Autism and ADHD assessment and support

❖ Understanding yourself or your child more: Reframing past experiences through a lens of autism or ADHD may help to make sense of difficult moments with compassion and understanding. You may learn more about yourself (or your child) and become more aware of the environments that help you (or them) to feel comfortable and thrive and those that are more challenging. Many of our clients have suppressed their neurodivergence for most of their lives as they viewed their difference in a negative way. We aim to help our clients discover their autistic and ADHD strengths. Acknowledging strengths and differences can help in living more authentically and moving away from forcing oneself to live in a neurotypical way.

❖ Mental health treatment planning: Many clients come to us having previously received other diagnoses (e.g., personality disorders, OCD, repeated episodes of anxiety) and sometimes neurodivergence underpins these difficulties. It can be useful for care planners (e.g., therapists, GPs, psychiatrists) to know about a diagnosis of autism or ADHD so that they can plan treatment and support and adapt interventions accordingly.

❖ Access to more support: A diagnosis may open opportunities to access new supportive communities nationally and locally. We can offer you post diagnosis support, therapy and we can share our recommendations for neurodiversity coaches, books and websites with you.

❖ Employment and education-based support: We hope that a diagnosis means that employers and universities or colleges can understand our client's needs more and make reasonable adjustments to promote inclusion.. For example, additional examination time or access to a quiet office when the noise is too overwhelming or distracting.

❖ Processing difficult memories and emotions: Receiving a diagnosis can take time to process. Sometimes, as part of this natural process, feelings of sadness and anxiety around past difficult memories may be elicited. Some clients find reaching out to friends, partners or neurodivergent communities useful after diagnosis. We also offer specialist post diagnosis support to help you.

❖ Joining the military: Employers legally cannot discriminate against neurodivergent individuals when they apply for a job. In fact, there are companies who actively encourage autistic people to apply for jobs. The only exception is if an individual planned on joining the military, as being autistic or having ADHD may pose as a barrier to joining at this present time.

❖ Driving and the DVLA: If you are applying for a license, you do not need to tell the DVLA about an autism or ADHD diagnosis, unless it affects your ability to drive safely. If you already have a license and you are diagnosed with ADHD or autism, you need to tell the DVLA if there is a change to your condition that makes you an unsafe driver. In the case of ADHD, you need to inform the DVLA if you are prescribed medication that causes side effects that will affect your driving. If you are unsure whether your autism or ADHD affects your driving safety, we would recommend that you discuss this with your prescriber and/or your GP. More information can be found by visiting Attention deficit hyperactivity disorder (ADHD) and driving - GOV.UK (www.gov.uk) and Autistic spectrum condition (ASC) and driving - GOV.UK (www.gov.uk)

❖Insurance: A diagnosis of ADHD or autism may impact on your eligibility and/or cost for certain types of insurance e.g. income protection insurance, life insurance. We would recommend discussing your ADHD with an insurance broker who can find you the most suitable insurance provider and policy for you.

As our assessments follow the national guidelines (NICE) for autism and ADHD assessments, there should be no reason for our reports to be rejected. In our experience of working privately for other non-NHS organisations for many years, we have not experienced a rejection of any report. However, we recommend that prior to beginning an assessment, you should discuss this with the education setting or support service, so that you can be reassured that they will accept a private diagnostic report.

Please see the below links for more information about the NICE guidelines for autism and ADHD assessments.

Overview | Attention deficit hyperactivity disorder: diagnosis and management | Guidance | NICE

Overview | Autism spectrum disorder in under 19s: recognition, referral and diagnosis | Guidance | NICE

Overview | Autism spectrum disorder in adults: diagnosis and management | Guidance | NICE

We do not offer prescribed medication within our service. However, we are able to sign post you to several independent prescribers who can offer appointments following diagnosis to discuss medication options, initiate the first dose and monitor how the treatment is working.

Usually NHS GPs will take over prescribing services once an effective dose has been established or clients may wish to continue receiving a private prescription if preferred. If you are hoping for the GP to take over prescribing, we would recommend that you contact your GP before booking an assessment to confirm that they are happy to offer 'shared care' prescribing alongside a private provider, as this request may be declined by a GP. In order to access our pharmacist prescriber, clients will need to attend a GP appointment for basic checks (including height, weight, blood pressure and listening to the heart and lungs). An NHS GP may be able to offer this but it is possible that the GP will decline this request. In this situation, we recommend that you access a paid for, private GP appointment https://www.findaprivategp.co.uk/.

This will help you make an informed choice regarding proceeding with the assessment. Alternatively, you may wish to contact the local ADHD NHS team to ask whether they will prescribe following a private assessment. This may mean joining the waiting list for a review of an assessment, which in some areas can be many months. We recommend that you find out the prescribing options available to you or your child before embarking on an assessment, if accessing medication via the NHS is a priority.

Autism (also known as Autism Spectrum Condition or ASC) is a neurodevelopmental condition. It can influence how an individual socialises, communicates and processes information from the world around them. It means that someone may have preferences for how they interact which may differ from people who are neurotypical and it might mean that environments designed for neurotypical individuals (i.e., open plan offices, schools, parties) may be harder for them. Autistic people learn in different ways compared to people who are neurotypical.

There are differences in how autism experts understand autism. Some believe that it is a disorder and others (like us) understand it as a neurodevelopmental difference that poses challenges, but one that is also associated with strengths. Some people are more profoundly affected by autism and it can come with learning difficulties,

Autism is something that an individual is born with, but experts don’t yet understand its origins. Some research has suggested that genetics are involved. It does not seem to be directly caused by abusive environments or vaccines. More than one in 100 people are autistic. This is likely to be an underestimate.

The belief that autism is a spectrum is commonly held and a spectrum means that people experience autism in different ways. Some people think of the autistic spectrum in a linear way, with people more severely affected at one end, and those at the other end less affected (sometimes referred to a high functioning autism, Asperger’s Syndrome or ‘mild’ autism). We find it unhelpful to view autism in this way for many reasons which we can discuss with our clients if we make a diagnosis of autism. Dr Michelle Garnett and Professor Tony Attwood have written a useful information sheet about why the term is problematic, https://attwoodandgarnettevents.com/high-functioning-autism/.

Whilst no two autistic people are the same, there are common areas of difference that autistic individuals can experience. The official diagnostic criteria (DSM) are deficit focused in the way that that they have been written. We have tried our best to reframe them from a neuro-affirming position.

Common autistic features:

❖ Differences in social-emotional reciprocity. This might mean that someone doesn't always know how best to approach people and start off interactions, they might prefer to engage in in depth discussions rather than social chit chat or small talk. They might prefer to keep their emotions or interests to themselves or they might not always know how to respond in expected ways when other people share their emotions.

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❖ Preferring not to use eye contact or finding it uncomfortable, not using many gestures or using gestures in non neurotypical ways and having a neutral facial expression.

❖ Friendships might be different compared to non-autistic people. An autistic person may prefer one very close friendships to multiple friends or they might not be particularly motivated to make new friends.

❖ Preferring sameness and doing the same behaviours repeatedly (hand movements, using particular words, organising objects in certain ways).

❖ Becoming highly absorbed and focused on hobbies and topics of interest.

❖ Either processing certain senses very strongly or not noticing them at all (e.g., finding noises, textures, tastes very aversive but not feeling the cold or pain).

Every autistic person is different and some of these may apply and others will not. Part of our work would be to explore these with you (or your child)

❖ Intense strong interests in new hobbies and passionately sharing these with others.

❖ Honesty: People can speak freely with you, and you say things how they are.

❖ A strong sense of fairness and social justice.

❖ Determination: not giving up when you are trying to achieve something.

❖ Creative problem solving: not being bound by social norms allows you to think outside the box.

❖ Natural affinity with animals, sometimes children.

❖ Highly developed visual processing and observation abilities.

❖ Motivated by more than what people think of you.

ADHD is a neurodevelopmental condition. It can influence how an individual organises themselves in daily life, how they experience emotions, how they interact with others, and how they process information from the world around them.

ADHD can cause difficulties at work, at home, or in social settings, depending on the demands in that environment and an individual's coping strategies. Some people with ADHD put a lot of effort into hiding their difficulties from others and this can be exhausting and stressful. You will find lots of information on the internet about the negatives associated with ADHD.

We view ADHD as a neurological and nervous system difference that can pose challenges, but ADHD can also be associated with many strengths. ADHD is something that a person is born with, but experts don’t yet understand its origins. It is likely that a combination of genetic and environmental factors leads to ADHD and there is not one same cause or pathway to ADHD for everyone. 3-4 people in every 100 have ADHD, which is likely to be an underestimation.

There are three presentations of ADHD:

Predominantly Inattentive Presentation: Difficulty starting, organising or finishing tasks and paying attention to details. When interested in something they can focus intensely, with great motivation. For less motivating activities, a person may be easily distracted or forgetful in daily routines. Daydreaming and struggling with processing what people are saying can make it hard to follow instructions or conversations.

Predominantly Hyperactive-Impulsive Presentation: Fidgeting and talking a lot. Enjoying movement and activity, feeling restless and having a highly active mind, full of ideas. It is hard for the person to wait their turn or listen to directions. A person might have more accidents and injuries than others. Difficulties with sleep are common.

Combined Presentation: Features of both.

Everyone with ADHD is different and some of these may apply and others will not. Part of our work would be to explore these with you (or your child).

❖ Curiosity about the world.

❖ Engaged in the moment and spontaneous.

❖ Energetic and able to motivate and inspire other people.

❖ Creative problem-solving abilities, thinking outside of the box.

❖ Sensitivity and highly attuned to the environment around you and the emotional atmosphere in the room.

❖ Willing to take risks and push oneself.

❖ Highly motivated, focused and determined when an interest or project inspires you.

Neurodiversity is an umbrella term, referring to differences in how our brains process information. This can include other conditions such as dyslexia, dyscalculia, dyspraxia, ADHD and autism. Some members of the autistic and ADHD community argue that all brains are different in how they function and process information, and therefore neurodiversity is a natural occurrence in society and not always related to autism. They argue that neurodivergence is when differences are more pronounced and that these differences would meet the criteria for neurodevelopmental conditions such as ADHD, autism, dyspraxia etc. At Discover Difference Psychology Clinic, we will work by using your preferred language.