Neurodiversity Hub resources

Transcript

Who are you?

Hi, my name is Joe.

Ask me anything about A-D-H-D-A-D-H-D assessments

and how best to get support.

What is the difference between screening, assessment and a diagnosis for ADHD?

So screening assessments in a diagnosis is a process.

So when you first start looking in to having a assessment

for A DHD, you'll complete some screening questionnaires

and there'll just be questions just to see

how you are finding things day-to-day in relation to

that kind of diagnostic criteria.

That can be kind of tick boxes,

it can be a general conversation with your gp.

After that, then kind of thinking, okay, you know what,

we're seeing some things,

so actually let's move on to the full assessment.

We're seeing some things, we're not quite sure

what this full picture is yet.

So then you move on to an assessment.

An assessment is much more in depth, really trying to see,

okay, is this picture A DHD or is this something else?

So then with the assessment, then

that's about pulling together all

of the rest of those pieces.

Okay, you know what? We've already got

these from the screening bits.

Let's see if we can kind of put all together all

those edges now.

And actually once that assessment's been done,

what we're hoping to see then is, okay,

what does this picture show?

Does this picture show yes, a diagnosis of A DHD?

Or does this picture maybe show something else?

And that'll then obviously be your diagnosis

or your non diagnosis.

Depending on the outcome of that appointment,

you can still get that diagnosis of A DHD without

that full picture, even if there's a couple

of things that's being missing.

And that's just the nature of just being a human,

having other things going on at one time.

No one's ever only just experiencing a DHD in a vacuum.

There's always lots of other things,

but that's part of the digging process

of having an assessment for A DHD.

What is the process of an ADHD assessment?

So the process

for having an A DHD assessment can vary

depending on where you are.

However, generally you'll be discussing things like

developmental history, so that can go all the way back,

or in terms of your mother's pregnancy with you.

So talk about how the pregnancy was,

were there any challenges

and go through looking at developmental milestones.

When did you first start to walk?

When did you first start to talk?

Talking about school, so, okay. How did you find school?

Was school easy? Were you a bit of a troublemaker?

Were you always known to be a pleasure to have in class,

but actually had you had in the clouds the whole time?

How did you find that?

Generally day to day

or look at basically moving

through your life chronologically?

Okay. How was a transition to potential university

or transition into working life

and talking about all of these things in relation

to the A DHD challenges that you may be experiencing.

So looking, okay. Well,

did you find it tricky when you moved to uni

and suddenly had to do all of your own things

because actually you'd never had to study

and do your washing at the same time before.

So they'll look at all of this kind of how your life is.

What does your life look like? It's very personal.

And what will also be covered then is the very specific

diagnostic criteria for A DHD.

So some places use the diva, which is a formal A DHD kind

of diagnosis questionnaire,

and it runs through the different criteria.

So they'll be asking, okay, do you find paying attention

to details challenging?

Did you find that challenging in adulthood and in childhood?

They'll run through all of those different things

to see whether or not you meet

that diagnostic threshold For a diagnosis of A DHD.

It can be quite an intense appointment.

There's a lot of digging.

There's a lot of, okay, we're seeing this,

but where is that stemming from?

Is that stemming from one place or another place?

So that we'll see a lot of questions.

You'll probably think that your A DHD assess is pretty nosy

in things day to day.

Is it common to be misdiagnosed with ADHD?

It is possible to be misdiagnosed with A DHD.

There's not necessarily any facts

or figures looking at the reality of wet where

or if people are being misdiagnosed.

The possibility comes from if

the information isn't being dug through properly.

So for example, with concentration, we all struggle

with concentration up and down throughout our lives.

So say if someone's saying, you know what?

Past six months I just cannot concentrate at all,

I can't get my work done.

It's really impacting me.

What we need to be digging as a DHD assesses, okay,

well why is this last six months different?

What is going on in that person's life?

Is it because they've spent a lot of years trying

to hold it all together and now it is just too

hard for them to continue?

Absolutely, that could absolutely be the case.

Or is it that actually they've had a bereavement in the last

six months, which has been horrendously impacting for them?

Because that can also really impact

that concentration level.

So for misdiagnosis, that would come from

not digging thoroughly into the causation of the challenges

that someone's facing day to day.

Also, people with A DHD are 50% more likely

to have a specific learning difficulty.

That could be something like developmental coordination

disorder, also known as dyspraxia.

And actually, are we seeing a lack of attention coming

through just that dyspraxia, just that clumsiness,

not paying attention to the environment, struggling with

that motor skills and movement,

or are we seeing, is it much more

that pure just the A DHD side of it,

or is it both of them working together?

So, like I said, it is possible for someone

to be misdiagnosed with A DHD.

However, it just requires a lot of specific digging and lots

and lots of questions being asked to you

to make sure we're getting the right outcome for

that person.

Is ADHD misdiagnosis more common in women than men?

A DHD diagnosis in women

can absolutely be missed a lot of the time.

So a lot of the time women are far more likely

to be diagnosed with low mood

or to be diagnosed with anxiety than they would be a

neurodevelopmental condition.

Particularly because so much of the past research

of A DHD is based on young white boys,

that it doesn't relate to

a 30-year-old woman who's got a job and running a household.

They are completely different.

And unfortunately, due to the historic kind of presentation

and idea of A DHD, it still hasn't quite broken through into

how A DHD can look in an adult woman

rather than a young child.

It can be the racing thoughts that are caused by A DHD

and having doctors

or professionals say to that woman, oh, that's just anxiety.

That's completely normal, when actually

what they're not seeing is all of the challenges

with overarching executive functioning issues

that are happening behind the scenes

of those racing thoughts also can be more likely for women

to be diagnosed with something like a personality disorder

if they're struggling with their emotional regulation in

comparison with a man.

And it's not necessarily to say that you can't be both.

There can be personality disorders co-occurring alongside A

DHD, but it's important

that we should be exploring A DHD in women much more

thoroughly, and particularly when women are more likely

to be diagnosed with an inattentive presentation.

So you're not seeing the hyperactivity,

you're not seeing the impulsive behaviours,

but we are seeing is the forgetfulness, the difficulties

with finding your belongings

or 1,001 strategies put in place to mitigate all

of these things day to day

that someone who's neurotypical wouldn't have to do.

What information will typically be asked during a screening or assessment?

So during a screening or an assessment for A DHD,

you'll be asked a lot of different questions.

So we'll talk about all about when you were little,

developmental history, your mom's pregnancy with you.

So we go into a lot of in depth detail around those things.

So talk about education

and then what we'll also talk about as well.

And what I like to do in my assessments is just talk about

what a typical day in the life looks like for you.

So just from the minute you wake up, how you find gain out

of bed, how you find brushing your teeth all the way

through your working day, what your lunch looks like,

how you find cooking your meals,

or the admin of just having a home, managing bills,

those sort of things.

And then looking as well into your evenings.

What do you like to do? How do you enjoy spending your time?

What hobbies do you have?

Do you like to do one specific hobby?

Do you tend to cycle through lots of different hobbies

and have your fingers in loads of different buys?

And how do you find things like settling to sleep?

It can be a lot easier to think about a DHD challenges

and strengths when we're just talking about you as a person

and about how your day is.

So we'll go into the clinical diagnostic questions,

but what your assessor should be doing is really just

relating those specifically to you.

So if talking about something like organisation

and they know you commute to work,

they would probably word it something like,

how do you find doing your commute?

How do you find getting on time into the office,

getting your bus or getting your train

or making sure you're not hitting too much traffic

and making it much more personal to make it much easier

to talk about and to be able to open up about the things

that you are finding difficult day, day,

and also maybe the things that you've got in place

to manage any of your difficulties.

It may be, yeah, I'm never late for work,

but I'm actually always at least an hour early

because I do this, this, this,

and this to make sure that I'm not late.

But really pulling out all of those different things,

whether it comes from strengths,

whether it comes from challenges, or whether

or not that comes from you.

Making sure by doing all of these extra things

that you're not going to experience the challenges

that may be present in your day-to-Day life as well.

How long can an assessment take?

So the assessments can be quite lengthy.

They can take anywhere between two to three hours,

which I find are the average length

of my assessments day to day.

It varies. Obviously, it'll vary depending on your age,

how much life you've lived.

It varies depending on kind of

where your challenges are lying,

and also about how comfortable you are with opening up

with a clinician, actually.

Is it something that you're finding quite hard,

you need a little bit more support,

a little bit more questions,

and a little bit more time with them just to develop

that rapport and feel comfortable.

All of those things are absolutely okay.

It can also take a little bit longer if actually find,

you know what, I could really do it a couple of breaks.

I always offer my clients a break halfway

through our session, and I always make sure they know that

any point they can get up, take a break.

It's absolutely fine.

It's not something that you're being expected.

Say, sit down perfectly in my chair

and answer all of their questions straight away.

I can't ramble. I can't do this.

It's just about being as much of yourself as possible.

For example, when I've assessed people

before, often if they're coming to us

for a remote assessment and they're logging in from their

phone, I've seen most rooms in

people's houses, you know what?

I'm just going to go make a cup of tea.

They'll pop the phone down, make a cup of tea.

Absolutely fine. Oh, you know what?

I'm going to go in this room. This

room's a little bit too noisy.

I don't like it all, absolutely fine.

They are things that can make the assessment a little bit

longer, but they also make the assessment much more

comfortable.

What options are available to someone if they are diagnosed?

If someone is diagnosed with A DHD, there's lots

of different options and routes that they can go down.

So some people choose to look at medication,

which is something that you can speak

to your GP about the options in your local area.

Some people go for, you know what, I don't want

to take medication, but I'd like to learn a little bit more.

And they may go down the education route.

And that could be accessing things available within their

local NHS, their local adult, A DHD service,

or also going through charities.

Lots of charities have really good online groups,

which have actually just got more

and more common since covid and they're

so much more accessible as well.

They take away the stress of having to get

to a random outpatient clinic.

Oh my gosh, how do I get there? Will there be parking?

Do I have to take a bus?

You can just log in off your phone

and digest that information

and meet people who are also struggling

with A DHD and with those different things.

And you get specific groups

as well, you can get specific groups.

Managing impulsivity. Specific groups are just learning

about what A DHD is, specific groups for A DHD in women.

And there's lots and lots

of lovely resources out there through charities.

Some people also choose to access more A DHD specific

appointments and interventions.

That could be things like a DHD coaching.

That could be things like cognitive behavioural therapy

or some people just also appreciate going

for something like counselling with someone who is kind

of neurodiverse trained

and just needing kind of talk through.

I found this really difficult

and I just want to talk about the effects

of having an A DHD diagnosis later on in life

and how that's made me feel.

And all of those things can be really helpful in aiding

that feeling of self-compassion in regards to the things

that you're finding difficult day to day.

What typical challenges do people face when going through an assessment?

So there can be lots of different challenges for someone

to face if they're seeking an A DHD assessment.

The first one can also just be the way

that they feel about themselves.

A lot of people have internalised a feeling of

not feeling like they're trying hard enough

or feeling that maybe they're imagining

it or they're making it up.

And to change that perception, say, you know what?

I am trying really hard.

I'm really trying my best here,

and this is still incredibly challenging.

I need to find out what's going on.

Or I need a bit of support.

Just to have that mindset shift is such an incredible

strength and it can be really, really

challenged for people to manage.

Another challenge that people can face is the forms.

There are so many forms when it comes

to seeking an A DHD referral and assessment,

and they can be really daunting.

They can take a really long time.

They take a lot of focus and attention to detail,

and sometimes people often get to the first part of wanting

to get a referral, and when it comes

to then filling out the forms,

they may get stopped dead in their tracks

because it's just too much.

I'm not going to be able to do this.

It's going to take too long.

I'm not going to be able to focus on it properly.

Or they forget about it and forget that there was a deadline

for it to coming back and it forms someone

with A DH D'S kryptonite.

They are so challenging.

So I say to anyone who's looking at getting an A GT

assessment, get someone to help you fill out those forms if

you can, because they are long, they can feel tedious,

they can feel like you're there repeating yourself,

but they are really valuable

to help you access the right support in the right way.

Another challenge can just be the length of time

that assessment takes.

Sometimes assessments can take two to three hours,

which can be really daunting for someone to have

to sit still and concentrate for that length of time.

Be open with your clinician and say, I'm worried about this.

I don't think I'm going to be able to do it. Ask for breaks.

Talk to 'em about how ways can be managed.

Can you log in on your phone if it's remote

and have a little walk

around your house when you're talking?

All of those things are really reasonable things to ask

for when completing these things.

Assessment. And finally,

a huge barrier can be the waiting lists.

At the moment, within the uk, there is a huge waiting list

for A DHD assessment all across the country,

and to manage that can be really challenging.

One of the key diagnostic criteria for people

with A DHD is difficulties of patients having to wait

for things to acknowledge, okay, I am going

to put in a referral now, but it may be five or six years

before I hear anything before I get an appointment.

That can be really, really difficult to get past that hurdle

and still have that referral in place.

How can someone support someone else going through a diagnosis?

So to support someone going through a diagnosis, some

of the best things you can do is help them with those forms.

The forms are long. They are tedious.

Remind them if they're due soon,

ask them if they want any help filling them out.

Ask them if they want any support, giving extra information.

A lot of services will ask for an informant questionnaire,

which is when someone close to you

or someone who's known you a long time,

will ask questions about how they're finding things day

to day, just from an outside perspective to see

where those challenges can be facing

because it's not always easy to see

everything ourselves else.

I think as well, just acknowledging that there is a lot

of strength as well, that goes with seeking a diagnosis

of A DHD.

It's a lot of strength in acknowledging, you know what,

something is really hard, something is

not easy to get through.

And having that compassion, that space to speak about it,

that space to really just feel all the feelings

that come alongside of, well,

why in adult life am I now seeking this?

Why wasn't any of this that I'm finding really difficult?

Why wasn't that picked up as a child?

Sometimes people who are going

through an assessment just really need that space

and time to talk those things through

and to feel the emotions

that can come along with it as well.

Just that compassion and listening is sometimes enough,

and also a bit of the practical support when it comes

to forms and the boring organisational bits of things too.

What can someone hope to achieve when seeking an ADHD diagnosis?

So some people seek an A DHD diagnosis to be able

to further understand

themselves, just to think, you know what?

This is a part of who I am. This is just how my brain works.

This isn't a flaw.

This isn't something because I'm not trying or

because I've been told I've got my head in the clouds.

Too many times I've told I'm dray dream all my life.

I've been told I can't manage my emotions properly.

This is all something that is explained

and that can be invaluable to someone,

particularly if you're getting a diagnosis

through adulthood and not during childhood.

To have an understanding of where all these things come

through is often the main reason why

people seek an assessment.

Also, what you can gain from it is not only

that learning about yourself

and that awareness, it can also allow yourself

to give yourself that little bit more grace when it comes

to having support day to day.

You know what? I want to ask for a bit of support in work,

or I want to ask for some adjustments in the way

that my deadlines are managed

because I can explain it better about why I'm

finding things challenging.

And it can also help people manage their relationships too.

A lot of people find that they struggle with friendships

with A DHD, and there's a little bit

of an outer sight out of mind.

If I've got a mate who lives three hours away,

I may not actually think about them until I get a text

and then I may forget to reply.

And it's not because they don't care, it's

because actually they just need

that prompt of someone being there.

They need that prompt of a text popping up on their phone to

remember, oh yes, I need to respond.

I need to reply to that.

And having an understanding from a friendship point of view,

it can be really helpful to go, oh,

they're not grumpy at me.

They're not ignoring my messages.

Actually, it's just because they've forgotten.

I'll just give 'em a quick reminder

message and it'll all be fine.

So that understanding from that relationship point

of view can also be really valuable for people

as well seeking assessment.

When should you look to go through an ADHD assessment/screening?

I think that can really vary.

Some people will want to go for an A DHD assessment

as soon as they can.

Some people will want to go for it if they're finding,

you know what, I can't cope with all

of these extra things I put in place anymore.

A lot of people with A DHD will do something called masking

where they're hiding all of their behaviours

and symptoms of A DHD all of the time.

And that can look like getting somewhere three hours early

because you're so aware that if you try

and get them on time, you're likely going to be late.

So that takes a lot of time.

It takes a lot of cognitive load.

It can be, I'm going to write absolutely everything down

that that person says,

because if I don't, I'm not going

to remember absolutely anything.

So I need to really overcompensate.

So that overcompensation can be absolutely exhausting.

And sometimes adults will get to the point, you know what?

I cannot do this anymore.

I seem to be working quadruple the amount of anyone else

to achieve the same results.

And that doesn't quite seem right.

And that's often where a lot

of adults will then start seeking that A DHD assessment.

What you also see is a lot

of young adults seeking assessment to,

and that can come hand in hand with leaving the family home

to perhaps go to university or go for their first job

and find that, oh, actually

what they didn't realise at the time is that their parents

or their home environment was hugely supportive.

They had lots of structure given to them in terms

of revision or managing deadlines for school.

Their parents were very compassionate

and they had friends

who had the same interests in them in terms of being really,

really active and wanting to utilise all

that energy all of the time.

And then when you're going into university

or working life, living on your own,

suddenly there's a lot more challenges to face.

Oh gosh, I've got to use my brain now.

Not just for studying, or not just for working,

but also for making sure my bills are managed every month.

I can't forget those. I can't impulsively spend my money,

so I don't have my money to spend for bills.

I need to make sure I've got clean clothes for the week.

I need to make sure there's food in.

I can have enough meals about thinking about it.

And all of those things added on can then make someone go,

oh my goodness, I can't do this.

This is really, really hard.

So people may seek an assessment in that part

of their life when they're seeing their support.

Networks may be lessened purely

because of where they are in terms of their life.

So people will seek assessments at lots of different time

for lots of different reasons.

Do you have any examples of where you have seen getting a diagnosis support someone in their life?

Yeah, so one of my favourite cases is I worked

with a young woman, incredibly bright, flew through school

and flew through university education as well.

I met them when they were completing a doctorate.

So as you can imagine us, incredibly time consuming

and incredibly challenging,

and they'd come for an assessment

because they weren't managing their doctoral workload, which

on the surface you think, you know what?

Doctorate sound really hard. That sounds pretty normal.

That sounds like, oh, well, you know what?

They're a lot harder than doing your undergraduate degrees.

They're a lot harder than doing your masters.

That doesn't sound like it could be something that

could be explained just by a DHD.

However, when we really dug into this young woman's life,

when we look all the way back to when she was at preschool

and nursery, she would flip between her things all the time,

much more than the other kids her age.

Say she'd be painting for a bit,

she'd be then in the sandbox for a bit.

She'd be doing something else, a bitch,

she would never sit down for story time or for circle time.

So you're seeing these hints of restlessness

and difficulties of a tension from a very young age.

And you could see then as she went through her life

with school, she grasped things super, super quick.

A very, very bright young girl, which meant that actually

her reports all said brilliant, doing really, really well.

Bit of a day dreamer sometimes probably chats a bit too

much, but ultimately doesn't matter

because she gets her work done with ease,

usually super, super quickly.

She may sometimes make a couple of spelling mistakes,

but it's not an issue because she grasps the concept.

Once again, we're seeing that flavour of A DHD there.

We're seeing the daydreaming from the inattention.

We're seeing the chattiness overactivity there as well,

and we're seeing missing little details.

But at the time, it didn't matter

because she was grasping the whole concept,

and that kept happening

as she went through secondary school.

All of these flavours were there,

but her ability to be academic in those settings

really just made her ignored in that potential

neurodiverse world and system.

And when it came to then looking at university,

what we saw is actually this young woman stayed at home

for university, so then she wouldn't have to think about all

of the additional things which she needed

to organise herself.

So she wouldn't have to think about managing her washing.

She wouldn't have to think about cooking.

All she had to focus on was her academic work.

And that worked for her

because what she found is when her parents would go away on

a holiday, they would come back

and she would've had takeaways all week

because she would've forgotten to

go shopping or forgotten that

There was things available for her, not

because she was feeling lazy and not

because she just wanted a takeaway,

because she could not organise herself to make these meals.

And when she would follow recipes, she'd miss out bits,

and the recipe would ultimately not end up very good

because she wasn't concentrating.

She'd miss out bits of the instructions

and she'd be returning to it time and time again.

So you'd see all of these things come out when

that support network was starting to fall down.

And all of this was having a massive

impact on her mental health.

She knew she was bright, she knew she had the academic

ability to do all of these things,

but in her head, well, why can't I adult?

Why can't I do the adulting thing?

Why can't I do my washing? Why can't I cook?

Why can't I do all of these things that I have

to have done for me by someone else?

And actually, when we really delved into it, all

of this flavour of A DHD was there through her whole life,

completely hidden by her academic ability.

And then when it came to actually having

to manage both academic ability

and other things in life, it was completely overwhelming.

And her anxiety levels were at such a high point

because of all these challenges that she was experiencing

that she then was starting to not do as well in her studies

because her anxiety significantly impacted by her A DHD

was causing her such issues.

So she ultimately got a diagnosis of inattentive A DHD,

and you could see her anxiety

just completely reduced

because she understood where her needs was coming from.

She gave herself the grace to pause her studies for a period

of time to work on her A DHD,

and to work on her anxiety, then be able

to return back at a later date

and just absolutely thrive on it.

It had a massive difference in this young person's life,

and I think probably without it, I can imagine

that she would've really, really struggled with any form

of independence following her studies.

And I can imagine that actually her mental health challenges

would've significantly worsened and worsened.

And I'm glad that she reached out for

that support in her early twenties

because absolutely someone, what we could have seen 20,

30 years later on in her thirties and forties

and fifties actually significantly impacted

and impaired by her anxiety caused by that A DHD.

What advice would you give to someone who is scared of seeking an ADHD assessment?

I think acknowledge the strengths it's taken to see that,

you know what, maybe things shouldn't be this hard.

There is such huge strength in just adjusting that mindset

of thinking, well, this is just part of who I am.

Surely everyone else struggles as much.

Surely everyone else has to work super, super,

super hard to do this.

And being able to step back, look around you

and see how hard that is,

and to want to ask for help is huge.

That is so important to acknowledge what that takes.

And also I think when it comes to being nervous,

seeking an assessment is completely normal.

Most people do arrive to us feeling a little bit anxious,

not quite sure what it's going to look like, not quite sure

what they're going to be asked,

not quite sure is this the right thing.

Some people come to us thinking, oh gosh,

what if I'm just making it all up?

And often come out

of our assessments thinking, you know what?

I was asked the right questions.

I felt like I could talk about the things I needed

to talk about, and I don't feel like I'm making it all up.

I feel listened to, which is the most important thing.

Also, when you are looking at getting an assessment,

once you have done that initial referral, you can always

speak to the service that

are going to be doing your assessment.

Say to them, what does it look like?

Usually staff will be more than happy to talk you

through the process, what it looks like.

And often people will have welcome packs when

it comes to welcome to the service.

This is what the process looks like.

This is what we need from you,

and this is how we'll progress through.

And it's absolutely reasonable to ask for

that additional support as well.

Can medication be used to support someone diagnosed with ADHD?

A DHD medication is absolutely an option for those

who have been diagnosed,

and that would be something to kind of seek through your GP

to see whether or not your local adult A DHD service

is able to offer it.

It's also used overarching in regards to nice guidelines.

It's used alongside both environmental strategies

that could be having support at work,

having strategies at home, such as alarms and reminders.

Medication isn't something that is a fix all

and can be used in just in itself without those additional

things being used as well.

Can an ADHD assessment differ between providers?

Yeah, absolutely it can, depending on the provider

that you do choose to go with.

What you want to be looking for is making sure

that you're getting a thorough in depth assessment.

Whilst it may not feel great at the time, what you want is

to find the nosiest A-A-D-H-D assessor that you can find.

Do you want someone who's really figuring out, okay,

where are these challenges coming from?

You want someone who's going to talk about early years.

They want to talk about developmental history.

They want to ask the questions about mother's pregnancy

and things like that, about whether

or not you're premature as a child.

They want to ask questions about day-to-day life.

Those sort of things do take time.

So what you also want to make sure is

that you are also given enough time to go through all

of these challenges or make sure that they're heard.

You don't want to feel rushed when you're going

through an assessment, so make sure whoever provider you go

with gives you that amount of time

to make sure you feel heard

and that you've able to talk through everything

that you feel the need to talk through.

Through that. Different providers offer different levels

of assessments and screens

and can have different levels of thoroughness,

so just make sure that you are happy.

Make sure that you are happy with the amount of time

that you're being offered to have your story heard.

In what way does Melios support people through an ADHD assessment?

At LIOs, our appointment times are two hours.

How if I do often go over those quite a bit

because I am incredibly nosy when

it comes to asking questions.

So the way that we support our clients moving

through the A DHD process is we've got a fantastic client

operations team who will talk you through the whole process,

okay, these are the forms

that we would like you to fill out.

This is how you do them.

This is what your appointment will look like.

So they are brilliant at answering any questions

that you've got about the process.

They're absolutely lush.

And then when it comes to the assessment in itself,

your clinician, so when I do it, I always introduce myself.

I always make sure that people feel comfortable,

make sure they know that they're not trapped their

chair the entire time.

They can get up, they can ask for breaks.

It's much more of a relaxed conversation.

It's not question, answer, question, answer.

It is more just tell me about where you are.

Finding these things hard,

and if you're finding it difficult to just bring

that information straight away,

then I'll start pulling it out with different questions.

We absolutely work it and tailor it to the individual.

One of my favourite things to do throughout the appointment

is just to ask you just

what a typical day in the life looks like.

Because sometimes it's so much easier

to see, okay, you know what?

These are my real strengths and I can see these day to day,

and these are the things that I'm finding

much more challenging.

And I can see that when I'm getting to work,

or I can see that when I'm having to make sure

that I've got my clothes

or my work uniform ready for the week.

And it's much easier to talk that in

that more daily life experience than in

that more clinical questions way.

Also, it can be really hard

when you are doing an assessment.

So part of the diagnostic criteria for adults is

to be reflecting on childhood about where we saw it.

Then sometimes that can be really hard to do.

I could feel, gosh, I barely remember anything from

childhood, and that's my job then to really draw that out.

Okay, well, what are your emotions?

What can you remember from school? Did you like school?

Did you not like school?

Because emotions can be a lot easier

to pull out sometimes than specific examples of, oh yeah,

I forgot my homework nine times that week.

No one can remember that. People can generally remember

those emotions much more so associated with school

and about those younger years.

So in terms of support, you will just be guided through

that assessment in that relaxed manner, in that talkative,

chatty way, rather than it being kind of yes, no, yes, no.

And once you've completed that assessment,

then I would always just say, okay,

well this is what happens next.

You'll always be given a full plan of, right, okay,

I'm going to go in and write all this information up.

I'm going to figure out the outcome.

I'm going to speak to a multidisciplinary team

to make sure we're run in agreement with it,

and then I'll give you a phone call

to let you know that's happening.

You'll be given a timeframe,

so you'll have a very clear plan about

what's happening next.

You're not going to be left in any sort of limbo phase

of thinking, oh my goodness, what on earth do I do now

that I've just divulged all this information?

So you'll be supported

through the whole assessment process within LIOs.

Are private ADHD diagnosis's recognised by the NHS?

So private diagnoses follow exactly the same

pathway in clinical guidance as the NHS.

So we follow the DSM five diagnostic criteria for A DHD,

and we follow the NICE guidelines to complete those.

So that should be the same in any private provider you go

to at LIOs.

What we also do, we do go kind of above

and beyond that what is expected.

So whilst the NICE guidelines will say

that just one clinician will need to kind of make

that formulation, what we like

to do at LIOs is also present your case

to a multidisciplinary team just

to make sure you've got someone else poking

and prodding to make sure nothing's got missed,

to make sure we've unturned every stone

to make sure we're really getting the right result for you.

If for any reason an NHS provider didn't

accept a private diagnosis,

what we would be asking is the why

or why is it that you're not accepting it?

Is it that you don't feel our work is thorough enough?

And if so, okay, well actually we can explain

to you why the work is thorough, where we've got all

that information from.

So it's important if you were to ever come across

that situation of a private diagnosis, not being accepted

to uncover the why that's happening.

And LIOs is also a company which would support you through

that if that was the case.

Do Melios assessments follow NICE guidelines and what does that mean?

So Emilio assessments do follow NICE guidelines.

So what that means is that NICE guidelines that stands

for the National Institute

for Clinical Excellence, right most.

And basically that is the guidance

that we follow here in the UK to make sure

that everyone is consistent in the clinical work

that's being done and to a high standard.

So in the NICE guidelines for adult A DHD diagnoses,

what's expected is

that you'll have someone doing the assessment.

And that can be a allied health professional like myself

and I'm an occupational therapist, be a psychiatrist.

It could be a nurse. As long

as they've got sufficient experience within A DHD,

they are able to do a diagnosis within part of that company.

So that'll be making sure

that they're being thorough in terms of seeking

that developmental history, seeking where the challenges

and the impairment is.

So actually this person does struggle with conversation.

What problems is that causing it?

They need to be making sure they're covering that.

And also then making sure that looking

to an assessment outcome, nice guidelines state that

that can be done by one clinician only.

What we do at LIOs, we actually, all

of our clinical outcomes, whether a diagnosis

or a non diagnosis for A DHD, they will always go

through a second clinician to making sure

that we are not missing anything.

So we do go above

and beyond that nice guidance just

to make sure we're getting the right

outcome for our clients.

And that's often a mixture of professions.

So like I mentioned earlier, you can often have an OT

completing a multidisciplinary team assessment meeting

with a nurse or their speech and language therapist,

or with a psychologist.

Or a psychiatrist. We've got a real breadth of

specialists at LY to make sure that we're really able

to incorporate those nice guidelines and go above

and beyond as much as we can.

Can I use an ADHD diagnosis to get support at work?

Yes, absolutely.

An A DHD diagnosis can help you get support at work.

So you can start with things like reasonable adjustments,

and that can be really basic things like, you know what?

A standing desk would be really helpful,

or a specific chair that instead of one

that's really stationary, you've got one that moves.

You're able to just get that movement out a bit more.

It could be that instructions are written down, so memory

and following verbal instructions can be super hard

for someone with A DHD.

So you can ask in work to say, you know what?

If you can ask me anything, please just send it in an email

or please write it down somewhere so that I can refer back

to it to make sure you are going to get it done.

Some people with A DHD as well,

like a clear deadline at work, so, okay,

you need this task done, just get it to me when you can.

That level of vagueness can be someone

with a DH D's worst nightmare

because they're thinking, okay, well

how on earth do I prioritise this piece of work?

Now I've got no idea when it needs to be done

by saying, you know what?

I would like that done by next week.

So that person then is able to utilise their time well

and able to have a clear thought of, okay, you know what?

This is when I need to get that done by,

and this is how I organise my time around that.

It can also be being flexible in terms of working location.

Sometimes office environments can be so overstimulating

for people with A DHD.

People with A DHD can be very easily distracted.

So if there's people nattering over here

or nattering over there just talking about work things

or just things, what they've done on the weekend,

it can be really hard for someone with a DHD to filter

that out and get on with maybe an impending deadline.

And sometimes they may find

that they're the one doing all the talking,

and then I've got 45 minutes later I've gone,

oh my goodness, I've just chit chatted away

and I've not done anything because of that distraction and

because of that tendency to talk a lot from that, lots

and lots of energy perspective as well.

So it could be allowing them to, oh, you know what?

You've got access to that little side office,

or you're able to work from home as and when you need it.

If you've got an impending deadline, you work better there.

Ultimately, it's about having an open discussion at work

and saying, these are the things

that I think will really, really help.

Can we give them a go, please?

And reasonable adjustments is a really interesting term in

my opinion, because what's reasonable

to someone isn't reasonable to someone else.

It feels quite tricky to know exactly what you can ask for,

but what you can do's.

Lots of really great resources.

So A DHD UK has a great resource on

what is a reasonable adjustment, what can you ask for that?

By law work will have to put in place to be able

to support you to do your job.

Obviously, disclosing an A DHD diagnosis in work is also a

very personal choice.

So that is something to think about when you are reaching

out for support too.

What routes are available to people wanting to access an ADHD diagnosis?

So there's lots of different routes when it comes

to accessing an A DHD assessment.

So in terms of if you are accessing your assessment

through the NHS, I would suggest going

to your GP in the first instance.

So you can go to your GP and ask for a referral.

And what they would do then is refer you

to your local adult, A DHD specialist service,

where they would then pop you on the waiting list

for an assessment there.

So that's one route going through the GP

and your local NHS service.

Another route is

that some places in the country offer

something called right to Choose.

So right

to Choose does exactly really what it says on the tin.

It gives you the right to choose who provides your service.

So for example, you could go to the gp, say,

I would like an A DHD assessment

because of this, that, and the other.

That I'm finding tricky. However, I would like

to go down the right to choose route

and go through a different company.

So a lot of different private companies offer a right

to choose route, and that can vary

what company it is depending on where you live in the uk.

So right to choose is always an option.

And another option is going privately.

So some people may have health insurance that may cover

diagnostic assessments for neurodevelopmental conditions.

If you do have health insurance,

I would always recommend just chatting

with your provider first to see what's on offer for you.

Sometimes they'll provide a full refund for it.

Sometimes it's partial refund,

but it's best to chat to your provider

about whether or not they offer that.

And finally, there is the option

of a privately funded assessment

where you seek your own private clinician

or company and pay for that assessment outright.

What safeguarding does Melios provide within an ADHD assessment?

LIOs provides really thorough

and robust safeguarding all throughout the assessment

that is from your initial phone call about accessing

LIOs in terms of an A DHD assessment.

So you'll be asked some questions about your risk.

So what that means is that you'll be asked, okay,

at the moment, do you feel that you're

at risk to other people?

You're at risk to yourself.

And you'll be asked about how your mental health is at

that moment in time as

or as well to see if as an online service,

are we able to meet your needs

and also able to manage a level of risk

or that level of support within our service.

Within LIOs, we are an assessment service

and as we are private and not linked directly to the NHS,

we want to make sure that you are in the right place

to make sure you are able

to access all the support that you need.

So you've got your first chat

about safeguarding in your first appointment,

that is then reviewed on your whole journey through lio.

So when you meet with a clinician for your A DHD assessment,

they will go through something called a risk assessment

with you, or they will ask you about different

behaviours throughout your life.

And that can be things like aggression,

it can be things about hyperactive and impulsive behaviour

and whether or not they cause you any risk in terms

of you thinking, not thinking, sorry, in terms

of maybe not thinking before doing things.

Does any of those things cause you to be an accidental risk

to yourself for any reason?

They ask about whether or not you've got any social work

involvement and if you're happy for us to talk with them

to make sure you're getting a cohesive service.

And once that's completed, we make sure

that you are signposted

to the right places if that's needed.

And then we monitor that throughout your appointments,

throughout LIOs.

So yeah, that is what we do with safeguarding.

I think it's quite thorough and I think actually a lot

of our service users have found it really, really helpful

because actually they know that they're being support

and they know that we've got their best intentions at heart

when it comes to talking through safeguarding processes.

What do you think of the JAAQ platform?

I think the JAK platform seems really accessible

for people looking to get easy bite-size information about

things regarding mental health

and neurodevelopmental conditions.

I think it'll be a really, really useful tool moving forward

to allow people to just digest the information a little bit

more easily than running through loads of stuff on Google

or in textbooks.

Neurodiversity

Learning about neurodiversity

Common neurodiversity conditions explained

ADHD

Dyspraxia

Dyslexia

Explaining autistic spectrum disorder (ASD)

Transcript

Who are you?

What is autism?

Are there different types of autism?

What causes autism?

Can autism be cured and can autism go away?

Does autism run in families?

Can you develop autism as an adult?

What is masking?

What is the difference between autism and Asperger's disorder?

What are the key signs of autism in adults?

What impact can a late diagnosis of autism impact someone?

What are typical struggles faced in daily life by people with autism?

What are typical misconceptions about adults with autism?

What are some effective coping strategies for autism?

What are the benefits of receiving an autism diagnosis as an adult?

What support services are available?

What is peer support?

What is the role of occupational therapy in supporting someone with autism?

What role does sensory processing play in autism?

How do co-occurring conditions, such as anxiety or depression, interact with autism in adults?

What % of the adult population is autistic?

What barriers might there be to someone seeking an autism diagnosis?

What is the difference between screening, assessment and a diagnosis for autism?

What do you think of the JAAQ platform?

Understanding neurodiversity

How to support someone you love with ADHD

Neurodiversity: your common questions answered

Eight misconceptions about autism spectrum disorder

Five myths about Tourette’s syndrome

Understanding neurodiversity terms

Being neurodiverse: my story

Explaining ADHD

Transcript

Who are you?

What is the difference between screening, assessment and a diagnosis for ADHD?

What is the process of an ADHD assessment?

Is it common to be misdiagnosed with ADHD?

Is ADHD misdiagnosis more common in women than men?

What information will typically be asked during a screening or assessment?

How long can an assessment take?

What options are available to someone if they are diagnosed?

What typical challenges do people face when going through an assessment?

How can someone support someone else going through a diagnosis?

What can someone hope to achieve when seeking an ADHD diagnosis?

When should you look to go through an ADHD assessment/screening?

Do you have any examples of where you have seen getting a diagnosis support someone in their life?

What advice would you give to someone who is scared of seeking an ADHD assessment?

Can medication be used to support someone diagnosed with ADHD?

Can an ADHD assessment differ between providers?

In what way does Melios support people through an ADHD assessment?

Are private ADHD diagnosis's recognised by the NHS?

Do Melios assessments follow NICE guidelines and what does that mean?

Can I use an ADHD diagnosis to get support at work?

What routes are available to people wanting to access an ADHD diagnosis?

What safeguarding does Melios provide within an ADHD assessment?

What do you think of the JAAQ platform?

Help for parents

How to support neurodivergent children

Where to find help and information near me

What support do schools and colleges provide?

Try Bupa's neurodivergent-friendly fitness classes

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Find more fitness classes, meditations, and expert guides in My Bupa

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