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?

Hmmm

there are a lot of severe mental illnesses where the person is able bodied and has a normal IQ but has for example schizophrenia or psychosis.

Severe mental illnesses (SMIs) often involve losing contact with reality (so not knowing what is real and what is not). Some people with SMIs are a danger to themselves or others (eg they get “commands” to kill people or similar).

some people with SMIs live in the community but others cannot (because they are a danger to themselves or others). Supported living is common but some with very severe SMIs are in permanent nursing care.

people in this situation who are in permanent nursing care and similar (eg locked wards in hospitals) will need to be funded one way or another to stay there,

Clinically significant impairment in an area of functioning is not the same as being non-functional, that’s my point. I’m not saying people don’t have difficulties, of course they must. But my friend is happily married with (successful) kids, has lots of friends and a very successful career as well as being autistic. She’s made adaptations to the way she lives her life of course, but saying she isn’t a functioning adult just isn’t true.

Are some adults looking for a justification that life can be a bit shit from time to time?

I do not know anyone outside edcuation - ie uni or FE who an adulty seeking diagnosis so can not say.

When I read about it on here it often tends to be in reponse to younger members in education being diagonsed and then something else triggering it.

When we were going through ASD diagnostic for one of them - they wanted people who know them all their life to answer questions and turned out not to be that but ADHD a whole new porcess to wait and go through - but they started out saying loads of people were seeing stuff on tic tock and on-line and mistakenly beliving they had it. Then midway through it was okay that's actually not normal in wider population though clearly is in your family. .

As diagosises in DCG have mounted - eveyone now think DMum has some form on ND - in a family of diffcult people she is one of worst - but depsite being married and having kids and relying heavily on coping stratergies I do think it's had an wider impact the high anxiety levels were a huge family burden.

Based on ours and other families experinces I do not think it's a fast process - loads of barriers and lost of waiting and seeing - though other area may be better.

But you won't get a diagnosis because life can be shit from time to time. Part of the criteria is that it must be present in childhood

With adults that can be subjective and depends on their accounts of their childhoods which can be embelished. That isn't to say this is what every adult seeking a diagnosis does just that it is a possibility.

I think adults are rarely objective about their childhood

I don’t now they go about assessing for a neuro developmental condition in adulthood if the people who can give an account of how the person was pre-school, at primary school etc are no longer around or memory not reliable. And there’s insufficient detail in medical records, school records. It can’t be easy when there’s similar presentations in other conditions such as PTSD and other mental health and acquired cognitive disorders.

I know for learning disability services you can only be referred for their support if there’s clear evidence of diagnosis in childhood

Fair enough. It is just one example of what could happen in one family, not necessarily the most likely example in most families. I was simply trying to give you an easy to understand illustration of the difference between normal coping mechanisms and what could be clinically significant coping mechanisms (and actually for ADHD in this case, not autism).

Ironically, you are experiencing my most common autistic misunderstanding ….. taking things too literally!

Okay. Fair point!

Just popping back to say i agree they dont need friends to have a happy life if they dont want them and im glad he is happy. I read a tone in your statement that wasnt there. Im always saying a good life can look different for different people.

I am interested though in your view are your dad, brother, cousin and nephew autistic or because they had children and two married are they not really impaired enough to warrant that diagnosis.

I do think you have a point about those with profound support needs.

i strongly doubt you are right about eveyone you know could potentially get an autism diagnosis. It’s confusing because most
autistic traits are experienced by everyone else to some extent, but not to enough of an extent to reach the diagnosis threshold.

@Owninterpreter I am sure they would be diagnosed as autistic. But they function fine. Their life is not like mine. My cousin's house for example is devoid of photos and ornaments but has perfectly clean functional good quality furniture. He won't eat out. And he has a fairly rigid routine. But he seems perfectly happy and is busy with his interests.
I think we have narrowed the idea of what if normal and try and give support to make people fit into this idea of normal.

School reports, exam grades, diaries, photos, other documents and the patient’s own memories about their play, hobbies and school. Personally, I can remember most things back to the age of 4 and quite a few things before that.

Okay so exam grades, patient reports should have got higher grades. School reports saying patient should have tried harder, all my school reports are very short. Diaries? You mean teenage ones filled with angst about not fitting in, a pretty universal felling. Photos? What of looking glum at a party?

In reality childhood symptoms in adults are self reported.

You don't get an autism diagnosis if you're functioning "fine". You may think they're functioning fine but they're masking

In reality childhood symptoms in adults are self reported.

I have ASD and ADHD diagnoses. An autism assessment was suggested by the MDT who assessed one of my DC. My autism assessment didn’t only look at self reported childhood presentation. It required an informant from my childhood. It also considered school reports (mine weren’t short and weren’t about ‘should have tried harder’) and medical records from when I was a child. During that assessment, an ADHD assessment was suggested. The ADHD assessment also needed an informant and used my school reports and medical records from childhood.

@roaringdragon what do you mean an informant?
When I was young all school reports were very short. But I have seen friends close in age diagnosed as older adults. My childhood medical records aren't even available.

@Constantrunner the team asked for someone who knew me very well as a young child to be part of the assessment. In medical terms, this person is called an informant.

My medical records from childhood were available. DM had kept some paper records and my GP surgery had some paper records too.

My DH was very recently diagnosed with ADHD and interestingly he didn’t need an informant or any childhood evidence. I would imagine that’s unusual though.

That’s unnecessarily cynical. My school reports are very brief but
quite poignant eg one for English that says something like “dizzy works hard but takes things too literally so can’t understand the nuances” and then for PE “Dizzy is very fit but doesn’t listen to instructions and struggles with learning dance routines” (poor working Memory).

Prmary school age 6 “Dizzy sometimes spends the whole day doing maths and is very ahead of her expected level but does not seem interested in stories” (not UK)

With grades in my case, that was very clear evidence - many As at O-Level (not English!) Es at A-Level for subjects i got As at o-level, so obviously below expectations.

Diaries - could be a family member’s diary.
i didn’t have this but some Do. ExDp’s mum used to write a few words each day along the lines - I cooked shepherds pie, exDp enjoyed playing trains at the park (or whatever).

family photos can occasionally be quite illuminating. It just dependd on what you have.

CV too was good evidence - obviously to look across my adult years not my childhoods

i think my memories are just as valid as DM’s
to be honest.

Okay I know that does not always happen as some people have none except siblings who were children.
Maybe if you still live in the same area you would have paper medical records from childhood? My medical records start at about aged thirty.

I didn’t say it always happens. You said “In reality childhood symptoms in adults are self reported”. You didn’t say in some cases. I was pointing out that isn’t true in all circumstances.

Obviously it depends on the individual situation but sometimes siblings can be informants. Those without someone who could be an informant were asked to call to discuss their circumstances. I know that happens with some other providers too, including some RTC and private providers.

No, I don’t live in the area I grew up in. My paper records were passed on (although not all some were lost) and were able to be dug out. Again, I didn’t say this is always possible, but it isn’t true to say it is just self reported symptoms.

@roaringdragon yes fair enough, I should have said some.
I only know my GP has zero access to my childhood records as I wanted vaccination as an adult that he said I would have had. I was clear I didn't have them as my mother was anti vax, and when he looked there were no childhood records at all.

Some people are just like that. Some of us do
the opposite. I’m sure plenty of people exaggerate pain when they go their GP too.

Thie is why clinicians have a very structured process and look across your life. In the end, for someone in their 40s or 50s, there is a good chance that their childhood memories are inaccurate whether it it is the patient or one of their family members recounting the story. This is why documentary evidence is so helpful.

@Constantrunner my old records aren’t on the electronic system, so e.g. I can’t see them on the app and they aren’t on the GP’s computer, my GP had to dig the paper records out. For vaccinations, I have my NHS medical card with them on that DM saved.