I run an ADHD/ASD assessment service

[Trolleydolly123]

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

100%!!

I always think it must be super frustrating for someone with a child with genuine SEN to find a support group to discuss their concrete challenges.

I think there is something about the education system which means it's quite rational for individual parents to get a SEN diagnosis for their academic-with-sensory-issues DC - funding/resources. I get it. But that issue should be solved another way, not by telling more and more individuals that they're actually disabled.

My DS had an assessment a 18m ago. Was ASD and thought to be borderline ADHD but they decided to diagnose ASD with anxiety. I accepted this at the time, but in the interim he has had GCSEs and mock AS levels. He is brilliant in class assessments, but the 90-120min mocks always lead to poor grades. We think he has ADHD after all and wonder whether it is okay to politely go back and ask for a review? His QB test showed he was on the 99th percentile for activity but normal range for attention and impulsivity. However, it’s a computer based test and his hyper-focus/special interest is gaming/PC based activities. If you add in the social masking from his ASD I do now query the decision to err on the side of no ADHD. He borrowed some of his older sister’s medikinet this week for a couple of his mocks and says his focus was incredible . He wrotes the longest essay ever in one paper… and got an A. Obviously have had to ban the lending of the medication, but it seems pretty compelling?

What is your advice on going back to the original clinic? We are concerned as he bombed his GCSEs and is predicted As in is AS levels based on class performance (ie he may be able to undo the damage of his GCSEs) - but in the unmedicated AS mocks he gots C/Bs, in the medicated ones… As.

ETA our concern is not As a pushy parents - it is that he was devastated by his GCSEs and has refused to connect with anyone he went to school with. He is finally regaining his confidence and we are worried that if the exam grades are less than predicted he will have a break down/not recover.

I wish I'd gone for the fun memes and meetups assessment.

Instead I got hours of crying, going over school reports, reluctant answers from my parents.
Loads of questions about my childhood and my symptoms throughout life.

No one gets diagnosed with ADHD because they are tired and middle aged. You would be asked about the cause of your tiredness, oh and whether you showed that symptom throughout your life not just in your middle age. And are they any other symptoms apart from being tired.

In your opinion, could a young girl with adhd masking in school present as autistic?

We are going through this right now with dd. I have always thought she was adhd. Yr1 now and school are reporting problems. They are seeing signs of autism - but the prevalent thing with DD right now is worrying. I just wonder if she is masking so hard at school anxiety is off the scale and it's presenting as autism.

Some of these comments are a huge worry for how the world will receive people with a diagnosis going forward. The discrimination and assumptions being made are scary.

DC was diagnosed by CAMHS after originally being referred for mental health issues and a serious eating disorder in their early teens. The CAMHS counsellor realised the cause and had them assessed for ASD.
My question is, how many enter the system for a different thing to then get an ASD diagnosis? Is there now enough understanding in GPs and paediatrics to look at the whole picture, beyond it presenting outwardly as an eating disorder, as an example?

Having the diagnosis meant we could support them to understand and regulate themselves and their environment better to the point where many on this thread would want to refuse them a diagnosis. That's not fair. To look 'normal' to the world, they don't get to live a normal life and no one except their closest family and friends would ever know how serious some of this becomes and how much they are limited by it.
We are still told by people, 'you'd never know they were autistic'. I want to say, 'you would if they trusted you.'

Thanks for saying this. I'm a psychologist and work only with adults. Some parents describe their child's fairly normal attachment behaviours in pathological terms (e.g. a 5 year old won't go to sleep without cuddles and a story; a 3 year old has big tantrums), and ask me if I think it could be ADHD. I hate it so much. It's unfair to people who actually have ADHD But if I never hear those four letters again it'll be too soon.

If it's just difference, not a disorder, then why is diagnosis needed?

As a professional in this sector, are you seeing a link in covid infection and neuro-development delays or diagnoses? There is a growing body of research that shows that this link.

Notably, covid infection in pregnancy is linked to diagnoses of neuro-developmental disorders in their children (just like infection with other viruses in pregnancy) see e.g.
Nature: Maternal COVID-19 infection associated with offspring neurodevelopmental disorders Maternal COVID-19 infection associated with offspring neurodevelopmental disorders | Molecular Psychiatry

Exploring the impact of COVID-19 on newborn neurodevelopment: a pilot study | Scientific Reports
Exploring the impact of COVID-19 on newborn neurodevelopment: a pilot study | Scientific Reports
Sex-Specific Neurodevelopmental Outcomes Among Offspring of Mothers With SARS-CoV-2 Infection During Pregnancy | Child Development | JAMA Network Open | JAMA Network
Sex-Specific Neurodevelopmental Outcomes Among Offspring of Mothers With SARS-CoV-2 Infection During Pregnancy | Child Development | JAMA Network Open | JAMA Network

Neurocognitive and emotional long-term effects of COVID-19 infections in children and adolescents: results from a clinical survey in Bavaria, Germany (open access) https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-025-10813-w

Long COVID Syndrome Presenting as Neuropsychiatric Exacerbations in Autism Spectrum Disorder: Insights for Treatment https://pmc.ncbi.nlm.nih.gov/articles/PMC9695881/

I despair to see the media blaming lockdowns that happened for a few months 5 years ago for all the problems we’re seeing, yet no one is looking at the elephant in the room, namely repeated infection with a virus that we have evidence causes brain damage, including in children. It’s a total failing of public health, and yet as parents we can be pushing for better ventilation and air purifiers in classrooms so limit the spread of the virus (and other airborne illnesses).

The next wave of covid is starting, so please take care of yourselves and your

Nobody wants to a label of a disorder (just called that in the psychiatric diagnostic manuals guiding practice). But people want to understand why they struggle. If you had a pain in your heel and everyone else didn’t, they could run and you couldn’t keep up with them, you would want to get your heel looked at. And you then discover there’s this piece of glass embedded that you weren’t aware of. And you looked pretty much normal to everyone else - but you couldn’t do what they could.

We seek answers to understand ourselves - and to find our tribe. It is a relief knowing that you are a zebra and not a failed horse. Hope that answers you, Mollusc.

Someone else commented about these ‘normal looking parents with degrees and jobs and marriages and children’.. with ND kids. Well of course, some of us can do all that. We learnt to mask over the years. But you never see what has or is happening behind closed doors. I don’t mean anything sinister, just that it takes a lot of effort to ‘look’ well put together. And do all of that. Until you get given meds (if you CAN have them, and if they work) you realise how much better your life could’ve been. Just like someone who gets glasses, and suddenly can see. So much better.

I wish I had known earlier that my brain is wired differently from the most. And that it is ok. Freeing to discover who you really are, even if it happening at 50+

I've come to accept that my ASD means I won't progress much further in my career because I can't get the politics right. I don't see how that's ridiculous - of course not everyone can be CEO. People have different things holding them back from this. For me the big one is autism, for others it might be intelligence, or caring responsibilities, or language ability.

Because most of the assessment is background, psychoanalysis, that sot of thing. If you only need to do this once it saves a lot of time.

I am not sure we are talking about attachment disorders anymore. Isn't developmental trauma ? Also I think ( know) FASD is massively under recognised.

Do you think attachment disorders could be linked to economic circumstances and the need for most households to have two working parents compared to eg gen X where it was much more common to have a parent at home? Or are some of the ones from poorer backgrounds coming from homes where people are not working due to other causes eg health?

So if you have been triaged and are awaiting an appointment, is there a high chance of ASD being diagnosed at the assessment? Generally speaking.

Do you not ever think that if the medication didn't help maybe she does not actually have ADHD?!

I hope you will be back to the thread today as I notice this was started yesterday🙂 Is the diagnosis ever wrong? My son was assessed 4 years ago for ADHD and found NOT to have it. The assessor said that this was based on his QB test result and information returned from his school. To be fair, his teachers kept asking me if he might have ASD but I pursued the ADHD route as his uncle, cousin and two of DP’s cousins are diagnosed and my son was showing just about every symptom of inattentive ADHD. The consultant who gave us the result helped us fill in a form for ASD assessment on that day as she said he definitely displayed signs of autism and she asked a lot of questions. Still waiting for assessment four years later. Obviously I’m full of regret for not pursuing the ASD assessment at the time as, at 16, he is struggling very badly and attending CAMHS due to low mood and anxiety. I can look back now and see all the symptoms of autism threading through his life. But I still believe very firmly that he has ADHD. I think he has both conditions. Is it possible to have ADHD despite having ‘passed’ the QB test? Sorry for the long post!

Because current demand versus commissioned resource is unsustainable and waits shouldnt be years.

There is global supply issues which have been going on for some time.

The adult version but yes its that robust and takes at least that long. Privaye via RTC is very different so I hear.

Yes typical within NHS. There is such huge demand for assessments there is no resource left over for much else.

Asd rates are slightly lower than Adhd, approx 25% get a 'no'. The triage is a brief table top review of evidence, it doesnt unpick comorbidity or early trauma/attachment etc, so diffiuclt to say how likley a yes is for anyone waiting.

It is possible to have both, keep checking how far from being seen he is, us RA stratagies to assume he is ASD and see if that helps, as thats all that will be offered if diagnosed ASD anyway. Consider RTC or private if you can and it feels important.

Thank you for your reply. I understand it’s possible to have both, as two of his best friends do. In fact every single one of his friends is ND (now that he finally has friends.) I’m still unclear about the whole QB test situation though and the possibility for an error with the diagnosis. Is this possible? Thanks!

Right to Choose (RTC) is NHS England-funded and approved diagnosis route that follows the very same NICE & RCPsych guidance that NHS follows. Just that they are paid by NHS to do the work for them as NHS can’t keep up with the demand for these assessments.

if private companies didn’t follow same guidance, GPs couldn’t take over care or NHS teams would refuse them. My private diagnosis report was approved by local NHS team after the report was combed over .

Do you think private via RTC is less robust?