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?

You should read the actual review on the gov website rather than versions spun by the daily fail. The review makes sense and is fair and balanced.

You do sone questionnaires before the assessment -
some witb tick boxes and others with open-ended questions. An assessment takes several hours and is a detailed discussion. After the discussion, the report is written up (mine is about 8 or 10 pages of commentary.) It is way way more complex and rigorous than tick boxes. The questionnaires are merely a starting point.

It’s not about suspicion, it’s about systems, power and politics. Take the DSM for example. The holy grail of diagnostic disorders according to a group of old, white men in suits. I use that as it’s a very good example of how medicine, power and society interact.

According to many psychiatrists/neurodevelopment psychologists EUPD, formerly known as BPD, is actually autism after all. Same thing, snazzy new label. One with far less stigma attached to it, and seemingly an identity that many young people now cling onto.

Just waiting for someone to come and tell me that autism is neurodevelopmental. Yes, i absolutely agree, in its purest, organic form, where it is quite often associated with learning disability, then yes it’s absolutely ND in nature.

But all this adult diagnosis and autism is my super power bollocks? Despite walking around as a functioning adult for the past 40
years, with all cognitive abilities intact? Hmm 🤔. I don’t buy it, and plenty of others don’t either.

It is not as scientific or as rigorous as you think. It is open to interpretation, opinion, bias, agenda and so, so many other things. They attempt to make it appear scientific though with the scales and whatnot. It’s qualitative data at best, reduced into boxes. 8-10 hours discussing another persons complexity isn’t a long time. Infact it is no time at all.

My own grandmother was in services for decades. A stereotypical revolving door patient. Every assessment, medication and treatment under the sun. I will not even write down all of the different diagnoses she received over the years. No one could ever really make their mind up. Doctors, consultants, you name it. I’m certain if she was alive today - autism, adhd, PDA and god knows what else would have been thrown into the diagnostic bucket too. 8-10 hours? Goodness. That’s a days work. One day.

She is just one person though and I don’t base all of my opinions on her, but it’s a subject I’ve been fascinated in for decades. Oh, perhaps it’s a special interest 😉.

From what I have seen, BPD or EUPD as a label carries the most stigma - autism nowhere near as much! (None in my mind) Whatever help people with EUPD try to get, considering a common cause for it is trauma, is dismissed as “attention seeking” or “manipulation”. I am not aware of people with autism asking for help, being treated in the same way?

One issue we find is that where me and dsis went to private school so smaller, they knew pupils, there was regular reasonable homework, little change. Very little disruption and while dsis kids are private mie are state and kts not suited to my nd kids.
The homework is often not set or too long or short
Cover teachers
Homework ynmarked so no feedback
Teachers with differing opnions you have no friends oh lets swap the seating or classes around so anyone you do get on with is in the other class. No supervision at breaks and no conversations to children wno are being verbally mean.
Also parents spend a lot of time sorting kids friendships and kids spend lots of time on play dates. Except my ND kids have been invited to less that 10 playdates in 16 years of school between them. They dont cope with too much at weekends and dont want people at the house all the time.

I do think there has to be a level or overdiagnosis or misdiagnosis as i dont see that 10% of dc year can have autism. I think for.some there is the benefits but for.many it is that the kid isnt exceeding at school and parent want them to be doing so are questioning school etc.
The waits here are over 4 years for asd.

Also some wouldnt be pursuing if it wasnt that things like gcses are expecting too much in short exams.

You don’t get a diagnosis of autism if you
are a functioning adult. It is literally part of the
diagnostic criteria.

All diagnoses rely on a history, professional judgement and interpretation. Many do not involve a definitive objective test. That doesn’t make them unscientific or lacking in rigour.

Most diagnoses are recorded as a
few lines in your GP notes or as a one or two page hospital letter. ADHD and autism diagnosticians produce lenghy
reports.

But you do.
The criteria say impairment, that doesn’t necessarily mean non-functioning.

Well perhaps we we not understanding the same thing under non-functioning’.

DSM5 says:

“Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning.”

So in other words you have to have serious difficulties in key areas of your life to get an autism diagnosis.

lookitng like you are functioning normally and functioning normally are not the same thing. People in the former category can get an Austism diagnosis and in the latter category not.

We decided not to pursue diagnosis as my DD seemed to be getting on ok and had no learning difficulties. We didn't want her burdened with an label. Well. Then she hit puberty and had a major mental health break. We then sought a diagnosis as well as counselling etc and it helped her immensely to understand herself better.
We are now pursuing a diagnosis for our younger DS asap, privately. We absolutely dropped the ball not doing so for our DD years earlier!

Note the DSM calls it a BEHAVIOURAL issue.

It is made up nonsense behaviour in the vast majority of cases.

Personally I don’t think it helps that the word ‘autism’ is used so broadly. Everyone receiving a diagnosis undoubtedly needs support, but the support required by an adult who attended mainstream school and has a career and a family cannot possibly be compared with the support required by somebody who’s been severely disabled since birth.

Erm, this isn’t true. I’ve seen the whole breadth of ND reports. They are a few pages long. That’s really not lengthy, or indeed that complex. I’ve seen other diagnostic reports too for other conditions - and they’ve needed a folder, or two. It’s not a competition, but what you just said was factually wrong.

Also, of course functioning adults are now receiving autism diagnoses.

Exactly. Far better to go down the autism route, than the personality disorder route (as an adult). Much less stigma.

There is overlap in adult diagnoses, anyone who tries to suggest otherwise is uninformed.

Autism presenting from infancy, childhood is often organic and neurodevelopmental in nature. ADHD in childhood is often a young brain shaped by an insecure attachment. If you are not securely attached, your brain matter will literally change, and you will present with needs.

This is my experience. I have very high flying cousin who is now retired. Amazing with computers, had a top job. No diagnosis but always struggled with communication, rigid habits and eating, and had speech therapy when young. Struggled in primary massively, but started to blossom from 14 when he discovered computers, which were very new then. No real friends but seems happy, has a massive income, and spends his time hiking and online talking about very nerdy stuff.

His son, his parents never got married or lived together, had help at school, also had speech therapy. Diagnosed autistic. Not academic at all. Got a trades job, is good at it and makes good money. Works as part of a team as he can't communicate really with customers, but does a great job. Had help of parents to find somewhere good as got bullied in first job by colleagues. Owner of firm now makes sure that doesn't happen. Own home and spends remaining money visiting car shows which he is obsessed with.

My own father clearly autistic, no friends, rigid thinking. Did various jobs, had a family.

My brother, again clearly autistic, zero school support, struggled a lot at school. Worked in computing, got married and had a family. Again no friends. Coming up for retirement.

There was far less support in the past and yet the older generation largely did get jobs, many got married and had children. They may not have achieved as high paying a job as they may have been capable of with support. But they managed to work and live an ordinary life.

This is what lay behind my wondering - yes, I’ve had very little personal contact with suffering from severe ND ‘symptoms’, particularly children. but I do have experience of people ALL being different, all with our own oddities and eccentricities.
By that token, I’m struggling to understand how a often a very successful adult can suddenly grasp a new diagnosis and claim life now makes sense.
Life can be shit/confusing/ upsetting/ out of control for us all at times.
So why do some find it so difficult to get to normal adulthood and just get on with life in all its colours?
And what is causing such severe issues amongst the growing number of children?

This is a bit of a nonsense. I know people performing well in high flying jobs, married with kids doing well, lots of friends and a good social life who are diagnosed with autism. I am struggling to see any impairment.
And I know you are going to talk about their internal struggles, but everyone has that. Impairment is about outcome.

My younger son knows three teenagers who all have autism. They all attend mainstream schools without support and mainstream activities without support. They also know DS’s older brother, who attended a special school and will never live independently. When DS2 told these friends that his brother also his autism, they couldn’t get their heads round him having the same diagnosis (in name) that they do. Their challenges are completely incomparable to his.

Im not sure impairment can just be about outcome. Its easier to imagine with physical disabilities but if someone with missing limbs can get dressed, wash themselves, get to work and compete as a para athlete ( swimming better than me with) is there no impairment? My sons friend is blind, he has a good job and gets the bus there. Is he not impaired.

What if the outcome is achieved with support and working harder, doing it differently, or by not doing other things to give time. What if the good job doesnt involve the things they are impaired with? But does involve things they are good at. What if there loving marriage also has the partner scaffolding support.

Someone with missing limbs or who is visually impaired has clear impairment. You don't get a diagnosis of visual impairment until any sight loss is severe enough to impair you. Otherwise it's just normal glasses wearing person, or sight not as good but largely fine.

A more accurate comparison would be if anyone with any sight difficulties at all was diagnosed as visually impaired or blind. So anyone who wears glasses or with some astigmatism. This is effectively what has happened with neuro divergence.

It this allows to continue it will be those without ADHD and autism who will need support.

We are all completely bombarded with this over diagnosed nonsense that is putting those who are severely autistic at risk due to overstretching limiting resources.

It wasnt meant as a comparison of conditions. It was a difference of opinion between us that outcome is the only measure of impairment and jobs and marriage are a good measure of outcome.

Clearly my blind friend isnt doing a job that relies in vision. He isnt a train driver. An autistic person might be succesful in a job that isnt relying on their area of impairment, so i dont see it as a good measure of outcome.

So what is a sign of autism impairment if someone is married, children doing well, performing well at work, and has lots of friends? This is based on people I know.

Why do you need a sign?

I am thinking wider than people you know.

Im simply saying you could be a very successful data analyst who has a friend group all based on a shared common interest like bird watching and a partner that scaffolds support at home and meet the criteria for diagnosis. You wouldnt necessarily see that in action.

Im not saying your friend is in that scenario. Im saying to me just hearing they have a job and a partner isnt telling me they dont have autism either. Its like a neutral position. Im not trying to provide evidence your fruends are autistic. Im saying the things you mention dont rule it out.

My son goes to a special school for pupils with autism. He still has friends.