‘Interesting’ article on overdiagnosing in Times.

[Soontobe60]

Just putting this here for discussion.
https://www.thetimes.com/article/9f82545c-57f5-4db2-8a47-9a8cc2304243?shareToken=c0f809004b0c59cf1b96f6b6eb6129c3

Many professionals I work with, both now and in the past who diagnose are questioning their own diagnoses of children that they've now seen grow up to consider attachment disorders more likely. Other professionals also query attachment disorders and trauma responses, the traits can be very similar. There is a huge overlap and its difficult to pick apart the behaviours. There is huge concern amongst teachers/SWs/health professionals/CAMHS about the lack of differentiation now between what was Aspergers and ASD and there being no descriptor for the differences. Its unhelpful, I think it will change back again, either to 'high functioning' or some other descriptor as so many professionals now are unhappy with the lack of difference.

Agree - unfortunately we now talk TOO much about mental health and turn kids into anxiety ridden worriers rather than kids that can take knocks and bounce back.

Thanks for this. I do think things are getting better now with this generally and am thankful for those medics who are pushing for research on ME/CFS.

👏👏👏

Or the parents ACEs lead to the children’s ACEs which is what we see more I think - children growing up in chaotic households because their parents did and so on. We are seeing many generations of inter generational trauma that’s being potentially misdiagnosed as additional needs which means families are not getting the appropriate support to break the cycle.

It's quite well known that being around horses is a form of therapy for autistic people. I work with an autistic lady who also has a learning disability, she can be violent, she cannot hold a conversation, can't safely cross a road alone. However, she can rife beautifully and is very calm and safe around the horses.
There's a good chance your relative struggles much more than you realise and you are making an unfair judgement.

And actually its reported on descriptions of behaviour more often than not. Its all very well people trying to validate their own or their child's diagnosis by saying 'there were several interviews and a history taken and interviews with me', well yes, whatever you're describing is taken as the evidence

There will be lots of children whose behaviour is very similar at school, in the community, at home, whose behaviour will be obvious during the assessment sessions and interviews, whose behaviour is well documented in other professionals reports.

There will be some children whose behaviour is said to be mostly or only at home and masking everywhere else.

When my son was diagnosed with cancer, they made it perfectly clear how brutal treatment would be to the point he didn't even have chemotherapy the first time around due to the complications the tumour caused making him critically unwell and it was all removed surgically. It was agreed that risking the cancer coming back was a much better option than putting him through chemo when his body was so weak and unwell.

When it did come back, he was stronger and able to have chemotherapy but even then, his body still wasn't 100% so they adjusted his treatment plan and he had a smaller amount of one of the chemo drugs because it was deemed too risky on his body to have all of it.

Of course, he's a child and not elderly so maybe it isn't explained as well to the elderly or maybe they don't understand? It is all very overwhelming and very easy to become confused about it all when you aren't elderly.

I agree. I stopped having smear tests before I aged out of them. I did my own research before I took the decision. I went to see a GP shortly afterwards for something else and he mentioned my lack of recent smear results so I took him briefly through my decision making process. He was a bit surprised but said he followed and agreed with my reasoning.

I think one day there will be a 'test' for ND, by way of looking at the genetics more clearly. Things move on and evolve in science.

If I had a diagnosis when I was a child it would have changed my life completely

Having a diagnosis would have triggered my whole family getting diagnosed. Which would have meant we would have worked better and probably wouldnt have led to suicide attempts and hospitalisation with mental health issues and with meds we wouldn’t have all been relying on benefits.

Imagine feeling ill. You have a list of symptoms, one of which means you can’t walk unaided but are not allowed to use a wheelchair.
You struggle through your whole life getting around on sticks until you get to 60 years old and suddenly there is a name for the reason you can only walk with sticks and with a diagnosis there is a pill you can take and when you take it you can walk unaided

Do you really think a diagnosis is any good

Remember people with undiagnosed/unmedicated ADHD have a much shorter lifespan than a NT person and their brains aren’t the same shape as a NT brain

Me too.

I didn’t mean the Head of Planning was handing out ASD diagnoses.

LAs part-fund CAMHS (alongside clinical commissioners), and the SEN teams in the LAs now work on the basis that the local CAMHS are no longer funded to diagnose so the lack of a diagnosis should not prevent the appropriate support being put in place for the needs evidenced.

It won’t be surprise anyone to know that there is a lot of scepticism that this approach is being done to meet need better.

I was reflecting on this very topic at a funeral the other day. I was educated in the 90’s and whilst there was an awareness that there was something ‘wrong’ with me no one at our school knew what to do so we were left in a room by ourselves (1 girl, 8 boys). Since we’ve left school 3 of us have died, 2 from addiction and one in act of violence. The remaining members of the ‘special’ kids have had substance abuse issues, partaken in criminal activity and all have mental health disorders ranging from schizophrenia to depression. We were all present at the funeral and it was very clear to me that we all would have received diagnoses and support these days. Things have got better not worse.

@Yalta Where there is effective treatment of course diagnosis helps. Where there is not it helps some people and is negative for others.

I hope you are being supported at the moment, however ADHD meds are not a panacea and dont work for everyone, and there is no medication for ASD specifically although lots for comorbid conditions

Its also very difficult to persuade reluctant children to take their medication, you may have not been such a child but many are.

@Bornnotbourne I am sorry to hear that.
I grew up in a very poor area. Every single boy in my street grew up to commit a criminal offence serious enough to end up in the local paper. Every single one, and we are talking about 20 boys. Now days they would probably all be diagnosed with ADHD or ASD. Some of them may have this, but most just lived in dire poverty and some had very chaotic families.

Ok I wasnt sure what you meant. Yes I know how they're funded

I can understand the skepticism

Possibly yes, I take that on board. However, a lot of children struggle at one time or another and then so on into adulthood. I just wonder where the line is drawn between "labelling" them with a condition or actively encouraging them to overcome such struggles.
A lot of us have to do things outside of our comfort zone a lot of the time. There are a lot of things in my life I would rather not have done (in school, in work etc) but pushed myself even though I may have felt uncomfortable and socially awkward. I do feel these days people would rather assign themselves a label than challenge themself.

I agree with this. I realised as a young adult that focusing too much on how I am feeling just increases any depression or anxiety. You have to do things to make life better.

But if the nhs is underdiagnosing, due to gate keeping of who gets a test, refusing CAHMS referrals, and long waiting lists, then it would make sense that more people who can afford private are diagnosed. Also if schools are not noticing neurodivergence so only the educated are likely to recognise it in their children then children of the educated are more likely to be diagnosed.
Resulting in over representing the white middle class. But only because others are underdiagnosed.

Part of the problem is the long, long wait for a child to be seen by an NHS ADHD diagnostic team. Especially if they are not causing too many problems at school.

My DD has recently had a private ADHD diagnosis after her previous teacher advised that it was likely that she had it. I have to say that it did feel like I was buying a diagnosis, especially with the invitation to pay significantly more money if we wanted medication.

I agree with an issue that a previous poster mentioned; I am concerned that the lack of thoroughness means that the possibility of another diagnosis (eg anxiety or personality disorder) have been missed. I’m not going to go into her symptoms, but there is obviously something going on and at least her (new) teacher will realise that she needs extra help not that she’s deliberately not paying attention. What else can I do? The ADHD assessment was a big stretch for us financially, we haven’t got infinite resources.

Is this because with the NHS referrals the kids are coming back with other diagnosis that are more difficult to diagnose? Or are they all cleared as ‘no problem’?

No it is a massive social experiment.

Adverse childhood experiences