Conners assessment for ADHD

[streakybacon]

There's a very long story attached to this but I haven't time to go into all the detail, so hope this makes sense.

Does anyone know what is regarded as good professional practice when Conners' scores vary dramatically between school and home? DS already has a dx of AS but we've always felt that some aspects of his presentation were more consistent with ADHD, though in the past we've been told that they're covered by the AS 'umbrella'. At (very brief) assessment in December we were shown results from us and school and the psychiatrist plumped for the school's opinion then ushered us out. I'd always thought that if there was such an extreme difference a good practitioner would get further opinion from another source to balance out the two conflicting ones, but the psych refused to do this. The outcome is that ds, with behaviours consistent with ADHD, can't be offered a trial of meds becaus the NICE guidelines say doctors can't prescribe without a formal dx.

Have any of you had similar experiences, and how was it handled?

Ta muchly!

i could write your post, but from the other way round. our son has dx of ADHD since 4.5, but we were always sure he had other behaviours consistent with ASD.he had Ados in 07,which showed up PDD, but, cos he didnt tick all the boxes, clinicians decided he didnt have ASD, and so we were left with ADHD, for which he is medicated, but behaviour for which he had no therapy.i can give you an example of BAD professional practise-our son was admitted as an in-patient adolescent psychiatric unit last year,cos he just could not cope anymore-neither could we. while there, he was diagnosed with Aspergers syndrome with co-morbid ADHD.things are not great now, but at least some of his behaviour makes sense. i definitely wouldnt reccomend you go down that road though.it is perfectly possible for your son to have AS and ADHD.when the Conners was done on our son, the school and home one was v. different, but the Psych. agreed to a trial of Ritalin(to shut us up, according to his notes), but she was also clear that Ritalin was not used for anything other than ADHD.surprise, surprise, the Ritalin had positive effect.you could ask the psych. to agree a short trial of medication and point out very obvious difference between home and school-eg, v. structured, clear routines,etc, where home can not always be like that.or ask for second opinion from different Psych. or go privately for a dx. failing all else, send your son to live with Psych. for a week, and see if that changes her mind.we are the experts in our children, not the professionals, whom after what has happened to our son and family, i no longer have any faith. good luck.

Thanks for your reply Bigpants.

We're definitely at opposite ends of this but with some similarities. We've had no therapy from CAMHS either, have had to work it all out for ourselves by NAS training and books, talking with other parents etc. The meagre slops of 'support' we've had have been at our own instigation or with negative impact, like when the CAMHS nurse told us to punish him some more for being angry at the end of a rotten day at school . Yes, that naughty step really helped

Our problem now is that we feel we've come as far as we can on behaviour management alone. Our son needs more than good parenting can give him.

The main difference in our situations is that your son is receiving medical support and that's the sticking point for us. We believe he NEEDS medication now because he can't make further progress without it, but because of the change in NICE guidelines the doctors won't do a trial without a formal dx. (We have asked, many times, and Risperdal too, but were always refused). He may well work through his issues without medication, in time, but why should he have to suffer so much in the process when there's such an obvious solution?

We do need to seek a second opinion, and may have to go private in the end, because the psych who assessed him was very clear that we were wasting the department's time as he'd been seen by several professionals in the past, none of whom had raised any concerns about ADHD. Well I guess they wouldn't, if they'd been asked to assess him for ASDs.

Thanks for your input, and good luck with your son.
x

Oh this makes me so cross. What ever happenened to treating the whole patient? The nice guidance is just that guidance - Grrr!
I remember reading that the signs/symptoms of ADHD must be present in at least 2 different settings (and to have been present since early childhood) for a Dx of ADHD so I suppose that is the sticking point for your paed. Can you ask to be referred to an autism expert? It does sound like you may have to go down the private route! We too feel the system has let down ds - but our story is different - it was the autism that went undiagnosed for years. We are at last getting support from Camhs but Ds is 9 ( and in snschool) now, and like you we have had to find our own way and quite frankly we needed the support when he was younger and in disastrous ms!.

dear streakybacon, have just seen your follow up. re Risperadal, it is recommended for children and young people dx with ASD for irritability and aggression. our son takes it and did while only had dx of ADHD, but psych(new and 10x better than anyone before), still uses it, cos he says it is recommended for ASD.we are in Scotland, and our guidelines for conditions and medicines is SIGN, but it is literally the English equivalent,(god forbid we could have a standardised British one),of NICE. have you got a copy of most recent NICE guidelines for ASD? If not, get one and see what it says re Risperdal. Although your son is not being given meds for ADHD yet, he should still be prescribed Risperdal if he needs it. While it wont target the hyperactive behaviours, it should help his mood and anxiety and you may see a little improvement just with this-it may make him generally calmer. Agree with Magso-why cant clinicians treat the whole person instead of just bits- makes so much sense. and why cant clinicians see that good parenting can only do so much, and that medication and parenting could make such a difference in these childrens lives-would they like to see their own flesh and blood suffer in this way?

Thanks, both of you. It really does help to have this kind of support from parents who understand.
xx