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?

I wish I could personally buy a copy of The Anxious Generation for every person in this thread.

Can you explain what it's about? I've not read it, but assumed it was mostly to do with the rise of tech and social media? My DD10 has no phone, has never played a computer game, and spends her free time playing outside/role play/small world play. If anything, she's quite immature by modern standards.

My child isn't mentally ill and his condition can be seen in family members who predate the digital generation. Which isn't to say it isn't a useful book (I haven't read it) but it's not what is causing my son's problems and it's quite insulting to imply we'd all benefit from reading the book.

Ah, that was less directed at you and more the last page or two of comments about children with anxiety.

I've written several paragraphs and deleted them but the core point is that there is a school of thought that the biomedical model of most common mental disorders today (ADHD, ASD, GAD, various other flavours of 'ND') is less explanatory than a biopsychosocial one. (For example: your DD seems like an immature daydreamer who does a lot of imaginative play and takes a minute to come out of that - is that an inherent biological/neurological problem or is that a problem of mismatch of social norms? perhaps it's actually incredible that she is able to concentrate so deeply on her role play games, while many of her peers today can't?)

This school also argues that there is iatrogenic harm, i.e. introduced by the treatment itself, of going down a medicalised pathway which causes you to reify the disorder in your mind as a fixed biological reality which sets you apart from the norm, rather than, say, a personality trait or a skill you need to develop.

Jonathan Haigt is one of several popular writers including also Abigail Shrier (Bad Therapy) who have this mode of thinking, mostly applied to anxiety but IMO it's as true for ADHD, and explain why they don't think "therapy" and "diagnosis" is always a harmless path to go down.

Note: I was that daydreamy kid, then the good scholar who didn't always do homework, then the young adult who fell off the rails at uni - I didn't go down the ADHD dx path and I'm glad I didn't.

What about those of us who can trace back 3 or 4 generations (back to the 1940s) of family members with SEN that went undiagnosed (labelled dunces, thick, stupid, bad)? No one cared. No one diagnosed. They failed, academically.

My father, my sister, my husband, my daughter, my nephews. All with the same SEN profiles.

I paid for my DD to have an assessment 35 years ago.

This isn't a new thing. It's just a more recognised thing. And if children were taught differently, taking neurodiversity into consideration, there would be a lot less need for diagnosis. Instead of forcing square children into round holes which don't meet their needs.

Of course therapy and diagnosis are not always harmless - the history of psychiatry is littered with horrors - but that’s not exclusive to neurodiversity and points to the need for proper access to qualified practitioners and guidelines. Waiting lists for NHS assessment are forcing people to turn to private practitioners who are not always scrupulous.

I think the key point in here is ‘in your opinion’. From what you briefly describe you didn’t experience any symptoms, so why would you seek a diagnosis?

The biological evidence for ADHD and ASD are strong and the role of epigenetics - and the biopsychosocial model in treatment are also quite established. Over medicalisation is of course bad, but so is under medicalisation.

As for wanting to but everyone a book… Neither of the people you cite are clinicians, and both books are quite broad brush, big on correlation and less on evidence. As you say, neither are really focused on neuro difference, so extrapolating seems a big reach.

I did not just have symptoms but my life was quite negatively impacted for several years. No diagnosis doesn't mean no problems. My fundamental conceptualisation of it is different.

But I feel like it's 2018 again and I'm trying to explain that maybe not all the girls suddenly saying they're trans are actually suffering from a biomedical condition... where to even start?

@OneAmberFinch Scientists have been studying ADHD for decades. They know people with ADHD have different brain chemistry. They have seen in scans that dopamine activity is lower. It has been known for donkeys years that ADHD drugs, which help to increase dopamine activity, reduce ADHD symptoms: They also know it is often inherited.

I know 6 kids that have been assessed for ADHD. 3 were diagnosed with it, 3 were not, but one was later diagnosed with autism. So yes, of course not everyone that gets assessed, gets diagnosed. My friends son was diagnosed privately and it was a thorough process.

This is clearly the weekly goady ND thread though, with the obligatory mention of a ‘label’. 🙄

Your wording isn’t clear - are you saying you did have symptoms that negatively impacted your life? No, of course no diagnosis doesn’t mean no problems. A diagnosis in itself neither solves nor worsens problems.

It’s obvious (to me) that there are various conceptualisations on the thread. Who knows if yours is fundamentally different, but your suggestion that everyone should read a particular non-clinical book to change their conceptualisation was quite insulting.

And goady analogies to trans kids are unlikely to win you any friends either.

The link below is helpful for treatment.

The reality is that it will involve the parent learning about what ADHD is and what strategies work.

There are a number of good books on Amazon available to buy that are helpful. Smart But Scattered Guide To Success For Teens is one (I have the version for adults). If you search you will find others.

It's likely there are traits that you are missing spotting the impact of because you are accustomed to them as normal.

If you can embrace it as learning journey its likely to be extremely beneficial. I am six years post diagnosis and my life is transformed.

It presents differently in girls. It took me a very long time to realise my extremely fast whizzy brain was part of it. I perceive much more than I can convey in words. Ok until demands of situations affect sleep then it crumbles.

With ADHD you need a huge toolkit of bespoke strategies that help with executive function and communication skills.

https://www.nhs.uk/conditions/adhd-children-teenagers/

With due respect to your experiences, if this was going back a few years now, is it still the case now? As this has been a fast changing field. I wad dx privately by P-UK', probably the other 'big one' that is often mentioned back in 2019, and that was with a psychiatrist.

Our NHS diagnosis wasn't with a psychiatrist

Well it was more recent than 2019 and I didn’t say other places were not using psychiatrists. I also said ‘it may be different now’ so I’m not sure what you take to be wrong with my post.

Presumably it wasn’t a pharmacist either