Autism & ADHD Assessments

If you suspect you or a loved one might have autism or ADHD your first stop will be your GP in order to request an assessment. It is important to have at least some outline of the traits or symptoms you have noticed in your own life and an understanding of the assessment criteria. It is an unfortunate truth that many general practitioners might not have specific knowledge of autism or ADHD and might still hold onto some of the autism or ADHD myths that are common. Neurodiverse people still regretfully have to advocate strongly for themselves within medical and mental health services.

Following this consultation your GP should hopefully agree to refer you to an assessment service within the NHS. Due to incredibly high demand and various limitations within the NHS, the waiting lists for autism and ADHD assessments can often be many years long.

One of the alternative options within the NHS is the Right to Choose pathway via Psychiatry UK, which offer significantly shorter waiting times. Due to high demand Psychiatry UK do at times close their new referral list, so it is worth keeping an eye on their website to see when they are accepting referrals. Further information can be found here: https://psychiatry-uk.com/right-to-choose-asd/. They offer both ADHD and autism assessments. Any follow up care will be referred back to the referring GP for ongoing support. (Update: Psychiatry UK have temporarily closed new referrals acceptances)

A new Right to Choose pathway is via Clinical Partners. Further information can be found here: https://www.clinical-partners.co.uk/nhs-services/right-to-choose . 

Another option for assessment is to use a private psychiatric or clinical psychology service. Many clinical professionals working within private services also work within the NHS and use the very same assessment tools. Some very questionable journalism recently cast some suspicion on private ADHD assessments and while many GPs are happy to take over follow up prescription care for a private ADHD diagnosis, a few might refuse and insist on a re-referral via the NHS pathway. It is worth discussing with your primary care provider. Most private ADHD assessment services do offer prescription support, but these will be at a fee. In order to book a private assessment you will get in touch directly with the service and do not require a referral via your GP.

After referral for an assessment, both via NHS or private pathways, you will receive a confirmation letter from the relevant service. An NHS service will likely give you an expectation of the waiting period and you will only receive confirmation of an assessment date closer to availability. A private service will offer you a date confirmation. On receiving your assessment date they will also send you some questionnaires for completion by yourself and a supporting person. This will ideally be a parent, but can also be a sibling, long time friend or partner. If you are estranged from your family and do not have significant people in your life, mention this to the assessment service and they will offer you alternatives.

Different services might use different tools for assessment. At their core they all share the goal of identifying autistic or ADHD traits based on either the DSM-5 or the ICD-11 criteria. While some assessors might confirm diagnosis at the end of assessment, others might only do so in their final report. NHS services often have a significant delay between assessment and the final report.

This report can then be utilised in accessing accommodation within studies, at work or for ADHD medication prescriptions.

Everyone has their own fears and hopes around diagnosis. While each person is an individual and their circumstance are different, there are a few things worth considering.

Pros:

• Diagnosis allows us the 'piece of paper' that we require in order to access accommodations and support at school, university or work. This can even the playing field and allow neurodiverse people to enjoy the same success in education or professionally.

• Diagnosis helps us to make sense of our struggles and to validate our needs. It can also helps us to be gentler with ourselves when we understand these struggles are not moral failings but a neurological difference.

• Diagnosis allows others to understand our needs and to take our struggles seriously.

• Diagnosis allows us the proof that we need for social and financial support.

• Diagnosis allows us access to ADHD medication, disability support and medical care.

• With a diagnosis I am protected under the Equality Act 2010 due to having a disability.

• Medication remains the best and most successful way for accommodating and managing ADHD symptoms and can only be prescribed following diagnosis.

Cons:

• Diagnosis can affect our ability to emigrate or move to some countries such as Australia, New Zealand or Singapore. Some countries exclude disabled people from being able to apply and autism is qualified as a disability.

• A diagnosis can cause some people to make assumptions about us based on stereotypes and myths, which can result in some discrimination or judgment. This is increasingly reducing as people are better educated about autism and ADHD, but still an experience neurodiverse people share.

• Disclosure of disability and neurodiversity, while illegal under UK law, might still affect my ability to succeed at job interviews or have equal opportunities at advancement. While there is no obligation to disclose diagnosis and our society is getting better, there are still systemic discriminatory processes in place experienced by most people with differences.

• Some autistic people have found that upon diagnosis they were discharged from mental health support services who did not offer autism support, despite having ongoing mental health support needs. Meaningful autistic services are also very limited and many neurodiverse people ultimately have to access private support which can be costly.

Each person must weigh their own concerns and needs when deciding to pursue diagnosis. Within autistic and ADHD support communities there is a significant acceptance of self-diagnosis and these communities are often very supportive regardless of formal diagnosis. However many neurodiverse people have found diagnosis deeply validating. If you are struggling with the choice of whether to pursue assessment it might be worth discussing with a therapist knowledgeable in neurodiversity.