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 haven’t alluded to anything. I haven’t flounced either. Why my DC are disabled isn’t relevant.

I find it ‘a bit silly’ when people are judgemental of disabled people, but there you go.

But everyone says ‘disabled’ without then elaborating, there needs to be a consistent definition. To me if you’re able bodied and have a normal IQ, you’re not disabled, even if you have mental health issues. It’s all got out of hand.

Neurodiversity isn’t new but it’s much more widely understood now. Once you start recognising it, you see it everywhere. My partner was diagnosed with ADHD in their late forties. They say that it explains so many things in their life and how they see and react to the world. It’s so obvious they spent their entire life up to that point masking and developing coping strategies. I didn’t even see half of it for years. I feel there are a lot of ASD traits too just to complicate things. I look back on people I’ve known in my life - those with anxiety, disordered eating, rigid routines, compulsive behaviours, chaotic lifestyles, poor mental health, IBS or digestive issues. All much more likely if ND. Firmly believe my partners parents are ND. Possibly one of mine is. So many times these days I’ll see a person on TV and partner and I will recognise ADHD or AUDHD traits, we sometimes google that person and sure enough they are ND. Im completely NT but you just start seeing the traits everywhere once you experience them yourself or you live with someone who does. There’s plenty of ND people who didn’t outwardly struggle at school, or in relationships, or maintaining a career. Flying under the radar until they can’t anymore. Most people would only recognise adhd as the typical hyper boy who can’t concentrate or sit still. People never used to think or probably even hear about the “internal” chaos that adhd can bring, the non stop brain, looping thoughts, anxiety, decision paralysis. The list goes on.

It would be interesting to know why young people are generally so much more anxious these days though.

Finally, there’s a lot of talk at the moment about over diagnosis but not everyone gets diagnosed. Dd was fully assessed for ASD and didn’t meet enough of the criteria in the end. We paid privately so anyone saying a private assessment guarantees a diagnosis is completely inaccurate.

I saw a feature on BBC News earlier where they contrasted a young child with very apparent high needs who was still waiting for an NHS assessment for Autism with a young woman who on the surface of it seemed highly articulate, presentable and able to function well. She was was also waiting for an assessment on the NHS for autism and ADHD. She did not want to go to a private clinic as she wanted a proper assessment not just a box ticking exercise which I think suggested her own scepticism of private assessments.

It's very difficult because the segment did not go into any specific on this woman's or the boys difficulties although his were obvious and I assume she must have good reason to pursue an assessment but it was also clear that the young boy was in need of far more urgent support than she was and so it seemed fair that they would prioritise him over the woman for urgent assessment. I suppose the issue then is that it is likely if availability remains the same that woman will never get her assessment.

I have an old diagnosis of Dyspraxia and I am almost certain that an assessment today would diagnose me as Autistic and ADHD and I have functional issues but I think it is really hard to untangle for people who most would regard as "normal" exactly what can be put down to a specific neurodiverse diagnosis and what might be something else like some kind of trauma, or a reaction to certain pressures in society or environmental conditions or even other health conditions, and that all applies to me too. There are also multiple precedents of over medicalisation and overdiagnosis the history of medicine and pharmacology so it's a valid question to ask.

I think it becomes emotive for a few reasons firstly I think that for many people who get a diagnosis it can be hugely validating and provide immense cathartic value to them for a lifetime of confusion and pain over parts of their experience and so when these diagnoses are questioned it can feel like a personal attack and I think we need to have empathy for people who do feel that way. I also think that for many people on the outside of that they feel that the way a lot of discourse on neurodiversity is framed on social media for example portrays a neurotypical person's experience of life as effortless and uncomplicated when that is rarely the truth.

I'm not a doctor so I can't speak to medication or the support needed by especially high needs individuals but I do think that there are structural and cultural factors that have likely made life much harder for people and that throw the difficulties of people with ADHD and Autism into even sharper relief in ways that are profoundly distressing to them.

My DC are disabled. Whether you agree with that or not. My DSs are disabled. Two profoundly so with complex needs. It isn’t just MH difficulties.

Your opinion on the definition of disabled isn’t what matters since the term is set out in legislation.

That’s fine but it’s still my opinion. I just don’t think high anxiety etc alone makes you disabled. I think we need to return to its traditional meaning. Ditto people saying ‘complex needs’ - this makes me think of a child with a feeding tube, learning difficulty in a wheelchair. But was the other day used to describe an able bodied teenager with no learning issues and normal IQ who was anxious.

The article is from the Daily Mail. Of course it's pure fabrication feeding the echo chamber of the 'I'm Alright Jack' and 'Never happened in my day' ill-informed brigade.

A diagnosis helps in so many ways.

For what it’s worth I think that it’s a matter of older mums and getting the CMV virus which they no longer carried anti bodies for ( and they would have done in their 20s) . This was exactly what happened to me and my son and the upshot was here we are with him being ASD / complex needs

I do feel that better categorisation is needed is straight ASD
ASD with developmental disorders ie language / motor etc but normal intelligence in some ways

Profound ASD

You can rest assure my 2 DC who have complex needs (as defined by the multitude of professionals involved) have gastrostomies and have enteral feeds. They would still have complex needs even if they didn’t, though. One uses a wheelchair/SN buggy. The other doesn’t but that does not mean he doesn’t have complex needs. Both have a normal IQ so don’t have a learning disability but do have learning difficulties. DS1 presents like he has an LD but because his IQ is above 70 the local LD service won’t diagnose a learning disability even though the current thinking is IQ is only one element and DS meets all the other elements. Even though they don’t have a diagnosed learning disability neither will ever live independently and everyone involved agrees they will need 24/7 care for life.

Not really relevant to autism given that it isn’t a psychiatric condition.

Do they have a named condition? That sounds very hard. Is it genetic?

And a no from me too. That was the polite version. I definitely don’t discuss things published in the Daily Hate with ransoms on the internet.

Yes, they have multiple diagnoses. What they are and whether they are genetic isn’t relevant or anyone else’s business.

Regarding ADHD and autism becoming an identity - it doesn’t mean the diagnosis is incorrect. It is extremely shattering to receive one of these diagnoses as an older adult. On the one hand it is a relief - confirmation that you are not lazy, stupid or any of the other bad things you have been told; on the hand it creates a sense of grief and anger for what could have been with a diagnosis 20, 30 or even 40 years ago. Even if it is irritating to you, try to recognize how life-changing this is. Older adults
in particular end up reevaluating their whole lives
through this new lens. It takes a good few years to actually mentally process one of these diagnoses. I guess I am saying: cut them some slack, they have been through a major life event.

The various reports produced by Prof Peter Fonagy’s work have said that autism and ADHD are underdiagnosed in adults.

This is a common misconception.

It’s hardly surprising that an adult woman with a medical condition will present differently to a young boy with the same medical condition. Why would you expect otherwise?

And more importantly, the fallacy you have fallen into is that a third party can tell the extent of someone’s difficulties from the outside. Masking means that people who have autism but don’t have intellectual disabilities as well (the genes we have identified that are associated with autism itself are actually very highly correlated with those associated with high intelligence, so there is strong evidence that in the absence of other co-morbid medical conditions, autism generally results in higher IQs on average) become very adept at hiding their difficulties. In many cases you’d have no idea they even were autistic as an acquaintance or work colleague etc, only if you were a very close friend or family.

The problem with this is twofold

1. people making assumptions, as you have, that someone has lower support needs than they do because they mask; and

2. Masking creates a “double whammy” because the person is not only trying to deal with their difficulties due to their neurological condition, but also the dismissive attitudes of people who mistakenly believe point 1), and on top of this the fact that an autistic person continually being forced into environments where they feel they must mask (such as schools set up for NT children) itself vastly increases the risk of developing severe mental health difficulties such as crippling anxiety and depression, burnout etc. Masking itself has been shown to be incredibly harmful. Continue to force children into an unbearable environment where they are forced to mask all day and you will, of course, end up with many dropping out of school and most of those who manage to sustain some attendance having severe mental health problems. Therefore, the obvious solution is to provide appropriate school environments where autistic children can thrive.

Schools are meant to be designed for children and to facilitate their learning. Clearly it’s not acceptable to have a proportion of children who cannot attend the available schools without significant harm and refuse to do anything about it. Even developing countries are required by international law to provide education for all children, and this has been a legal requirement in the UK for many decades yet it being deliberately ignored by all of our politicians because they don’t like the answer about what they need to do to fix it.

If we want autistic children to thrive and grow into competent adults who can manage in environments designed around the needs and preferences of neurotypical people (which of course inevitably the world is, because they are the majority) then these autistic children must be given a manageable and appropriate learning environment in which to develop those skills without becoming completely traumatised and unable to learn to their ability. If one was to sit down and try to design hell for an autistic person it would very closely resemble a state school classroom. So it’s hardly a surprise that these children’s mental health, education and subsequent employment statistics are appalling in comparison to the general population because they are systemically denied access to an environment in which they can thrive during their crucial developmental years and instead subjected to one that feels like daily torture, bringing me back to the points that I made in my first post on page 1.

None of this is a mystery. It’s all well-documented in robust, peer reviewed medical research. The question is why the Government is refusing to accept the established facts and proposing “solutions” which are the precise opposite of what is required to improve the situation, condemning thousands more children to having their life chances and mental health needlessly destroyed by forcing them into a system which is the polar opposite of what they require to learn and develop and build their confidence and resilience.

No. There conclusions on this topic are extremely clearly evidenced from all of the reams of statistically validated medical and academic papers on the topic.

Conversely, a report trying to conflate causation and correlation with no evidence whatsoever to support its unevidenced assertions or to refute the huge body of medical evidence already available, and written at the commission of politicians not doctors, isn’t worth the paper it’s written on.

Well I’m able bodied and have a very good IQ. I look very well too. I am disabled. Unfortunately extreme fatigue, dizziness and sensory issues are extremely disabling but invisible.

Where is your evidence for this?

DDs were born in the 90s. DD1 was in special provision from age 4. I came across countless children with SEN, and plenty had siblings (and parents) with similar problems. Autism and ADHD were clearly genetic then!

It’s just been on the news just now about the issue of over diagnosis. Completely inevitable that this was going to happen.

On central news there was a 7 year old boy who clearly presented with autism. The women who was at home playing with her cats just needs to get a job and stop navel gazing.

IQ impairment and mental health problems are not the only effects of neurological conditions. Your comment, I’m afraid, is absurd; effectively you don’t “believe” in a disability and think you know better than neurologists, geneticists, brain scans etc, just because someone doesn’t use a wheelchair to carry their brain around so that you can “see” their illness.

I wonder if you take this same approach to other conditions. Do you deny that cancer exists because you can’t see the tumours inside someone’s body? Will you deny someone’s Parkinson’s disease until they become symptomatic? Do you believe that MS is imaginary because you can’t see it? How about viruses like Aids? Epilepsy presumably doesn’t exist except when someone is actually having a seizure?

Absurd.

Also it may be hard to get the diagnosis as a child but if you’re an adult willing to pay £ then it can be obtained very easily, just by knowing which boxes to tick. Comes in handy for the PIP.

Not necessarily. Some private consultant and specialists are actually far, far more robust and detailed in their diagnostic processes than the useless NHS.

Oh come off it. You can get the job done for a few grand not even that.

Do you not think we have enough already?

What an absurd comment. Diagnoses are provided based on “ticking boxes”. They involve a multidisciplinary team of specialists examining multiple facets of the patient’s life, childhood development, family history, as well as current functioning in multiple different areas. You clearly have no idea what you’re talking about and are regurgitating tabloid nonsense.

Secondly, no diagnosis of any medical condition is needed for PIP and neither is a diagnosis of a medical condition a basis upon which PIP is granted.

It’s usually best to refrain from making comments on topics of which one is ignorant, it saves embarrassment.