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.

@magictits I was diagnosed privately with ADHD (the inattentive type). Which later turned out to be B12 deficiency that was easily corrected via injections. I only discovered I don’t have ADHD after going on holiday and forgetting my medication (a little while after my B12 injections started) and found I had no symptoms!

Do you recommend getting checked out for this type of deficiency prior to an ADHD assessment?

What was your path to qualification?

Sure, but I would have thought you'd be involved in therapy groups and sessions rather than assessments in any major way

This is the biggest struggle I find when assessing someone older. Separating trauma from neurodiversity is notoriously difficult. Especially because trauma will increase the symptoms of autism, as will menopause/puberty in women.

Unpicking that is very very hard. We often see menopausal women, who also have maybe experienced a traumatic divorce and they have presentations of both trauma AND autism. But as we know that trauma does increase some symptoms of autism this isn't surprising. There is some real overlaps - and sometimes it isn't neurodiversity at all it simply the trauma, but often its both.

Absolutely.

"You cannot do the training in ADOS-2 without a masters in social work or psychology." - that's not true, at our local hospital they are carried out by the SALT on the paediatric team.

My dd has her autism diagnosis. She is 6 and isnt yet verbal but is acquiring language slowly 🥰

I think that she also has adhd. She is constantly jumping and running. Can I get an adhd diagnosis at 6 for her?

And does sugar make the adhd hyperactivity worse?

Thank you x

The assessment for my child was robust - seen by paediatrician, clinical psychologist, speech therapist. Evidence obtained from parents and nursery.
What objective evidence is obtained when assessing an adult or is it all self reported.

I honestly think ADOS-2 isnt fit for purpose. It is so male-centric women and girls commonly get misdiagnosed or missed diagnosed. We use it, as that is the gold standard main tool, but we go way way further with our assessments. That is why the comments earlier from the 'you must be a medic' kind of sticks in my craw, because I strongly believe social workers do the best assessments. We do extensive family assessment and history that is often overlooked in medical profession. And we look at the history and wider picture. As social workers we see time and again in practice the effect it has on women and girls through their lifespan being underdiagnosed or worst still - misdiagnosed (usually with BPD or Bi-polar). It makes me very angry in fact. We see females struggling so much with abusive relationships, work, motherhood, addictions, and often it is undiagnosed autism and they could have received help and support.

Anyway I will leave that there because I could rant about that all day....

Autism isn’t a medical condition …..

My Ds is badly affected by additives and colourings in foods and too much screen time. He still has symptoms without these but they definitely make it harder for him to regulate himself. Cutting out ultra processed foods has made a difference.

My DS (23) has been on the autism waiting list for nearly four years and we have been told his assessment will be in the next few months. Will he be given a choice of face to face or via Zoom? I’m worried a zoom assessment will be difficult as he’s barely audible face to face. Will he be expected to do the assessment without me or his dad present? I’m concerned he will not answer questions and will mask.

I always do actually. Full blood count. Because low iron and b12 can do very funny things to you.

Thank you for this thread, OP.
My DD is just going into Y8, and has really struggled with secondary school, albeit not academically. She’s always been very shy but over the course of Y7, I’ve started to think there’s more to it than shyness — and, specifically, that she might have ASD.
I’m planning on talking to the school welfare team/SENCO next week when school reopens, but my big fear is making my DD feel even more different than she does already (especially if it turns out she doesn’t have ASD).
I’m not expecting you to advise about my situation specifically but do you think it’s always beneficial to go down the assessment route? And do you have any tips or advice for parents (me!) who are only just beginning to consider it?

Can you still be assessed as an adult if you have no one to be interviewed about your childhood or your home life? I enquired about assessment but the place said they would want to do an interview/questionnaire with a family member or partner and I don’t have anyone who could do it

@magictits thank you for this thread.
I recently had an online interview for my dd ados.
It was incredibly hard to answer the questions. And most of them were "did she do x when she was 4?" "Give examples"
1 I couldnt remember as it was 13 years ago and my memory is shot after peri/menopause
And 2 how can you notice if someone is behaving "unusually" if they behave like your whole family?
How can a family member be expected to notice ND behaviour if they are themselves genetically similar but undiagnosed? There doesnt seem to be a place in the 100 or so questions to say how should I know?
I feel like i have failed my daughter by not knowing what to say.

A full bloood count doesn't identify low b12 or iron, only anaemia, you have to order these seperately. Good to know social workers are diagnosing anaemia and vitamin deficiencies too

They are for the NHS assessments here but it is all reported back by the SALT to the multidisciplinary team to see if the threshold for diagnosis is reached.

Well I dont know how because for my training I had to supply all my qualifications and they needed to see I had a first in my masters as well, and contact all my employers to look into my experience. You can't get on an ADOS-2 training course easily. They literally wouldn't let me on it until I showed evidence on my first class Msc.

I was assessed as an adult and needed input from old school reports, my parents and my husband. They spoke to my husband for three hours (we’ve been married for 20 years).

The main role of a social worker is to complete holistic assessments to analyse what is happening and why. That is what they are trained to do. I've never seen a medical doctor write an assessment as detailed and thorough as a social worker so I'm not sure what all the outrage is over a social worker with additional training completing autism and adhd assessments.
OP, there seems to be a lot of overlap with CPTSD. How can you be sure an adult being assessed has autism or adhd when there isn't strong evidence about their presentation in childhood?

Next question 😂 if a girl has been assessed and has been told that she is 'quirky' but 'passed the ados with flying colours' how do we get her reassassed? We've been told that she can't be as her 'issues' are due to having adhd which was already diagnosed. Her sisters and both parents and 2 aunts all have a diagnosis of autism and I'm not convinced by the process.

I've heard that there is a move away for labelling towards identifying individual need/difficulty. What do you think about this? Autism is such a huge spectrum that it does seem a bit unhelpfully vague.

I was told that someone who knew me well at school either a teacher or friend, if I could find them, would suffice.

apart from validation, is there always a point to a diagnosis in adults?