How accurate is ADHD diagnosis

[Hotdoughnut]

Thinking of getting my DD10 assessed. She gets distracted easily, seems to have seconds where she is absent, doesn't meet her full potential at school (although is above avetage), mild issues with clothes/sensory, easily gets obsessed with things (a certain film etc). All of it is almost unnoticeable, friends think I'm mad (even husband thinks it falls within typical kid). But I think she masks well, especially at school. If we get her assessed, is she bound to be given a label? I've heard that nobody gets assessed and is told they're neurotypical. I just want her to get the support she needs to thrive, but I'm worried I'm seeing something that isn't there and she'll be given a label regardless.
Are the assessments pretty accurate?

The mild issues with clothes/ sensory to me hint it wouldn’t be bad for you to go to someone (from an adult who puts clothes on backwards, struggles with tiny things that make me faff about more than others and make everything seem that bit harder) I suppose that’s what I think of a diagnosis of anything as, you get a bit more in terms of coping tools but also people give you more space and leeway if you need it. Best of luck either way op x

@Hotdoughnutand handwriting? My dd just cannot do lego, jigsaws etc. my dd also has hyper mobility - only really in hands though I think. She hates all sport - especially stuff involving throwing balls.

I know you didn’t ask my but I have an experience, or rather lack of, to share.

i was looking for an adult ADHD assessment and ADHD360 had actually been recommended over a few places, forums etc so (true to form) i impulsively booked an assessment only to find out it was going to be a pharmacist doing it. I immediately contacted them and got a refund for my deposit. For something so important I just assumed it would be a psychiatrist. I then spent a lot of time researching and realised most of the services offering these assessments privately had information about the assessors and their qualifications clear for all to see. ADHD 360 did not. They may be different now, I am going back a few years, but for me a pharmacist trained to follow an assessment isn’t the same a a psychiatrist who can also ‘see’ other things going on and signpost if necessary.

Yeah I think if I was paying privately I would have expected a psychologist too and done exactly as you did.
They do now have their clinicians listed. We used them via right to choose as they continue to prescribe if your GP refuses shared care which the GP in our town does.

I would not seek assessment with minor issues, where there is little impact on day to day. Services vary in a quality of assessments, and NHS does not need to accept the outcomes. I am also aware assessors may lack the experience to rule out other causes, and overinterpret everything as neurodiversity. But this is only my view.

You have captured exactly my concerns. To most people she is a completely normal child. A little quiet, but bright, lovely and polite. But I see it, increasingly as she gets older, and I worry she is exhausting herself by masking constantly. It's a lot to think about.

Handwriting scruffy/spikey until end of Y2. Then she got an amazing teacher who showed her a few techniques and from Y3 onwards she has the most beautiful handwriting and was very proud to be first in school to receive her pen licence! She is very keen to please, and worked so hard on it.

Yes please can you pm me? We're in Buckinghamshire but near Hertfordshire, Oxfordshire and Berkshire borders, or London. Would definitely travel. Thank you!

You can't get diagnosed witb ADHD if there is little impact - that is part diagnostic criteria.

The trouble is that much of the impact of ADHD cannot be seen, plus girls and intelligent kids are especially good at hiding it.

https://thekidsclinic.co.uk/about-us/ was recommended by a work colleague who used them. I didn’t as too far from me.

I was diagnosed a couple of years ago. Never crossed my mind that I had it, but it was spotted by EIP. Good lord, the assessment was gruelling. Took about three and a half hours.

I don't have much advice when it comes to assessment- I'm not in the UK- but I was diagnosed in my teens and it has made a world of difference to my self-esteem.

Before my diagnosis I didn't know what was wrong with me, but I knew something had to be. I was clever, had always been told I was clever, but useless at using it for anything. I couldn't even focus on the things I wanted to do, which colloquially seems to be a key indicator of whether or not someone has ADHD. Struggling to do things you don't want to do is normal to some degree, being unable to complete things you love and are desperate to do is not.

Unfortunately I was diagnosed too late to make much difference to my school experience, and I never achieved the grades I wanted and was predicted. My mother had suspected autism and ADHD from my early years but was dismissed by the family GP who had little to no understanding of either. I fell apart in my teens- severe anxiety, self-hatred, depression, stress-related illness- and after a few years was referred to CAMHS by my school due to poor attendance. I tried medication and ultimately found it wasn't for me, but I spoke to others with ADHD online and in person and developed my own coping skills and techniques. Thankfully at university, understanding how my brain works far better following my assessment and diagnosis, I managed to make up for my poor performances at school. I haven't noticed any downsides to my diagnosis, personally.

(I'd still love a chance to go back and do secondary school again, now able to work with my ADHD rather than against it. There's so much I'd love to learn, and I feel like I missed so many opportunities)

As PPs have said, if you find a reputable assessor then there's no reason to distrust a diagnosis. The process is quite thorough, usually involving several questionnaires/interviews with different sources and then an in-person/video call assessment of symptoms. I hope you find the path going forward that's right for your DD!

I think it’s more than support at school, it’s about understanding herself and potential vulnerabilities. I’m going through assessment for Au/ADHD now (40s) and can trace many very difficult things that happened in my life to my rejection sensitivity (doing anything to fit in, desperate to be accepted), not understanding other people’s motivations and problems with executive dysfunction.

It’s harder and harder to mask, which is mostly good, but also the same problems with concentration and confidence eat away at me. I get why people don’t want a label for their child - or themselves - but it’s not just about how others see them, it’s how they can accept and know (and protect) themselves. I have been been broadly successful with some disasters, so as a young person/young adult I don’t think anyone would have considered assessment for me. Thankfully for your daughter she has a perceptive mum and lives in a time when these things are better understood.

The definition of 'impact' varies almost as much as the definition of 'often' in diagnostic criteria when it comes to different services.

I don’t suppose the actual word ‘impact’ is used and I expect whatever the wording is, psychiatrists have a clear understanding of ‘serious impact’ or whatever the actual term is. You really won’t be diagnosed if your symptoms are genuinely ‘mild’.

This is very interesting. She was hypermobile as a baby, and even at 10 doesn't enjoy physical stuff, cycling etc. Although she enjoys running (build like an athlete, she's so slim!)

I agree with this.

I’d like to add:

• ADHD affects people’s executive functioning, which is to do with stuff like organsing and planning. Impulse control and working memory. As a child gets nearer to adulthood, these types of skills are needed more and more. So for example with a bright and motivated child, they may not have issues with GCSEs but studying beyond that could start to be a problem because greater executive functioning is needed. Another example of this is time blindness - this is why people with ADHD are usually either ridiculously late or early.
• Teenage girls with ADHD (especially if undiagnosed) often have crippling anxiety and very low self esteem
• According to my psychiatrist women with ADHD are more vulnerable to domestic abuse due to low self esteem and people pleasing tendencies, so they need to be aware of the signs
• Difficulty reading social cues can cause misunderstandings
• sleep problems

this is just a few. There are many other points on this thread. Not all of them will apply to everyone.

Hypermobility is common witb people with ADHD and it was assessed in both mine and DC2's assessment. DC2 is hypermobile and I am not. DC2 can do the spilts and bend their thumb back to touch their wrist and contort their arms into amazing positions.

@dizzydizzydizzyagree. My dd has massively low self esteem and is a people pleaser. She would rather be miserable than upset ‘friends’

One of the main concerns I flagged to the assessor was that as she is getting to an age where she may think about starting about a relationship this could put her at risk of getting pressured into things that she is not happy with.

Does the medication help with that anxiety & self esteem?

Yes the medication helps massively with anxiety. I would say self esteem is something you have to work on over time, potentially with counselling.

The first time I took the ADHD medication, I felt this massive tight knot somewhere in the centre of my body melt away. It was anxiety! I never knew it was there until it went! It was totally amazing! I also felt an overwhelming sense of focus and calm.

DC2 has suffered terribly with anxiety and I can tell when I am talking to them if they have not taken their medication or if it has worn off because they are much more anxious.

Thanks @dizzydizzydizzy. At the moment she is completely unreceptive to the idea of counselling. They started on some at school linked into self esteem and she refused to go after 2 sessions. I am hoping that once she is on meds maybe emotions will even out and she will be more open to it.

That sounds tough. My DC2 liked counselling at school because the counsellor had her dog with her but apart from that insists it is a waste of time - went to a couple of sessions at uni and refused to go again.

Counselling has helped me massively - at least it did once I found the right counsellor. I have had 4 in total and only one of them has has helped me make big strides forward.

@dizzydizzydizzyShe is also potentially autistic as well, the adhd assessor she doesn’t seem to understand her feelings and maybe that’s why she finds it so hard to talk about them.

but that’s been the case since she’s been 7 - she had sessions in primary on it.

Yes, DC2 and I are also autistic. I’m late 50s and even now, all I know is that any emotion I have is either positive or negative. I have very little ability to narrow it down more than that. I have improved slightly over the years. It is a serious disadvantage and it has made it easy for people to bully me.

I've seen two reports by them where the assessments are done by pharmacists. While it technically meets NICE guidelines as they are very vague, I think it's worth getting someone properly qualified and experienced to do the assessment.