Rush to diagnose ADHD and autism can damage children: As rates soar up to 40-fold, a major review warns of the toll on those wrongly given a label

[Rubydobydo]

Britain risks harming a generation of children by over-diagnosing ADHD and autism, a major review warns today.
Parents are incentivised to have their children diagnosed by misguided schools and welfare systems that reward such 'labels', the report found.
Youngsters have also been influenced by social media posts that wrongly present common traits as evidence of the conditions.
https://www.dailymail.com/health/article-16194777/Rush-diagnose-ADHD-autism-damage-children.html

Discuss?

i've noticed that any kind of speech delay in toddlers is thought to be due to autism, even though there are many different speech and language disorders, genetic disorders and gdd.

Well to be fair, my comment on lengths of report was silly but my main point that ADHD and autism diagnoses are scientifically valid is reasonable and fair. Both conditions have significant bodies of scientific evidence showing that that they are neurodevelopmental disorders. The diagnostic process for both is highly structured and guided by evidence-based criteria. It is not based on vague feelings or personal opinions - specific criteria have to be met including a consideration of developmental history, functional impairment and possible alternative diagnoses.

Regarding autism and ‘functioning adult’ - the diagnostic criteria require clinically significant impairments in important areas of your life, so in that sense, “by definition”, an autistic person cannot be fully functioning. If you simply mean it is possible for an autistic adult to have a job, pay bills, have children etc then of course you are right. However, please remember that an apparently successful autistic adult is likely to be experiencing significant difficulties that aren’t apparent to outside observers. They may need to put in considerable effort or make use of significant levels of support to maintain their lifestyle.

@dizzydizzydizzy so internal effort that cannot be measured is impairment?

Interesting. All the older adults in my family who are diagnosed with autism, or undiagnosed but with clear signs, do not have friends and have issues communicating. They all work or worked, some are married with their own kids.
Their impairments are clearly in relationships and communication. It's not about internal struggles, but clear impairment.
The people whose diagnosis I massively doubt have no signs of impairment. They are socially skilled, get on well with people, and plan things and make them happen. They just find life difficult. But life is difficult.

There seems to be this idea that if you are not neuro diverse, life is easy. That is so far from the truth.

Well the impairments are not necessarily obvious.

DB is a software developer. He leads a small team, is married, owns his home and has a DC. He is also autistic.

His job plays to his strengths - precise and analytical, and structured.

He rarely has to talk to clients, so has few requirements for socialising and small talk at work . He can work online from home.

It he has an afternoon of meetings, he is absolutely exhausted and needs to work at home the next day to recover. He is ok with doing presentations in meetings because they are structured and prepared in advance but he finds the social chit chat incredibly demanding.

He also finds unpredictable change, extremely difficult. apparently his manager handles this by always telling him about this in writing and allowing some processing time.

Similarly at home, sudden changes of plans can really upset him in a big way. He also finds quite low volumes of certain types of noises very distressing.

No friends at all that so sad, maybe they didnt get the support they needed when young?

Friendship looks different, but its very real. My son has enormous communication issues. He still has friends they do parallel play basically even though they are 17, so share a space doing different things and then show each other the thing. They info dump on each other about thier interests. But its a definite preference for those people over others

He cant do groups of nt people and sit in a group chatting as he cant process the conversation quick enough or know what most of it means.

I do understand what you mean. It is a social communication disorder but a lot of people even say they have no communication issues which does puzzle me.

Potentially.

An example would be routinely spending half
the evening after work ruminating about conversations with collesgures trying to work out what they meant. Or requiring your manager to always email instructions rather than tell you in person so you have enough processing time, regularly being unable to do basic tasks at home after work because the working day has been too overwhelming.

i’m not talking about normal hard working or conscientiousness.

Yes no friends. My father had no friends, my brother had one friend for a few years as a child. My cousin had no friends. Two of them married though and all have children. Another nephew one friend as child, no friends now.
Is it sad if they are happy? They all have their own interests, work or have worked, and see family. Why do people have to confirm to one idea of a happy life?
I find friends essential for a happy life, but plenty of people dont

These are women who when they get home look after children, cook, clean and have a social life.

My son has a few good friends who are all severely affected by their autism, as is he. He also has many acquaintances who are NT, but those friendships are very different because he struggles greatly with communication and with the way NT people think. Those friendships are more one-sided kindness from the NT people towards my son, than true friendships.

I think it's really shit for autistic children and their parents. Getting pushed further and further back in the queue because everyone else wants a label.
How are the experts able to help those in most need first, when everyone else wants a diagnoses.

I've just been discussing this thread with dh. We do talk about autism and tbe spectrum a fair bit as have a ds with severe, old school autism.

We can't think of one single person who if they wanted a diagnosis woildn't be able to point to areas of their life that they could use to evidence impairment and support a diagnosis. This isn't becauae of the groups we mix in, we mix in vastly diverse groups of people of various interests etc. We feel it's because the diagnosis has now lost it's meaning as it could describe anybody.

They need to break up the diagnosis again especially for those who are profound/ severe so that they can be diagnosed ahead of those with fewer or needs relating to mental health. This won't be an opinion liked by many but it is insane that people with such differing needs all share the same diagnosis. I do think it benefits those who are more capable to be associated with those with more severe needs.

Well either they are very good at camouflaging their struggles (this is normal with intelligent ND women) and they are at risk of burning out with illness - this is what happened to me and I am now
too ill to work. Or you don’t know them as well as you think you do - none of my friends believe my diagnosis either and that disbelief ended up with me being diagnosed for a second time by one of the most experienced consultant psychiatrists in the field in my the UK.

The final but less likely alternative is that they have been misdiagnosed or are self-diagnoded. Misdiagnosis does happen of course but Prof Peter Fonagy said in his report yesterday that there was no evidence of widespread misdiagnosis but there was a risk that it would happen in the near future due the enormous pressures in the system- hence his recommendations for changes.

@SupernaturalAddict exactly!
Unlike some people I do think autism and ADHD are real. But the real question is at what level do we diagnose it?

I think social media and Instagram have made some people think everyone else is coping with life well. In the real world most people struggle day to day. Staying on top of work, your home and garden, basic self care, family relationships, kids, friends, a social life, etc is hard. We all feel at times like it's too much and all struggle in at least one area. That's normal.

I do actually think it is similar to visual impairment/blindness in some way. People with visual impairment either can't see at all, or have extremely limited vision. This affects their daily life. Lots of people have mild visual impairment. They need glasses. And most people as they age need reading glasses. This does affect you daily as without glasses you can't read signs, menus etc. But this is rightly seen as normal human variations rather than a disability.

Neuro diversity needs to be viewed in a similar way.

@dizzydizzydizzy mixture of diagnosed and self diagnosed. My own view is that they are too busy and expecting too much of themselves. People aren't super human.

Both of our child have/had a speech delay, no one has ever mentioned any possibility of autism at any point.

I am another who believes the diagnosis needs splitting up.

Blindness yes, is possibly a reasonable comparison.

Having short or long sightedness corrected witb glasses is a very unreasonable comparison. Nobody can put on a device to correct their ADHD or autism. There are things that can help, in particular ADHD stimulant medication but there is nothing that eliminates neurodivergence.

@dizzydizzydizzy people use coping mechanisms as is obvious when people have a job, family, kids and a social life.

It's not a label

And if you helped those most in need first what happens to those who've been on the waiting list for years?

I also found your quoted post a little perplexing. I would in no way consider myself to be within miles of being ND but understand what was described. But don’t we all feel like that from time to time, from the sheer drudgery of domestic life, being low grade unwell, menopausal, or maybe just plain bloody tired.
I also don’t have really close friends. I have people I get on fine with, but after 68 years of life don’t want someone - other than my DH - to be that close.
Are some adults looking for a justification that life can be a bit shit from time to time?

Yes, everyone whether ND or NT uses coping mechanisms, because life is busy and hard. That is the skill of the diagnostician to work out which coping mechanisms are clinically significant and which are not. So busy parents might have a shared calendar to coordinate work, school and home commitments and it generally works fine because both parents glance at it each morning. A parent with ADHD will have tbe same calendar but with complex systems of alarms and partners reminding to check the calendar, they have an appointment in half an hour and yet they still forget many appointments, often turn up late. This is because their understanding of the passing of
time is very poor, as is their working memory. Not saying NT never have these difficulties but they will be happening less frequently and not as intensely.

@dizzydizzydizzy people with an autism diagnosis in responsible jobs are not turning up half an hour late for work or every meeting. They would be sacked if they did.
We have a shared calendar and we both forget to check it every day. We do check it enough though. People aren't robots. You have an inflated idea of what is normal.

I think they think life is easier for other people when it's not. It's why you get newly diagnosed adults saying things like I didn't realise I was doing life on hard mode.
Life is hard. Nobody has all areas of their life sorted, especially if they work. Coping with life is holding down a job, maintaining your relationships, and doing basic self care. Everything else is a bonus. We all have systems to help organise ourselves that sometimes work and sometimes don't. Before direct debits I knew loads of people that would miss paying bills through forgetting or disorganisation. Direct debits is a system that removes that stress. Other systems don't work as well.

This is the usually frustrating media reporting (especially of course by sites like the Daily Mail) jumping on any opportunity to suggest that there are loads of people out there faking having ADHD and Autism when the Professor Fonagy report categorically states that Autism and ADHD are NOT being overdiagnosed.

The issues are about diagnosis being a gatekeeper of support and is calling for a needs-led system so that some people might be able to succeed with reasonable adjustments without straight away needing to seek a clinical diagnosis. At the moment, schools and many workplaces are hostile environments for people with any form of neurodivergence. Some may be able to manage successfully with reasonable adjustments that schools/workplaces can currently legally say no to. A diagnosis is then chased for these people because then they can access help. Both my children would be an example of this. My daughter could access a primary school setting quite successfully - the environment was more welcoming to a very quiet, socially insecure child with sensory difficulties. Staff had the chance to know even the quiet children well enough to make adjustments for them perhaps without even doing so consciously. Secondary schools with their increasingly rigid uniform requirements, technology, fear-inducing behaviour management strategies etc are particularly difficult for autistic girls.

However, as a primary school teacher I can see how the environment is not helpful to many students with ADHD. Even in KS1 very high curriculum expectations, lots of powerpoints and worksheets as teachers are not trusted to design their own lessons any more, lots of sitting and listening and absorbing facts rather than exploring. Limited opportunity for play. Try to change any of this as a teacher though and you have SLT on your back.

Workplaces have also become increasingly hostile to ND people too, especially the recruitment process. So much focus on group interaction, the ability to speak confidently in front of others, limited flexibility.

However, far more important for the mainstream media to try and say that the fault is with the diagnosed rather than expecting anything else to change.