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.

yes, there are secondary questionnaires etc added on if you don't have someone to fill out. I was assessed (by a psychiatrist btw, over Teams) yesterday.

This is exactly the same for me

EPs didn’t say that. The person I replied to said it was those she knew in the education setting so I was explaining how an EHCP worked.

@katmunchkin
That's odd because Psych UK have referred me to their medication titration waiting list, yesterday...

How much does a lack of disciplinary action at work/record of being fired from previous places of employment factor into the outcome of an assessment?

I was assessed for ADHD a year ago and the man in question seemed rather fixated on asking if I'd been written up or formally disciplined for issues at work. He didn't seem satisfied when I explained that my workplace (a nursery) had known me since I was a child and therefore had given me a lot of leeway other places wouldn't. (For example, I struggle with key person paperwork to the point where supervisors frequently have to step in and complete the work for me, and I was recently relieved of that aspect of my job entirely in order to work as a "floater".)

(I'm generally really good at the on the floor aspect of my work but struggle with completing multiple documentation-based tasks on time.)

I did mention other factors that I felt were pertinent to a diagnosis, such as a lack of organisation, messy living environment, poor time management, failing to complete tasks on time or at all etc etc But he said I just had anxiety. I'm well aware I have anxiety, and what it feels like to live with it, but I feel that there's more to it than just anxiety. Almost everyone I've known, from childhood to the present, says I fit the criteria. My therapist (not in an attempt to diagnose me) said I also appeared to fit the criteria.

This isn't an attempt to seek a diagnosis from you or anyone, as I'm aware that nobody is qualified to assess or give me a concrete answer on an online forum. I was just curious if, as an adult, it's expected that someone must have documented issues with their job in order to be diagnosed.

(The man in question seemed to fixate on the intrusive thoughts I had mentioned struggling with, then failed to ever contact me again despite promising a follow up appointment, but that's neither here nor there.)

...On reading this again, I realise it's turned into more of a vent piece than a genuine question. 😅So with all that being said....

TLDR: For adults, is a history of job loss or recorded disciplinary action a key factor that the assessor must receive evidence of, in order to diagnose someone with ADHD?

Also, is it feasible to attempt to seek a second opinion and assessment from the NHS if I feel my first appointment wasn't satisfactory or helpful? Or is it a "one and done" situation? The experience of feeling so dismissed and discounted made me experience some of the worst suicidal urges I'd had in years, so I'm hesitant to put myself through that again if it won't lead anywhere :(

Thank you for taking the time to offer advice to everyone! I hope you're having a lovely Saturday :)

I don’t see how the examples you’ve given are contradictory. I still don’t understand how autism and ADHD contradict each other yet I see it written on here all the time. Are you basically saying that an autistic person without ADHD can’t be extrovert with heaps of energy?

You can ask for a second opinion but it may be a long wait. I asked for a second opinion for my DS. Both assessments were NHS and both resulted in no diagnosis of ADHD. I was told rather abruptly when I asked for a second opinion that it would be the same assessor so expect the same outcome, it was actually a different assessor but still the same outcome. We waited 4 years for the second opinion.

Frustrating as I’m convinced he would get a diagnosis if we went for one of these private assessments but on the other hand it’s made me seriously question the validity of all these private diagnoses

Thank you for responding, and so sorry to hear about your disappointing experience with the assessment for your DS. I had a private assessment a year or so prior to my NHS assessment that resulted in me being diagnosed with ADHD-I, but communication between the private clinic and my GP was difficult, and the medication was too expensive without a shared care agreement.

The private assessment consisted of a questionnaire for myself, a questionnaire for someone who knew me as an adult, and a third for someone who knew me in childhood. The appointment itself only lasted around an hour, which is rather quick. The NHS assessment, however, was two hours at most, which also seems quite brief compared to other assessments?

Although there was probably an additional third hour of the assessment spent talking on the phone to my DM, who has a talent for turning even the most banal anecdote about her trip to the shops into an odyssey so great in length and exacting detail that it would make Homer jealous 😂😂

We discussed the fact I've never held a job longer than two years and have often left of my own volition, yes.
The long and patchy nature of my CV was highlighted at a recent job interview.

I think your message is a touch acidic.
I re-read the doctor’s report. “The parent was present throughout the assessment”.
The doctor’s report is incorrect on behavioural traits, and incomplete on the family medical history as I first described.
He starts the Elevanse on Monday.

How do explain regression and skill loss in young children if you only believe in the social not medical model? Surely given the breadth of the spectrum the reality is both models have their uses?

The adhd process is very odd.
Dd14 is being assessed.
Forms by primary, secondary and parents and child
Initial assessment mainly pg/labour and till maybe age 2 but virtually no detail. (Seemed more about trying to eother say no causes or to find out causes etc) then a qb test.
The qb she moved too much and couldnt follow the instructions.
So no diagnosis
And yet issues weve had
Excluded from 2 extracurriculars
Told off every single year at school. (Throwing sticks at a kid/hitting other kid on head, biting, scratching etc. There was a an element of school pockong on her on later years due to previous behaviour. But also even y6 teacher didnt want her to go on residential. Sent to HT loads ibcluding from reception or sent out of class a lot.
Operation as she did something stupid at 4
Every single extra curricular club has told me about some behaviour (not following instructions/listeniing/kicking someone when sitting/talking too much)
At home severe issues as she hits sibling suddenly every few months. And needs a parent to lead through all homework. But even then it takes hours (yet shes clever)
And yet despite all this school are allowed to fill forms in incorrectly to say no educational issues.
She is definitely very impulsive (but no longer hyper - though hardly sleeps) and more and more inattentive.
but because shes a girl so not getting up in class and because she may have asd she doesnt talk in class or interrupt. (Also scared of bullying)
The state schools literally dont care as she is achieving meeting expectations. She never finshes any tests at school (science, eng, maths) but school wont let her have any extra time!

so the questions would be
--Are girls still being missed for adhd by school and in assessment as both are looking for the worsr which would usually be boys. But the girl could be worst affected girl...

• Is adhd beong blamed on asd because for nhs there is no treatment so no cost
• Do you find audhd girls behaviour flips from say hyper on somd waiting rooms etc to asd when meeting new people.

--shouldnt evidence for adhd be more important than anyones opinion?

• Can adhd turn up in boys at 11 or so or is it more likely trying to impress friends. If so why are schools more keen to blame that on adhd (when it didnt start in early childhood) vs other children who have consistent issues.i
• Do people cla om their child os masking adhd and can it be masked.? Or is that just schools saying its fine except we repeat everything and they never get any work finished etc.

if girls arent usually hyper wouldnt qb test look odd for a hyper girl?

re asd.
can girls with asd seem ok socially until around 7 then start withdrawing?

overall i just dont think a kid who was excluded from 2 clubs and who teacher didnt want to take on residential is ok. And dont think it is just asd

Autism is neither a MH condition or a physical health problem, it's a neurodiverse experience.

If you don’t believe ASD is a physical disorder, are you saying you don’t agree with some autistic children qualifying for high rate mobility DLA in part due to the fact autism is recognised as a physical condition?

@Lindy2
ithink there definitely is something like pda/odd etc as ny eldest is extremely demand avoidant.
Its not just for her in a crisis its pretty consistent eg
She dosnt want to brush teeth, go to toilet, do work at school or home,
She doesnt want to say hello, goodbye or sorry.

@Tiredreal Not getting up out of his seat during a school observation, and being observed to put up his hand rather than blurt out are reasons we were given for DS not having ADHD. Fair enough - except all these late diagnosed women, they weren’t leaping out their chairs and blurting out answers at school were they? Certainly not in the classes I was in.

It’s not clear from your post, does your daughter have a diagnosis of ASD? My DS does have a diagnosis of ASD and this is the main reason he was not given a diagnosis of ADHD, we were told all his symptoms can also be explained by his existing diagnosis of ASD. Yet you read on here about other people being diagnosed with so called AuDHD all the time.

That’s why I’m interested to hear from @magictits about these apparently contradictory ASD and ADHD traits as none of this makes sense to me.

The conditions comorbid to autism such as ADHD, anxiety, depression , OCD, learning disabilities are what makes some autistic people disabled not the autism itself …. Autism is a neurodivergence. My 5 year old daughter is autistic she is not disabled she doesn’t have any learning disabilities. ,when she was non verbal she was arguably disabled as she could not make her needs understood. She is now fully verbal and just started in mainstream school.

That doesn’t actually answer the question in my pp. Some autistic DC without any co-morbidities can satisfy the criteria, including the physical condition part of the criteria, for HRM DLA.

For some, it absolutely is their autism that disables them.

You can choose to describe DD however you like, but ASD meets the legal definition of disability as per the Equality Act.

I disagree with this. I am autistic and very much feel disabled by it. I have difficulty processing due to my autism which has a negative impact on my abilities. I also have social communication difficulties and problems with executive functioning which are disabling. I could go on…

Symptoms causing significant impairment on functioning is literally part of the diagnostic criteria.

How bizarre that our experiences were so different, but then I guess it all depends on the assessor selected, and maybe the fact my appointment was booked for 8pm in the evening!

This is utter nonsense and probably something you made up because you are in denial. Autism is a disability. If you meet the criteria for diagnosis of autism you also fit the definition of disability under the Equality act 2010.

I suspect my child might have ADHD. She also has autistic traits.
But no I would not say it's obvious. And all her difficulties come out with me. Her dad has ADHD.
She lives with me, not her dad.

It all seems a bit of a minefield to me. I mean I know those in school don't see what I see with her. At all. I am also put off by the process of getting a diagnosis. I don't necessarily trust school/medical professionals to know her. It is hard to think of everything and express everything about her. And they can't spend the time I have with her and as there's no definitive test for it how can we be sure.
What I read on here makes me nervous about an assessment. Will they just want to blame it on me and her dad splitting to when she was little?
I have so many thoughts going round in my head all the time about it all

I’ve recently been diagnosed with ADHD and am on the waiting list for Ritalin (it’s a 7-10 month wait) I see lots of traits in my DS 4.

How early can a child be tested? A lot of people I speak to will say oh kids will be kids and boys are later to develop and while part of me thinks yes that could be right, I think he does have it.

He’s always slept terribly, sometimes I can see he’s extremely tired but it’s like his brain won’t switch off to let him sleep. He was delayed with speech and toilet training is still not going well. Main issue is not being able to get or hold his attention to communicate things. It’s like I’m talking to a brick wall, he might be humming/singing/talking about something unrelated at random while I’m trying to talk to him. It makes communication difficult.

He is so easily distracted once I do get his attention and think he’s about to do the thing we’ve asked he will see an object or toy and will pick that up then I have to explain all over again what we’re doong

He can’t seem to focus yet if he’s doing a jigsaw or playing his trains he will hyper focus and it’s like he’s in another world.

He’s very sociable and full of energy but has no sense of danger so being at home or out and about with him we’re constantly on edge. Is 4 too young to diagnose? We don’t want to necessarily label him but want him to feel supported as I didn’t feel supported when I was at school

I totally agree with this and am very grateful for your thread, OP. When I was diagnosed with both Autism and ADHD a few years ago, I did a lot of research and actually had input into some trials. Menopause absolutely amplifies Neurodivergence. I see women on here saying they think they are coping OK and have been masking and being successful. That was me. And while that may be the case in ones 20's, 30's and even 40's, life does tend to fall apart when you hit menopause.

I'm disabled too. It's a bit like you're only not disabled until you are.

That said, it was always blatantly obvious that I was always Autistic (and had ADHD) I was very grateful that both my assessors were very thorough in their assessment of me. My traits definitely go back to being a baby, as do my DD's. Clingy, shy, fussy, separation anxiety. Sensory issues, severely limited foods, the list goes on.

Before I went for assessment, I wrote dozens of pages of my experiences over the years. I was lucky that my Mum also eventually came on board and described my difficulties from being a baby. This was not easy for her as she was in her 70's at the time. I think she also knows she's likely Neurodivergent. My grandmother certainly was.

I also think that ND people are subconsciously drawn to ND people. This goes some way to explain why more children are diagnosed these days as we choose our own partners as opposed to 60+ years ago when you were just married off to the first man available when you hit 18. It is 95% genetic (as almost all recent medical trials suggest) so it's largely multiplied over the last few decades.

So many people self medicated with alcohol and drugs in the past (and still do) Many women were 'bad with their nerves' back in the 70's and 80's that I remember. They were given Valium. A lot were agoraphobic. They were just seen as neurotic women.

Something else that's occurred to me recently is that a lot of kids used to sleepwalk when I was a kid. You don't hear much about that these days. I wonder if that was a symptom of ND.

I don't like the rhetoric that it's over diagnosed. That it's 'just' bad parenting (my personal pet hate) That they give out diagnoses like sweeties, or that the Pandemic caused the upsurge (although it clearly amplified a lot of kids anxiety and inability to cope). It doesn't help anyone.

My final point is that school isn't helping. Lack of funding, and pressure to reach targets is causing both kids and teachers a lot of stress. That said, back in my day, the 'thick or naughty kids' were all just put in the remedial classes. And there were a lot of them. I guess at least we are moving forward, but there's still so much stigma and misunderstanding. Even people with Autistic kids talk about the 'two ends of the spectrum ' like it's a horizontal line (which it isn't) and don't get me started on 'we are all on the spectrum' This is largely the reason that a lot of folk keep their diagnosis to themselves. Sure, there are the Tiktockers, but there are also Tiktockers pedalling botox and lip fillers. That's social media for you.

Thanks again for your thread, OP.

Oh gosh. An 8pm appointment sounds like a nightmare. I guess it's like anything; you get good GP's, good Tradespeople etc and also not so good. It's frustrating and exhausting though. I've spent 5 years fighting for me and my daughter with our various health conditions. Paediatricians, Immunologists, Rheumatologists etc. It literally seems like a never ending merry go round.

I wish I could have given you the name of the Psychiatrist I had.