I run an ADHD/ASD assessment service

[Trolleydolly123]

As the title says, curious to hear questions/thoughts.

I have dyslexia which I know is different from autism and adhd but I feel I am living proof that adult diagnosis is important.

I have 4 gcse's at grade C, the rest are below and it took 4 attempts to get my English one.

I have 2 a levels, both a c grade

I was diagnosed with dyslexia in my first year at university and became entitled to disabled students allowance.

I have a 2:1 degree, the same as both my siblings who have much better GCSE and a level results than me.

lots of us would expect you to try wearing tinted glasses /sunglasses for the light issue

1. The combined weight of Fitovers and prescription glasses is such that wearing them for eight hours at work is painful.
2. When glasses with two axes of prism in each lens come at £500/pair, a second tinted pair on top of the clear pair isn't affordable, so Fitovers it must be. Without a diagnosis, you cannot claim PIP to help with the cost of the second pair. No, I can't go to Specsavers for cheaper glasses because Specsavers don't even examine for prism correction.
3. Wearing tinted glasses or Fitovers indoors gets comments like "stop being weird", "you're indoors now", and "who do you think you are, Bono?". "Actually, I'm autistic" stops those comments and, at work has generated "there's a desk in room two and the lights in there can dim".

too many people reaching instantly for diagnosis and official 'adjustments' rather than at least trying to help themselves first?

Since I was at infant school, trying to help myself be more comfortable has resulted in bullying, ostracism, being labelled "fussy" by teachers, "wuss", "wimp", "frumpy" [for choosing comfort over fashion], "everyone else is OK", "no one else is wearing a hat [to shade my eyes], take yours off so that we all look the same", "everyone else has gone to the [noisy] party, why don't you go?", etc. We live in a world that prizes conformity very highly and autistic people already struggle with fitting in without doing "helping ourselves" stuff that makes us stand out. We are conditioned from birth not to do the different-from-others things make ourselves comfortable and actively penalised for doing so. You cannot, given that context of lifelong punishment for helping ourselves, turn around and tell us that we should somehow magically feel that self-help is a) acceptable to others and b) comfortable for us.

My six page diagnostic report is two things: a sword to fight for what I need, and a shield to defend what I do to help myself.

Based on your post, I'm confident that you are NT. If you were autistic, you'd understand all the above already.

I am still wearing my flak jacket from yesterday so might as well bite on this too.

I think that we have a general problem with over-clustering, which affects how we talk about ADHD, ASD, depression/anxiety, and a host of other issues including "disability" itself.

What do I mean by over-clustering?

I mean grouping people into very broad categories where the needs of the most and least serious in the group have very little in common, but the group is always discussed as if everyone in the group has the most serious version.

I've known people with very severe depression, usually after severe trauma/illness. I agree it's really debilitating and almost impossible to escape without treatment, often meds. (Likewise severely autistic non-verbal incontinent people, wheelchair bound paraplegic people, etc.)

But it's just obvious that not everyone who is depressed, including not everyone who has a diagnosis of depression, is this level of disabled.

And it's unhelpful to always just talk about "the disabled", instead of in more specific profiles like the A-E profiles the OP of this thread used, that just cast so much light on the actual people and their needs coming through these services.

That's a lot of words to say that you don't understand set theory. A defined set xan contain multiple subsets without invalidating the definition of the set.

host of other issues including "disability" itself.

We tried reserving the word "disability" for only certain people with impairments that substantially affect their lives, with the concept of "registered disabled" people. It didn't work very well, with lots of people being excluded from important parts of qlife, so Parliament passed the Disability Discrimination Act with a more sensible definition and things got better for everyone.

I mean grouping people into very broad categories where the needs of the most and least serious in the group have very little in common, but the group is always discussed as if everyone in the group has the most serious version.

With autism, the opposite problem occurs: the least-impaired people talk online a lot with their "superpower" amd "difference not a disability" narratives and it results in profoundly disabled autistic people being erased and their needs ignored.

Do you honestly think a few people saying 'do you think your bono' means you should take priority for diagnosis /assessment over someone profoundly affected, with no ability to speak, understand, even use the toilet?!

Is it honestly not possibly to say 'bright light hurts my eyes so I wear tinted specs', I know quite a few people at work who do and guess what, we are adults there's no mocking or that sort of nonsense!

Your question does four things:

1. It's a straw man argument: it fabricates an opinion and ascribes it to me. I actually said that people with higher needs than me should be prioritised ahead of me on the waiting list.
2. It ignores the profound impact of lifelong bullying and relentless pressure to conform has on someone who already, by definition, struggles socially. These social struggles have physical consequences as well as psychological ones, they are called "self-harm scars" and "intentional self-poisoning followed by my parent taking me to A&E".
3. It cherry-picks one detail of my sensory issues whilst ignoring how my social difficulties have resulted in me being fired twice, which I also posted about on this thread.
4. The profile you describe is of someone who is severely learning disabled, hence they have "no ability to speak, understand, even use the toilet", etc. This profile is not on the OP's A-to-E profile list, you have fabricated this profile as part of your straw man argument. The person you describe is severely learning disabled whether or not they are also autistic and will already get support with care needs based on their LD diagnosis. One could ask how such a person benefits from an autism diagnosis, given that they are not someone who can be supported to live independently or work, they don't need an assessment to get support within the criminal justice system, and they don't need an assessment to get an appropriate care placement because their severe learning disability already justifies their care needs and so those needs will be met.

As for "we are adults", you over-estimate the decency of many adults.

Based on your post, I'm confident that you are NT. If you were autistic, you'd understand all the above already.

I really struggle to accept this.

You seem to be arguing that someone who is either unaware of, or decides to ignore due to practicality/convenience, social norms about not being weird...

...must definitionally not be autistic.

No!

I'm arguing that only someone NT could so grossly underestimate how the pressure to conform coupled with the inability to do so would absolutely nuke both one's self-esteem and willingness to advocate for oneself. The word I couldn't think of, and only found whilst reading articles searching for a source for my next paragraph, is "shame". I bet NT people can find feelingy words like that easily.

Some experts, like William Dodson, M.D., estimate that children with ADHD receive a full 20,000 more negative messages by age 10, on average. https://www.additudemag.com/children-with-adhd-avoid-failure-punishment/

ND people are shamed all the time. We are shamed for getting social stuff wrong, for not sitting still, for being too quiet, for never shutting up, for being inattentive, for being too attentive to just one thing, for the things we do to try to be more comfortable, for melting down when we try not to do those things. We are shamed as children, we are shamed as adults. We are constantly told to just try harder, to just cope, to be like everyone else, including on this thread. Telling us that we don't need to be diagnosed and it's just a personality type and we should just get on with life is another form of shaming. We already try so hard all the time and you don't even see it and when we tell you, you don't believe us.

The day I was diagnosed was the first time I recalled being fired and didn't feel ashamed.

@User37482you are probably perimenopausal then with those symptoms. Friends of mine report the same inattentive conditions since reaching menopause but I’m able to tell them that I’ve been like that ALL my life, not just the last few years. In fact menopause made it even worse.

Absolutely this. The research is also clear that mental health trajectory is much improved with diagnosis for both ADHD and autism. I had an extensive MH history and then an ADHD diagnosis in my late 30’s which has been very helpful in better managing from a MH perspective. The increased suicide rate for people with Autism and ADHD the level of addiction, self harm, obesity and the interface with the criminal justice system are all clear. Given the ADHD prevalence is around 4-5 percent for ADHD in the general population the ‘over diagnosis’ rhetoric doesn’t match the research. Obviously social factors and opportunities impact outcomes and presentation within that cohort. You need skilled assessors and a thorough assessment of development including developmental trauma etc which needs to be understood. That said there is often an inherent overlap - the incidence of FASD in the looked after population is high (I think over 25 percent) and will often result in ADHD/Autism criteria being met so often it’s not one or the other it’s trauma and neurodivergence. Autistic individuals have double the amount of ACES for example. The either/or narrative is not always helpful. Anyway I digress (it’s my superpower 😂). Affording people the ability to understand why things are so difficult and what can help and understanding difference/developing a positive self narrative within that can be life changing.

Absolutely all this. I think writing women off as "self discovery" or "following tiktok" or not really needing it... Is missing all this. It's not taking women's lives/problems seriously.

Perimeno makes ADHD symptoms worse because dropping oestrogen lowers the uptake of seronotin (causes anxiety, depression) and dopamine (tamped up ADHD symptoms). I had various lifehacks and ways of coping, using lists etc but with perimeno I couldn’t stay on top
of life and too distracted/no focus.

i was assessed privately. Discussed my life from childhood, school years to present and diagnosed combined ADHD (you must have symptoms before the age of 12, you can’t just get diagnosed based on adulthood symptoms)

so obvious ADHD symptoms may not be ‘just perimeno’.. it could be existing one making itself known. My life is so much better with medication.. shocking to know I have Rae dogged life for 50years and could’ve had a quiet brain had people realised by issues all along were undiagnosed/untreated ADHd.

You're right. No one whined about "overdiagnosis" when men and boys made up the majority of diagnoses, but as soon as women and girls get a look in it's "we don't have the staff" and "bandwagon" and "self-discovery".

Plain old medical misogyny, in other words.

Hi OP. Hope you’re still around. To what extent do you think high IQ and asd/adhd are related? DS has 142IQ but I think he also is on the spectrum as well as adhd. He goes to mainstream school and is able to make and maintain friends but I’m pretty certain he is ND. (He is undiagnosed)

If you can please share any insights into high IQ and asd/ADHD. Many thanks for any input.

Interesting. Could be just coincidental but our of the 7 of us in my family, 5 have high IQ's and 2 don't. The ones with the IQ's are autistic and the others are not.

OP, I don't know if you are still there?

I have noticed someone on Instagram who keeps coming up on my suggestions of people to follow who was diagnosed with autism fairly recently as an adult. She seems to have quite high needs from what I can see as she has an autism assistance dog and wears ear defenders most of the time. I always thought that people diagnosed with autism as adults either have fairly mild symptoms, are good at masking or they are much older and were children when there was much less understanding of what autism is. This lady seems very obviously autistic though so I struggle to understand how some people including her would slip through the net.

Since I was diagnosed with ADHD I don't mask as much anymore. I've realised how exhausting it is and know now it's ok to just be myself. So it's possible this women masked more before her diagnosis.

Don’t know what the evidence base is but in the old days there was high functioning / Asperger’s and low functioning /ASD so the people in the low functioning group definitely did not have high IQs. Those in the higher functioning group tended to be across a range of intellectual functioning.

There is a whole ‘drop the disorder’ movement that says something along the lines of - we are medicalising human responses eg someone who’s child is murdered in horrific circumstances is diagnosed with depression and a complex grief disorder. People (usually women) who have experienced childhood abuse and trauma are diagnosed with personality disorders.

By extension people struggling to cope in a ‘neurotypical world’ ie one where we are r petted to be educated, home owners, do everything online and constantly multi task etc etc have a ‘disability’ rather than the world has gone mad. Diagnosed with anxiety disorders but living with threats of war, terrorism, climate emergency etc etc, ….

Hi, I’m an ADHD assessor and just wanted to say hello!

Hi @DisabledNurseofTiktok, any chance you could shed some light on my earlier post if you have any insight? Thanks

Hi @WoodenForkandSpoon

I don’t test my patients IQ so couldn’t possibly comment I’m afraid.

Hello, I'm currently a counsellor in the NHS with over 25 years experience and just wondering what sort of training would I need to move into ADHD assessment and would I even be considered without a medical background? I've also just been diagnosed with ADHD at the age of 60.

What do you tell parents and can you predict future positive development ?

Son is 7, not verbal although will hum and screech, can't toilet train him despite best efforts, is on laxido and therefore no bowel control. Sometimes will pee in toilet but only if taken. Constantly hitting himself right now, also licking glass using his saliva and licking his fingers and smearing saliva all over the place. Screams if told no. Won't do PECs just hand gestures. Trying makaton but just gets frustrated at us. Hits his elbows and back of his hands against hard surfaces until he bleeds. Wits end is an understatement.

Been on the waiting list since ,Feb 2021 and still waiting. We are in Scotland. It's shite.