Im an Autism and ADHD Assessor - AMA

[magictits]

I get heaps of questions about this IRL so thought I would post here and answer any questions in case they are helpful to anyone.

How many sessions does it take for a child to be assessed for ADHD? My Ds has his first appointment on Monday. I’m diagnosed with autism and ADHD and school already have adjustments in place for him.

The assessments are gruelling. I was mentally and emotionally wiped out for a long time afterwards. I think people think it’s an easy and simple process to get diagnosed. They certainly don’t understand female presentation.

I can't get my head round this thread. Surely the major parts if the assessment are done by medics. It doesn't seem appropriate for a social worker to be involved in the majority of cases. Involving a young child with a social worker equates to being involved with social services

My DS was fairly recently diagnosed via NHS and as you say it's a very very thorough process. I know it's highly genetic and I see traits in me, his siblings, his Dad and extended family. His grandfather who was highly academic also had significant traits.

How common do you see one diagnosis leading to other diagnosis in same family? I have a suspicion that ASD is way more common than we realise and for every one diagnosed there is probably a number undiagnosed, would to you agree?

How rude.

You cannot do the training in ADOS-2 without a masters in social work or psychology. And you can't be part of the MDT team without extensive experience. Social workers aren't taxi drivers.

Im doing this thread to help people in my free time because I care about the struggles people on the spectrum are facing. So Im offering FREE advice in my own time.
I wont respond to you again.

Also, when I tell people I think I’ve got ADHD they are shocked because at work, they see me as ridiculously organised and extremely calm. However, the over organisation is a strategy for me - I find being organised very stressful and chaos even more so, so I over over over organise myself to avoid falling apart of that makes sense? Is that a recognised symptom? And although I may appear calm on the outside in stressful situations I think this is just me freezing as inside it’s like a volcanic eruption!!

Not doctors making the diagnosis then.

This is the next bug medical scandal, social workers should be part of the psychiatry mdt in order to help people with their social issues, not as a cheaper pseudopsychiatrist. Doctors are the only health professionals who are trained to diagnose. In a few years time there is going to be a lot of backpedalling and difficulties trying to unpick this mess.

That’s good to know, thank you! I’m so worried about when it comes to filling the forms in that I’ll end up being dismissed before the assessment because I’ll put the wrong thing!!

I have three children all diagnosed autistic and for about the last 10 years I have seen many of the traits in me as has my husband. I asked my gp for a referral for assessment but at the initial appointment the dr said he didn’t think I was as I was obviously a social person (I said I had three friends and when we meet we go to the pub) and I had got to my age (49) without major effects ( I haven’t worked for 19 years as I found it too stressful so I’m a sahm but he didn’t ask about work) instead he thought I was probably anxious and should try anti depressants and trauma therapy (I’m not depressed and only get anxious in situations I can’t control)
I felt very unseen but also maybe he’s right so now I don’t know. Should I go for a private assessment?

Our are 3-4 hours of time with the client. I know how gruelling that can be so I split it up for the client if they need to. For a young child I ensure they can take breaks/jump/use fidget spinners whatever they need. I dont think other assessment places do that though. For me the clients comfort is important and to put a neurodiverse client through a 3-4 hour assessment in one go is insane.

Sorry - another question (DH is literally still filling in his initial ADHD assessment forms right now and getting extremely stressed!!) - he is being thorough with the forms because I’m helping him think of examples - but I worry when he has the in person (or zoom) assessment that he will just play it down and be unable to think of examples or remember the ones we have discussed. I feel this is a symptom of ADHD as he forgets EVERYTHING and avoids difficult questions. Would they take this into account without him specifically saying ‘you’ll get better info from what I put on the forms because this is very overwhelming and I can’t think of enough examples/context now to support my assessment’ ?!

Neurodiversity in the immediate family is a huge indicator.

@Hobbiestwriterwhy are you being a dick to OP? Most doctors haven't a clue about ASD and ADHD because they aren’t trained in it. OP is and the diagnosis is made via an MDT so she’s not diagnosing in isolation. If you knew anything about the assessment process you’d know you are talking utter nonsense.

I would - and did.

As I said before GPs are widely misinformed and uneducated about autism.

Is it reasonable to say if somebody becomes fatigued by socialising then that is a sign of ASD, or is that too generalised and from TikTok?!

My son was diagnosed on the NHS by a speech therapist, there was a doctor involved but she never even spoke to him she only spoke to me. This was over 15 years ago. I believe the process has to be overseen by a clinical psychologist, psychiatrist or a paediatrician but there are many other professionals who can do the assessments.

You do realise that social workers do a lot more than child protection right? I'm not being sarcastic here. We specialise in all sorts of fields.

How long are wait lists currently. One of my twins was referred to children’s paediatrics nearly 3 years ago for neurodiversity assessment, her identical twin was denied, but last year got an acceptance to CAMHS referral, for ADHD as secondary school supported the referral, both are still waiting to be seen.

Him being honest about his overwhelm and not masking in the assessment is my advice. When we see the struggles and in what areas then we have more understanding of what he can or can't do.

Like for me, I am intense with my eye contact but then it gets to the point after an hour where my eyes feel like their burning. I shared that with my assessor - that information is good for them to know. So get him to share honestly how he is feeling and why through the whole thing. Because its not just what we are talking about with you, we are noticing HOW you are presenting in the assessment if that makes sense.

Im currently waiting to be assessed via the nhs (its been 3 years). I score very highly for asd, watching the inside our minds documentary, i instantly related to one of the participants. I displayed autistic traits as a child too. However i also suffered a very traumatic childhood, and am wondering whether the traits i display are because of the damage done to me from a very early age.
When i have my assessment should i mention this or will the assessor be trained to look for signs that possibly stem from a difficult childhood? Is there a way of differentiating between the two?

I would say it could be. But the assessor would need to know far more.

Do you think the ados is weighted towards boys - girls present very differently and this doesn't seem to be reflected in the assessment process. Do you think that girls are more difficult to diagnose, particularly with masking and giving answers that they think the assessors want to hear

Depends on location. But sadly its long - talking years.

I'm a parent of a teenager who has ADHD with autistic traits. Not diagnosed ASD - in fact in hindsight it was burnout from secondary school that caused a sudden escalation is autistic type behaviour and PDA.

Anyway as a parent living with a neurodiverse child/young adult I have a few questions. I hope that's OK.

• What do you think about the explosion of non binary/trans in neurodiverse children? Has it always been there but hidden as less socially known or is there social contagion? Do you think this tendency is here to stay now?

• What do you think about the level of support given to families? Personally I think there is some support for low level needs but when needs escalate, like we experienced with puberty and burnout, there's just nothing of actual practical help out there.

• Possibly controversial, but my growing belief is that there is just neurodiversity. There's so much overlap and such a range of symptoms that I increasingly believe there shouldn't be different ASD, ADHD diagnosis. It is in fact just neurodiversity.

• Do you believe PDA exists? I understand some professionals say it doesn't. My experience is that when overwhelmed my ADHD child goes into a massive PDA crisis. When not overwhelmed the PDA lessens. Perhaps it's a sign of crisis rather than an actual diagnosis?

Due to long waiting lists via the NhS lots of charities are competing to do Assessments with NHs funding (they are not NHS services) and it is much cheaper to get an allied health professional and get them to do tick box forms and assessments than to pay a proper psychiatrist to do a 3 hour face to face assessment which is the only way to actually have confidence in the diagnosis.

Even in NHS services there is a shortage of psychiatrists so work has been outsourced inappropriately to social workers who should be focusing on social assessments, not diagnosing and prescribing! It's to save money but it's framed as 'mdt working is best for the patient, we are all the same just differently trained' It's a huge scandal akin to physician associates filling in for GPs to save money and then making the wrong diagnosis and killing people.

A but like physician associates, transgender prescribing it is a scandal and in a few hears we will be looking back in horror. If you haven't been diagnosed by a psychiatrist you have no idea if your diagnosis is valid. Most of the ADHd charities are cowboy firms who do a poor assessment and then try to bounce it back to the GP for 'shared care' (NOT very shared) and wash their hands of the situation )

Do you think Covid or the Covid vaccine has “re-wired” our brains?