I run an ADHD/ASD assessment service

[Trolleydolly123]

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

Well yes, but it's reporting from the child, the mother, the father, the school... not just one viewpoint

“I think the key issue is level of impairment, if someone can function, maintain relationships, socially interact in an acceptable way, hold down a job etc, what will a diagnosis or not add or change. There is a rise in medicalising the normal human condition in many areas”

do you triage out those who function well as above? My local NHS service won’t allow anyone onto the waiting list now unless they have severe impairment, mental health issues, prison time etc now

These conditions are linked to poverty and poor housing, which are also conditions likely to correlate with problems at school.

These days the answer to all behaviour problems is a diagnosis of ADHD or ASD so I expect that’s why you’re seeing a correlation.

100%. Screen time in under 5s also is an issue IMO. I dont work with kids though.

We dont yet but i think this is where we will and should go.

What is your job title or how did you come into this role? I would love to retrain in this area

Why are you/why does the medical model still using the term ASD? Autism is recognised elsewhere as a different, rather than disordered neurotype, but in most of the different areas I've worked (in the education sector, as a teacher/SENCO/Communication and Interaction Advisor), the medical model still labels it as a disorder.

great to hear yo will sign post to other services. It feels so many children in care end up with ASD or ADHD diagnosis. I worry that this is in place of quality therapy to support with their ACEs.

Agree. I think those health issues are related to health inequalities and social.deprivation which are the groups we see increased diagnosis/seeking dx of children. Symptoms which can meet asd criteria.could also be attributed to impaired attachment, attunement, excess screen time etc.

10% 😳 that can't be right

There is not enough research or consideration given to the impact of trauma/neglect.

Intrigued by this … Which attachment disorders do you feel are commonly thought to be / mistaken for ASD? Do you mean having an insecure attachment towards a parent?

I.dont know. It comes from ICD 10/DSM criteria, not services.

Yes.

I'm under the care of adult ADHD services. It's a very small county of 125k to give you an idea of population.

The ADHD team is made up of four admin staff and one prescriber.

When I first became a patient, 3yrs ago, scripts were handwritten by the prescriber and you could either travel to collect from the centre or allow a week for it to be posted to your nominated pharmacy. They've now switched to digital scripts and we're advised to ask for a repeat THREE weeks ahead of time (scripts are only for 4wks).

Problem is, I request, they give me a date 3wks ahead to collect, go.to the pharmacy, they don't have it or any record of it, I go back and am told that, sorry, they're a bit busy, a script will be there in a fortnight. So I'm on and off controlled drugs, I'm supposed to be in titration, nothing in 3yrs.

Can you shed any light on this? Is this normal?

Ds's journey to nhs diagnosis - raised issue with GP, raised with school, initial appointment at CAMHS, confirmed likely to have adhd, waiting list for assessment, <years pass>, multiple forms to complete, diagnostic appointment (several hours worth), diagnosis given.
if you've made it to the end of that process, it's not surprising 90% of patients do actually have the condition.

RMN by background. Many years in a range of settings clinical and managerial. We have social.workers, OT, RMN, NMPs, SLT, psychologists and psychiatrists.

That's interesting - does the tendency toward other family members displaying the same traits not act as an argument against that?

I would suggest speak to the pharmacy to understand how to improve. There have been global meds shortages for around 3 years too which also complicates the issue.

Or it could be epigenetics and inter generational.trauma, maladaptive.coping and poor parentimg styles.

Do you think there is a high rate of misdiagnosis of Borderline Personality Disorder amongst women who are in fact ND? Has there been a reduction in that diagnosis amongst younger age groups who are more likely to be diagnosed ND?

Well yes. Or it could be they both just have ASD/ADHD.

Yes. In 10 to 20 years we may see reduction in diagnosis of BPAD/Eupd of women who are considered ND. But not yet.

Not the OP but social media. For sure. I’ve seen hundreds of posts all convincing me I have ADHD. It may be true but wouldn’t be thinking it without social media (mainly Instagram or TikTok)

Relatedly, would having a BPD diagnosis make it more likely you'd accept someone into your service, especially if they'd had difficulties as a child too? I guess I mean is it something of a "green flag" for persuing assessment?

Edit: typo