ADHD and social anxiety... I mean she may have ASD too like you said and I admit it's true she may still have it. But also ADHD symptoms sound similar, and social anxiety too fits the bill.

[spickles]

Hello we've just gone through this privately as we couldn't bear the year long wait on nhs. We found a paediatric psychiatrist through BUPA, they list their approved consultants on their website. She saw our DD within a week, assessed within three with a report for us. We weren't expecting ASD diagnosis as well, but ADD with ASD now makes complete sense the more I read. My DD is very well behaved and blends in too. She's a complete sweetheart. But can't stay on task very easily and has lots of accidents with spatial awareness issues too. She wasn't in the radar for this at school as doing OK but now she is 8 they see what we mean and the report has helped no end. In the meantime, still on the nhs waiting list 9 months plus. Best of luck. Google paediatric pysciatrist in London, and there are a few good ones to chose from. Ours was a lady practicing in Highgate.

[kettleoffish]

Thanks Spickles.

I've just read Daphne Keen's description on the St. George's website here www.stgeorges.nhs.uk/people/dr-daphne-keen/

She sounds just the ticket, based on what they say her specialties are : ADHD, ASD, Selective Mutism. She isn't a psychiatrist though. I wonder if I should have DD see her or see a paed psychiatrist instead. Also planned to have DD see an SLT for the selective mutism and to see if ASD is part of her problem but now not sure as I'm not sure if SLT can also see if it can be ADHD.

[kettleoffish]

Well they are all expensive and I want to see the right person... I can't afford to have her see them all.

[kettleoffish]

Another option I think would be to have her assessed at Belle Vue House in Ormskirk. They do multidisciplinary assessments there. Only problem is transport but I guess may be doable still.

[kettleoffish]

Just not sure who she should see really, and if we should do a multidisciplinary assessment instead of seeing one specialist.

[constantlyconfused]

My DD was much like yours slipped through net WAS "well behaved" sadly in the last two years that is not the case and she is on the brink of being excluded.The issue is they don't slip through the net forever then they can't catch up or follow difficult instructions so frustration and anger set in. DD is under CAMHS and has been for two and a half years very very slow process .DD isn't high priority as she doesn't self harm or harm others .If I had the money i'd go privately and get to GP for refferal .

[3dimensional]

In the USA some paediatricians diagnose ADD, but they aren't all qualified to do it. A child psychiatrist (paediatric psychiatrist) would be better qualified to assess for ADD. Medical doctors, however, will not do any cognitive testing.

I am having my daughter assessed in a couple of months by a neuropsychologist. She assesses everything to do with the brain including autism, learning disabilities (specific learning difficulties), ADHD, etc ....

My daughter is younger than yours, but she sounds so similar.

Some books that you might find useful (I haven't read them yet) - 1) Smart but scattered by Peg Dawson and Richard Guare - 2) The organised student by Donna Goldberg and Jennifer Zwiebel

and some links - children and adults with AD/HD //www.chadd.org
attention deficit disorder resources //www.addresources.org

All the best

[sugarman]

I have taken a somewhat circuitous route in getting my ds (7) help. I will desribe to you in case any of the fragments strike a chord and are therefore helpful.

V loud voice, v emotional, v huggy, sometimes flies into rages and cannot be soothed. Until age 4 woke every hour. Better now but still thrashes, has nightmares, wakes at least twice.

First year of school kept up but I felt something wasn't right as he seems bright but reading and writing seemed so difficult for him.

Ended year 2 below standard in reading and writing, above in maths.

This prompted me to contact a reading tutor who asked me to have him assessed by a behavioural optometrist, an occupational therapist and for auditory processing before she saw him.

Behavioural optometrist ($75) diagnosed Irlen Sydrome irlen.com/ and explained it can look a lot like ADHD. Ds got glasses and immediately calmed down, very noticeable, and reading improved at speed.

OT ($330 for 3x 1hr sessions) diagnosed sensory processing problems with touch (the flipping out when accidentally bumped, the constantly wanting hugs), light (hard to stay focused in a classroom with so much movement and so much on the walls) and sound (loud voice to counter what he experiences as a noisy, busy world).
She prescribed a sensory diet of skin brushing and joint compressions, plus lots of heavy work (plenty of physical work/play that includes resistance but doesn't rark him up).

Also physical exercises for hand strength and core strength (he can do 50 press ups but not one sit up, has trouble using tripod grip)

They break the tests down into specifics so you can find out how best to help them e.g. If the visual sequential memory is poor (spelling) then you can counter that with audio work and other tricks. mrsprattclassroom.weebly.com/memory.html


Whatever the visual thing is most required in maths is ds's strong point, 99 percentile she said, hence his varied school results.

Haven't done the audio yet but after that we will do some tutoring to plug gaps and help him catch up.

I also saw the GP about a referral for ADHD assessment but he wasn't keen saying it could at best result in a diagnosis of ritalin which would only blunt the symptoms.

I have also adjusted his diet to be protein-based and put him on supplements (Floradix, omega oils).

It will be interesting to see how he goes at school this year but at home things are much improved as he is so much calmer and I feel as though I understand him better.

Sorry for the essay but I hope that there are elements of helpful advice in this post. All the best.