Autism / ADHD diagnosis via Zoom?!

[WhatEh]

I had heard this was happening on the news, but to be honest, I thought it must be a small, isolated amount of people…

However, upon speaking to my friend yesterday, it turns out it’s very common for the NHS to refer people for ‘remote’ diagnosis - her own DC just did their autism assessment over Zoom and was diagnosed!

I understand needing to reduce the waiting list and burden on the NHS. I can’t help feel this is totally inappropriate.

When my own DC was diagnosed with dual ASD and ADHD, so many things the psychologist picked up on were from physically seeing them. Differences in body language, eye contact, sensory differences (one of the things that alerted her was them taking their shoes off when they came in the room).

I just don’t understand how something as complex as ASD can be diagnosed over Zoom, especially when lots of the criteria relate to differences in body language and communication. I am not autistic and I communicate differently when doing a meeting in person vs online. They haven’t even met the person who they are diagnosing.

I did my autism and adhd diagnostic exam over 2 days - 1 day at the centre; they met me and we went through the autism. The next day was zoom - so they had already establised who i was, seen me,recorded me etc and then this was just to back up/supplement what they knew/had seen

I really would challenge it - an incorrect diagnosis can lead to all kinds of problems long-term.

I understood what you mean in your circumstances as you already have the EHCP in place for your DC. Some kids won’t be eligible for an EHCP even if they do get a diagnosis.

My provider didn't offer assessments for children under 7 (?) I think, whilst as an adult a lot of the diagnosis is based on your experience as a child. I can see why it wouldn't work for children but for many adults it can work.

ODFOD

@feelingbleh it's not good enough

Def ask for a review

Not ok at all

My son had a zoom interview, but it was one part of the bigger picture. He had to complete an assessment form, reports were gathered from other professionals involved with him, we were interviewed by zoom as well.

The zoom bit took the place of the face to face interview.

There was much, much more involved than a zoom call.

I think you are making assumptions about autism - your child taking their shoes off may signal sensory issues but so can a survey - people are not expected to visually show their sensory issues.

My daughter has autism but masks - she knows to actively look someone in the eye while seeing them in person. In fact she shows more of her autistic characteristics online as she is less likely to mask. She had an online ADOS assessment (could have done this in person) and they were able to articulate her body language which was suggestive of neurodiversity.

As for hyper mobility surely it is observed and revirded as one of the symptoms leading to the review? It doesn’t need to be demonstrated during the zoom meeting?

While I agree that for some a diagnosis doesn't help, I think it's true that for almost ALL children WITHOUT a diagnosis, support is non existent. The diagnosis means the chances of getting that support is there.

And certainly, I think as schools and employers etc are educated on ND, knowing someone has ADHD or ASD can impact lots of things. At school especially, for example, because of DS' diagnosis, it will be EASIER for the school to apply for him to get extra time and/or the quiet room for his GCSEs. Even WITH the diagnosis, it's not guaranteed. But it's on the table whereas it wouldn't be at all without it.

I also think that for a lot of ND conditions, parents seem to think that "support" means "fix". It's totally understandable - if our child breaks their leg we go to the hospital and expect them to do things that fix their leg. But that's not how ND works so sometimes that support, minimal though it may be, is as much as you can hope for.

I have been wondering about this.

im looking into going down the right to choose pathway for my son who is 6.5 but what puts me off is it being online. I just don’t think they will see anything.

he masks at school very well so they are 0 help.

Was the assessment done privately? We’re thinking about going down this route as I agree, I don’t have any confidence in a zoom assessment, especially when medication might be recommended.

My secondary school age dc has been disagnosed within the last year, in persom, and received the exact same things.

Lengthy questionnaire to me, one for school, an assessment in person for dc, and a meeting with me covering their childhood and development.

Recommendations for school (and Uni goinh forward) were discussed in the final mmeeting when they gave the diagnosis.

Surely it depends on the child and the level of their needs?

I have 2 on the spectrum and it's not my experience. I theory, support should be based on need but in the real world in the UK with limited resources a diagnosis is more often than not an important door opener! Should not be but that is the reality .

I doubt the validity of an online diagnoses

Yes, both the ASD and ADHD were private. I appreciate I am in a very fortunate position to be able to afford it all. It was probably close to £4k for both, with all the follow ups etc.

I do feel it was worth it as it was a very thorough assessment, and they really understood my child. We also continue to see the same ADHD clinician on an annual basis and they really know and understand my DC.

I’m certainly not disputing it’s better and right to get a diagnosis, I just think it’s a shame that even with a diagnosis, it can still be a struggle to get help.

Schools are supposed to help children regardless of whether they have an official diagnosis or not (considering how long the waiting lists are in some areas) but there just doesn’t seem to be enough funding for the extra classroom assistants. Even those with EHCP’s can struggle to get the support they need. It’s a shame all around

Yes, I agree with you. I often think th ebiggest difference between the educatino many of us had was that the class sizes were smaller!

We are lucky in that DS' school put in place a lot of things even before his diagnosis. But those were things they had control over. The diagnosis benefits us because of things like increased time for GCSEs etc.

Oh - and my child didn’t reach the threshold for diagnosis by the NHS - because they weren’t in crisis and don’t have symptoms at school. They are very clearly ‘high-functioning autistic’ and moderate ADHD, with ADHD impacting them the most.

The whole system is broken, but I’m not sure online assessments are the answer.

Contrary to what the media like to suggest, autism and ADHD are often chronically under diagnosed in the U.K.

I know of many, many children who attended face-to-face appointments where the paediatrician failed to pick up on certain cues.

I had a paediatrician use my DS’ eye contact as “proof” that he couldn’t be autistic. My DS use to stare intently at me, which is actually a form of sensory-seeking. He made eye contact with me but his eye contact was not normal. But that is immaterial as NICE guidelines specifically state that eye contact shouldn’t be used to definitively diagnose or rule out autism.

My DS is now 15 and has very high and clear support needs. He will never live independently and is still in nappies. But this is the child that was initially dismissed by a paediatrician in a face-to-face appointment (he was later diagnosed by a second consultant).

I agree there should be input sought from other sources - eg/school (if the child is in school), an educational psychologist, and a SALT assessment.

By the way, getting a face-to-face diagnosis is just that in most cases - a diagnosis. Both my twins have a diagnosis - diagnosed seven years apart. But in both cases the diagnosis was handed out - and that was it. No further support or help. A diagnosis is useful as it allows you to fight more effectively for support elsewhere but the diagnosing doctor isn’t the person to give it.

If the process is thorough there is absolutely no reason why a teen/older child can’t be diagnosed using Zoom for interviews.

I’m pleased that you’re getting the support for your two DC.

On what basis?

I was diagnosed with ASD online during Covid. I had 3x 90’ sessions with two different assessors, involving various questions and tasks. They record the sessions which then get reviewed by a wider team before diagnosis or not. They did mention body language, eye contact and tone of voice in the report.

I would say that if someone can manage not to show significant signs of autism during that kind of assessment with people who know exactly what they’re looking for, then they’re probably not autistic. The people who assessed me said that it tends to be more straightforward online because people are in a familiar environment, haven’t had to travel and tend to be less stressed, more themselves and mask less.

My brother regularly pays for tests online... he now has ADHD, Dyslexia, Dyspraxia... and something else...
IMHO if you are paying for an online test you are ultimately paying for the result to be positive...

Based on what? How can you doubt someone who’s medically qualified to diagnose a condition?