I run an ADHD/ASD assessment service

[Trolleydolly123]

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

Belittling people who may be on the spectrum is revolting.

Agree

Absolutely we also have people with autism in my family who require some heavy duty anti-psychotics. It’s miserable for them and has taken a lot of work for them to be able to function. I am not denying people have problems or denying that they should be able to access help. My issue is that I think there is a problem with how we are diagnosing.

I remember reading that neglect and trauma can often be read as ADHD. I think we need to have a good hard look at misdiagnosis and also pointless diagnosis. I also think we are scared of talking about environmental factors because no-one wants to tell parents that theres nothing wrong with their kid but there may be something wrong with the way they are being parented. I am a very imperfect parent myself so I’m not finger wagging.

Post pandemic there have been a number of research papers pointing to an increase in neuroticism, I think this may be contributing as well.

This is both funny and painful. Because of personal experience.

Perimenopause hit me like a freight train and suddenly I none of my coping mechanisms & life hacks worked no more (oestrogen is needed for both serotonin and dopamine uptake - making us women often anxious, depressed, and ramps up ADHD symptoms to a 100 for those who have it).

Diagnosis was a relief and with medication I am hoping am able to get back into FT employment. Adult assessments matter too - it is not just about catching the kids and helping them thru schooling.

with diagnosis I have found acceptance of my neurodivergence and am allowing myself to self-regulate, and unmasking by not trying to be so darn NT all the time. So what if I stim in public :)

I work for the NHS. I would suggest google NHS ASD children in whatever county you live, this should bring up your NHS webpage which will explain criteria and who they take referrals from.
Ask GP and HV to refer, also nursery if they attend. Each area is different depending on how 'young' they assess and what provision there is.

Go back to the provider (RTC or NHS) and request second opinion.

Despiie being very very bright I've never managed FT work. I'm still awaiting part 2 of my autism assessment, but the adhd meds really have made a difference and I'm hoping with accommodations I will manage.

I now want to read more about ADHD and perimenopause.... any ideas where I should start?

I still am someone from the outside people would say "has a family/ job...."

Are you able to say a little more about the impact of tech/screen? It looks like it is addictive and I wonder if it makes that search for dopamine part of the daily norm. When I travel on the train, everyone is on their phone, and when they get off, are still looking at the phone when walking. I find myself watching a film while trying to do the shopping online. I really worry about younger people in particular and the inability to focus or just ‘be’, always needing stimulation. No idea how it might link to any kind of diagnosis (if at all) but interested to know your views. Thanks.

So everyone is entitled to ONE assessment funded by NHS, either done by NHS or via RTC which NHS pay for. You can request second opinion fron either, but cant request another assessment. There would likely be timescales to consider. The other option is to pay for private.
If you were borderline and its recent i would go back and request second opinion.

I will try to reply to more later, have to do some work now :) although this is very interesting and insightful.

Yes ill try and post later about screens, trauma and also the RTC v private discussions. Just my opinions on it of course.

Thankyou so much for posting and for this thread - and for the amazing work you do ❤️

Unfortunately he’s been referred by both GP and HV and has been rejected twice. It said “he shows signs of ASD but due to age has been rejected”. Makes no sense. But thank you.

What qualifications do you need to do your role? Thank you

Interesting one.

1. how old was the youngest child to be diagnosed with either autism or adhd?
2. do you get a mixture of different ages coming in or is it mainly a certain age group.
3. why does the waiting list vary so much? I reported concerns about my son when he was born, the paediatrician agreed he had symptoms aged 4 months but he wasn't diagnosed until he was 6. And yet some children are diagnosed aged 2.
4. do you get many people who are assessed but not diagnosed and is it common for them to come back later and be assessed again?

Thank you - will do that. Like a PP above I think that his ASD in what he perceived as a stressful situation in which he masked (plus he is desperate not be appear ‘problematic’ like his older sister) means that some of his behaviours and answers were not actually representative of him in, say, a typical school environment.

I’ll go back and ask if we can review his assessment. Thanks

For me it was having children. Wiped out all the time and space I had to put in place my coping strategies. I didn't realise they were coping strategies at the time but they were. Weird things like working at home with my feet in a bucket of warm water to keep me awake because if the work I was doing was too unengaging for me, my brain would literally shut down and I'd be falling asleep due to lack of sensory stimulation. Nothing to do with being tired either - in my 20s, I'd go into work meetings after a full night's sleep and have to pinch myself to stop myself nodding off if I wasn't engaged by the subject-matter. On the other hand, I was completely "on it" in crisis situations and, subjected to sufficient stress, could pull repeated all-nighters. I once worked 96 hours in a row to close a deal and it didn't seem to have any effect.

Looking back, I can see both the positives and negatives of my ADHD, but it did (and still does) completely fuck up my life to some extent. Low self-esteem, lack of organisation, always feeling on edge. But then this is countered by the ability to hyper-focus and perform at speed either while under extreme pressure or when something catches your interest. But when the pressure eases up or the interest wanes, you're right back to being essentially mentally unable to do the things you need to a lot of the time.

It's difficult to explain and I'm not medicated yet, but essentially unless I can "trick" my brain into complying, it literally goes into revolt a lot of the time when I try to do things that don't trigger a dopamine response. A few examples are, I'll get stars in front of my eyes or the fidgets or suddenly feel sleepy, having been fine just before.

My understanding, but perhaps the OP will correct me, is that ADHD means the sufferer has lower-than-average levels of dopamine or difficulties with dopamine processing. So "less dopamine" is not the answer and screens have nothing to do with ADHD except that people seek them out as a means of getting the "hit" they need.

NT people have something that those with ADHD do not. And that is sufficient levels of certain chemicals that have a stimulant effect and act as neurotransmitters in the brain. That means they get a "reward response" from everyday activities that is lacking in those with ADHD.

Left undiagnosed, therefore, ADHD sufferers will seek out alternative methods of getting what their brains need - whether sensory stimulation, screen time, food, exercise or, in extreme cases, alcohol or drugs.

Medication involves artificially replicating the chemicals which NT people already have in their brains and which allows them to better regulate their behaviour and responses.

I suspect my older DC also has ADHD and I let him have screen-time in small doses in between doing homework so he gets the "hit" he needs and can then concentrate on the homework. I also encourage frequent screen breaks and going outside on the climbing-frame with bare feet in between doing questions as that works to improve his concentration. He doesn't need that at school so much because the environment there seems to put him on hyper-alert anyway. But we have real problems with concentration at home.

I agree!

Threads like this answering questions in a calm and informative way are a rarity. Usually there’s a goady title and big bun fight😆 This is fab.

I know a couple of adults who have been diagnosed with ASD or ADHA, it hasn't made any real difference to their lives - both are graduates, in professional jobs, have good social networks etc.

Do you think that the NHS should be focusing its limited resoures on diagnosing and supporting ND children?

I know you work with adults, please don't take this as a personal criticism!

I appreciate that, however I wonder if a significant proportion of people who are perceived to be “functioning”, are actively masking, but would not be able to keep that up forever. That it’s a potential case of kicking the can a little further down the road.

How do you know it hasn’t made any real difference to their lives?

For women, having children or changes in hormones later on in life will often be the point at which everything comes crashing down. I burnt out within 6 months of being back at work after maternity leave, left my job and have been working part-time at something a lot less stressful ever since. I am definitely under-achieving, but could not manage to combine what I did pre-DC with the constant organisational demands that having children puts on people. I don't have space in my life anymore to recover from the huge toll that my job was taking on me, and I hadn't realised how important that was in enabling me to cope.

If you only diagnose the loudest or those who are most obviously struggling, then ADHD will continue to be undiagnosed in women who will then cope until they no longer can... And then it's not only them but their families and children who will suffer, since our society is still built on women coping and caring for everyone else.

Yes I do actually. I think focus on kids where there can be real impact to education and outcomes.
In addition to kids, adults who are severely impaired and a dx can impact their placement/hospital discharge etc.

My Grandson has just turned 3 (March) and autism was first mentioned at his 12 year check. Nursery have also flagged it and he is now on a “pathway” at nursery thanks to the Senco at the school the nursery is attached to.

Is there a rough timescale of him getting an actual diagnosis and should his parents be looking into an EHCP already? Some people tell them yes and others tell them there’s no rush!