Diagnosis
Understanding your child, how they see the world and function within it can be a very powerful starting point as you can then identify the strategies that will be most successful for your child in their environment. Thus it is often more productive to look at blockers to learning rather than neurodevelopmental diagnosis.
What’s in a diagnosis?
Most parents just want their children to be healthy, happy and achieve their best potential.
They see their child struggling with their friendships, schooling, learning and behaviours, and they often don’t know how to start unpicking and supporting the issues.
Within Doctor Kate we aim to understand what the difficulties are for your child and what the impact of these difficulties is for your child and how to address them. Some children are brought to clinic because of their behaviours – they are always on the go, they won’t sit still, they won’t do what we ask them to do. Other children are brought because school are worried about their academic achievement or focus and concentration in class. Sometimes families are worried about a child’s social interactions and friendships. Sometimes parents are worried about their child but can’t quite articulate why – that’s ok too – we can help you unpick this.
It is common for families to have looked up their concerns on the internet, or to have discussed their concerns with friends families and school and to be worried about a neurodevelopmental diagnosis.
Often when we see children, parents will say "I am worried they might have ASD or ADHD or Dyslexia or Dyspraxia" when in reality they mean that they are worried about features that are seen in these conditions and they want to help their child. Misdiagnosing a child can mean that the true reasons for their challenges are not identified and addressed. Thus it is really important to fully understand a child and the environment they are living in before jumping in with a diagnosistic assessment.
Neurodevelopmental diagnoses
Neurodevelopmental diagnoses have clearly defined criteria.
The criteria for most neurodevelopmental conditions are on a spectrum and are typical at different developmental stages. The terrible twos are called that for a reason! You wouldn’t expect the same behaviours and profile in a 5 year old as a 14 year old.
"One persons perfect environment is another ones nightmare"
We also know that there is a spectrum of behaviours that we see in the neuro-typical population – "one persons perfect environment is another ones nightmare" – think actor versus librarian. Some people love a big party; others would much prefer a walk with a friend.
Of course most of us enjoy different things at different times and showing different behaviours at different times and places is totally expected. Neurodevelopmental conditions are pervasive – this means they are present in most situations most of the time.
We know however that we do behave differently in different settings and some children who struggle at school can mask this and then be even trickier at home. So whilst it is not impossible for a child with a neurodevelopmental disorder to have no signs at school or at home, it does make a diagnosis unlikely.
We know that the threshold for a diagnosis is high. This is so that we can identify the people who do see the world in a different way to most of the population and who do function in a different way and may need even more support.
Thus just because your child doesn’t reach the threshold for a diagnosis doesn’t mean that they do not show features of these conditions, and it also means that often the strategies used for children with these diagnoses will also work for your child. So not getting a diagnosis does not mean that you are wrong or the professionals are not seeing what you are seeing – it just means they don’t reach diagnostic criteria.
Dr Kate and Diagnosis
At Doctor Kate we try to understand the barriers to your child’s learning, progression and the causes of their behaviours and challenges.
It is also important to remember that we often spend time discussing a behaviour when what we need to do is understand why a child is showing this behaviour. Inattention can be due to ADHD, but it can also be because you are excited about something – perhaps a trip or your birthday, or you are worried about something, or you are just more interested in something else.
Sometimes it can be hard to pay attention in a noisy, busy environment, or if the work is too tricky children can zone out and not pay attention. Being tired can mimic many of the neurodevelopmental diagnosis.
We hope that by helping you to understand your child’s profile, and how their environment is impacting on them, you will be able to support them fully both at home and in education. If they reach the criteria for a diagnosis they will be given one after a robust assessment – but it is important to remember a diagnosis on its own doesn’t change anything – it is understanding why and knowing how to support that makes the biggest change.