What help do I get for DD with possible ADHD & OCD?

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I know that there was a very similar thread recently but I can't locate it, so apologies for the repetition, but I need some advice.

My DD, 17 is anxious and struggling in various ways and after a conversation with a teacher friend yesterday it was suggested that she may have some ADHD traits (she certailnly has several OCD behaviours - repeating words/behaviors/routines to stay safe or keep others safe). She also a wondeful, reflective, insightful, funny, sensitive kid. Over the years there have been periods of school refusal, anxiety and she has had some support and counselling.

We have suspected possible neuro-divergence for a while, but weren’t sure a formal diagnosis would add anything and we were keen not to pathologise what was basically often teen or hormonal behaviour. However, with the mega stress of A-level exams coming up we possibly need to advocate for accommodations for her. She is very bright and predicted good grades, but she struggles a lot with timing and her spag and handwriting are appalling - to the point of unreadable. There is also a massive discrepancy between her class and coursework (all As) and her exams (Ds). This was the aspect that alerted my friend to something different going on.

This may not sound like much - and some will say it's just exam technique (which she is working on and does recognise -but is finding incredubly hard to grapple with), but procrastination and lack of focus (then hyperfocus) are real issues, combined with her anxiety. I didn't realise till this weekend how much she had internalised her sadness and feelings of failure, until we talked about this being a possibility. I have, unforgiveably, acused her of being lazy in the past and only compounded her feelings of worthlessness.

Please forgive my approach, language and attitudes if they are offensively wrong, I am trying to grapple with all this. We are not clear that she masks, more that she has coping strategies (as I do - we are very similar in personality and behaviour), which I thought everybody had for dealing with the world. I think I thought if I encouraged her and shared my work-arounds that this would be enough. (All it's actually done is make me feel very sorry for my younger-self, but this is not about me). Also as she is bright she is largely coping, but the internalisation of finding things very hard or impossible makes her feel awful about herself - which is killing me right now.

Obviously, we will have to go privately even to seek advice, as there is no way the NHS would see her in time. Sorry this long - but what I am asking is how do we go about finding someone to support her and possible assessment? She would likely only be borderline anything, but school is saying that they only really accommodate for “processing” issues. She currently has a weekly session with the school's therapist (who I will contact), but they are moving towards "next steps", ending sessions.

I don't really even know what I am asking, I feel I have failed her, don't really know how to help her and it's all too late.

GP can prescribe anti anxiety drugs.

OCD and ADHD are quite different beasts. I’d suggest finding a private psychiatrist and speaking to them.

This sounds tough.
My DS1 is probably ADHD, but has never been tested. V intelligent and successul but at huge personal cost.
He has OCD which peaked in year 8 and 9. He had 4 talking sessions with a charity psychologist around dealing with his rituals.
But really he has had to learn to manage it himself. As he always did well at school I could never get anyone interested.
As he got older (he is a YA now), he has gained self awareness and recognises when his rituals are getting in the way and challenges them himself.
He has the occassional crisis and calls me up to ask me to help him find a therapist. But then his procrastination and v high standards means he never calls, or they are not the right fit.
One of the main things that helped with us was to remove all pressure from him. He puts enough pressure on himself.
He is also recognising that his 'issues' are also his greatest strengths. And he doesnt want them 'medicated' away.
He has hard dark times though, when his intrusive thoughts are overwhelming. Fewer now, but adolesence (esp early adolesence) was tough.
I guess I would focus less on testing and more on strategies to manage the situation. A therapist that offers CBT is a good place to start.

My dd is also year 13 and has just gone through this process. She now has a diagnosis of stealth dyslexia, which is really tough to spot and awarded 25% extra time as she has slower processing issues.

It is good you have a point of contact at school already. I would run it by them then contact the SENCO. The SENCO at school can hopefully put you in touch with a local assessor for dyslexia or you can google yourself eg through the dyslexia society. The assessor can also test for processing issues to see if your dd needs extra time (25%). This is a form 8 evaluation. The school needs to be on board with this as they have to fill out a section of it.

Explain that although issues might not have been raised at school, your dd is having a lot of issues at home surrounding school, needing much more support than would be typically expected for a teenager of her age and you believe she is heavily masking at school. That she is having a lot of difficulty sitting exams. And that you are noticing some issues around her spelling and grammar that makes you think it would be worthwhile getting texted for dyslexia and form 8.

Explain that you are happy to pay for this privately and just ask the school to give you details and support you with the application. This costs about £500. Don’t delay.

As for assessment for ADHD, I would get this done. I would actually screen for ASD as well. It is possible your dd could have both. You can find local assessors privately. We are going through this now. Ensure that they are able to assess and give a full diagnosis and that the diagnosis will be recognised by the NHS. ASD testing is often faster as fewer people are trying to get the tests so you could book this first perhaps. You don’t need these diagnoses for exams. But they would be really beneficial for university if she is going so that support is in place if she needs it.

Just because your dd is heavily masking, it doesn’t mean that assessment isn’t beneficial. From my experience with my dd, it actually means she needs a lot of help to come to terms with possible neurodivergence. If she gets a diagnosis of dyslexia, this is a neurodivergence in itself and being linked with ASD and ADHD, not often a stand alone diagnosis.

This is so close to where we are - your son sounds very similar to DD. She/we don't really want medication, just support around getting through this phase. The burnout and negative self talk is very real though. I didn't really know about all the rituals, she hadn't told us and apart from being very germ phobic, fear of getting ill and an absolute horror of being sick it has seemed within the realms of normal/managable.

Yes support and therapy is where we are heading, as school has said already that there will likely be no accomodations. She was very calm about this, which surprised me.

Thank you for the clarity around how to proceed with this. I just wish we had done it at 13 - there was so much going on then too! We are thinking ahead to university as I am well aware how overstretched resources are there too, so we need to get something in place or at least options (hoping that she does get the grades!). I need to now research ASD.

It's a lot right now and I feel like I have failed her horribly.