If this is something on your mind at the moment, you are not alone. Many parents wrestle with this question for a long time before deciding what is best for their child.
You might have read my recent blog post, "Is my child neurodivergent or am I a bad parent?", which explores the journey that many people go through when noticing their child's differences. In this article, I highlight why your parenting approach is often not the reason behind children's differences or challenges, and that parents are not usually imagining these differences. We explore why and when neurodivergence may be a more likely explanation.
If you have moved through the wondering process about your child, and are at the point where you are considering seeking a professional opinion about autism or ADHD, you might find this blog post helpful in making a decision. Read on to find out more.
How sure do I need to be that my child is neurodivergent before I seek an assessment?
The answer to this is: Not sure at all! It is the job of healthcare professionals to work this out.
My previous blog post highlights that parents can often spend an inordinate amount of time and mental energy trying to be sure whether what they are seeing is neurodivergence, or not. Parents often become confused by what they read online, and cycle back and forth between being more and less sure about neurodivergence,. This process is not helped by family members or school staff who may have a different picture of your child, or different opinions about parenting.
Parents can often spend an inordinate amount of time and mental energy trying to be sure whether what they are seeing is neurodivergence, or not.
However, the important thing to remember is that spotting autism or ADHD requires expertise, especially in cases involving internalised traits, multiple diagnoses, or high-masking individuals. Most parents are not trained in assessing for autism, or ADHD, or another neurodivergence - and even when they are, seeing the wood for the trees for your own child is completely different.
The main reason for seeking a professional opinion is to better understand your child's differences. It is often because these differences have an impact on your child's day to day life, and involve challenges for your child as well as for you as a parent. It may also be because your child has started to notice their differences and has wondered about them.
Rather than grappling with this yourself, I usually encourage parents to seek a screening assessment from qualified clinicians as a first step. A professional multi-disciplinary team can determine whether neurodivergence might explain your child’s differences, or whether a different understanding makes more sense. The responsibility does not fall upon you to decide. Remember, you do not have to decide which type of assessment your child needs. A clinician who is trained in assessing both autism and ADHD will be able to screen your child and guide you.
Seeking a professional opinion won’t change your child or create neurodivergence if it isn’t there. If you have questions - seek support from a clinical specialist.
What are the benefits of an autism or ADHD assessment for my child?
Seeking a formal assessment is not the right path for everyone. However, in my clinical experience there can be a number of benefits to having some formal understanding of whether or not our child is neurodivergent, such as autistic, or ADHD (or often both - AuDHD).
Benefits for parents
Let's first explore the possible benefits for us as parents. These include:
Understanding our child's neurotype means we have the opportunity to better understand their pattern of differences, strengths and challenges. We may be able to see them through a new lens of “can’t not won’t”. This can help us respond to them in a more empathetic way, and better support their emotional and behavioural development.
It lifts shame and blame from our shoulders as parents, knowing that this is not something that we caused, nor is it something we have imagined. This leads us to feeling more confident, sturdy and more emotionally regulated in difficult situations, that previously may have triggered our threat response because they brought up guilt and doubts, as well as stress.
We can better advocate for their needs. We can work collaboratively with people around them, including family members and schools, using clear recommendations and all working from the same page. Being able to put support in place pro-actively, especially before challenging transitions such as a move to secondary school, can be helpful for our child to make sure they don’t need to “fail” in order to get support.
It can allow parenting couples who have previously disagreed on the best approach for their child to form a more shared approach, backed by recommended strategies suitable for neurodivergent children. Consistency between parents is helpful for children, as well as a more harmonious home environment.
Self-identification as neurodivergent
Many of these benefits can also be found through "self-identification". This is where we start to see our child through the lens of autism, or ADHD, or both (or another type of neurodivergence), but without a formal assessment. The neurodivergent community see self-identification as a valid way to be accepted as neurodivergent.
Many parents find self-identification for their child a helpful bridge while they don't feel their child's needs are significiant enough to benefit from a formal diagnosis. It can help to guide our understanding and support for our child. It is often a popular approach when children are younger and there are some doubts remaining.
Referring to being "wired differently" can be a gentle and easily accessible way to broach the topic with our child, and to build up their self-understanding gradually. The word "neurodivergence" can be helpful as it's less specific than using diagnostic names like autistic or ADHD. It can help to give a name to any differences our child may be aware of about themselves, without a formal diagnostic label.
Referring to being "wired differently" can be a gentle and easily accessible way to broach the topic with our child.
The downside of self-identification can be that we might not see the full picture of our child's needs. It may not be specific enough - since the strengths and challenges of an autistic person may be different to an ADHDer, and to an AuDHDer. Others around our child may not agree with us and it can be difficult to advocate for our child's needs without some external validation. It can also be difficult to know how much to tell our children about our thoughts around their neurodivergence when we aren't completely sure, as we don't want to confuse our child or get it "wrong".
Benefits for the child
Now let’s think about the benefits of an autism or ADHD assessment for our child. Similar to the benefits for us as parents, a formal evaluation can help our child be able to understand themselves, and advocate for their own needs from a place of strength and neuroaffirmation:
A diagnosis can mean our child has the opportunity to grow up knowing that their strengths and difficulties are a valid part of their neurotype.
A diagnostic label can mean our child can avoid alternative explanations for their differences such as being “difficult”, “lazy”, “rude” “naughty”, or any of the other labels that neurodivergent people hear from others. It can prevent our child starting to believe these things themselves.
It can allow young people to develop a healthy identity as a neurodivergent person, and to let go of (or prevent the development of) unhealthy masking and camouflage behaviours.
It can also allow them to find their "tribe" in the active and proud neurodivergent communities, which can reduce the impact of loneliness or peer difficulties.
In my clinical experience, and drawing on the research literature, a young person understanding their neurodivergence sooner rather than later can act in a preventative way for their future mental health. Unfortunately, we know that autistic people and ADHDers are at greater risk for poorer mental health in adolescence and into adulthood. A significant part of this is related to neurodivergent people not understanding themselves, and others not understanding them, leading to inner criticism and other psychological difficulties.
Having a framework for understanding and accepting ourselves, connecting with others, and gathering appropriate support can help to prevent these difficulties, especially during adolescence when we are developing our sense of self identity.
Having a framework for understanding and accepting ourselves, connecting with others, and gathering appropriate support can help to prevent these difficulties, especially during adolescence when we are developing our sense of identity. Many late-diagnosed people have spoken out about wishing they had known about their neurodivergence in childhood for this reason.
Based on this, I tend to more strongly recommend a formal assessment, over and above "self-identification" once children get near to secondary school
transition. At this age, children may also be more able to be part of the conversation around seeking an assessment.
Possible downsides of a child autism or ADHD assessment
Of course, it's important to be mindful of possible downsides of seeking a neurodivergence screening or assessment. Issues to consider include:
The emotional impact on you and your child: Sometimes the process of seeking an assessment can bring up difficult feelings for parents, even if it also provides clarity. The child may experience a range of emotions if they receive a diagnosis, and it can impact on family dynamics with siblings. Parent also sometimes worry that attending assessment appointments might upset or stress their child, or make them feel that there is something "wrong" with them. Some children may express that they do not want an assessment. These are issues that can often be worked through with the right neuroaffirmative support.
Stigma and discrimination: Many parents worry about the impact of stigma related to neurodivergence and feel that they do not want their child to be misunderstood or labelled in an unhelpful way. Parents often worry more about autism than about ADHD, because of past negative stereotypes. Young people themselves may have unhelpful stereotypes about what neurodivergence means. The good news is that neurodivergence is talked about much, much more positively nowadays then even 5 years ago. Stereotypes are being broken down. The neuroaffirmative movement has made huge strides in creating a more neuroinclusive world, and there are now many positive role models out there for neurodivergent people to identify with.
Privacy concerns: Parents sometimes have concerns about the fact that a diagnosis can become part of your child’s medical or educational record, which could potentially be accessed in the future. In most situations, it is not mandatory to disclose a neurodivergent diagnosis (either you for your child, or your child for themselves), and it is a personal choice.
Misdiagnosis or overdiagnosis: There is a lot of discussion in the media and social media about "overdiagnosis" of neurodivergence, however, research shows it is likely to be the opposite: many people who meet the criteria for a neurodivergent diagnosis are still undiagnosed. There has been high profile coverage of the perils of poor quality assessments. There is a possibility of misdiagnosis or a missed diagnosis, especially if the evaluator lacks experience with nuanced presentations, or if they are only trained in assessing either autism or ADHD. Since these diagnoses commonly co-occur (in more than half of cases), and have overlapping features that can be difficult to tease apart, finding a qualified and experienced assessor is paramount.
Access and cost of assessments: Long wait times for assessments within the public health service can be frustrating. Assessments can be expensive if pursued privately, and not all private insurance plans cover them. Linking back to state provided education and healthcare after a private assessment can sometimes be complicated, even if the assessment was completed via a gold-standard protocol. It can be helpful to investigate the situation in your local area.
Possible ways to mitigate downsides include:
Choosing a trusted, qualified professional for any screening or assessment.
Ensuring that the clinician is experienced in assessing both autism and ADHD, rather than just one or the other, to make sure that nothing is missed and that you do not have to decide which assessment to choose.
Ensuring that any private assessment follows a gold-standard process as set out by NICE so that you have the best chance of it being recognised by your child's network.
Focusing on your child's unique strengths and realising that a diagnosis doesn't have to define who they are, even if it becomes a helpful and healthy part of their identity.
Equipping yourself and your child with knowledge to counteract stigma and advocate for their needs in a neuroaffirmative way.
Talking honestly with your child and looking at positive neurodivergent role models to build their healthy sense of self.
Seeking out supportive communities of other parents or professionals who understand the challenges and benefits of a diagnosis, and really "get it".
Other benefits of understanding our child's neurodivergence
Finally, exploring our child's neurodivergence also allows us as parents to consider our own possible neurodivergence.
Because of the high genetic heritability of autism and ADHD, for example, our child’s diagnosis can validate the differences we may have noticed in ourselves.
It can help us understand ourselves, and remove the “neurodivergence imposter syndrome” that can have us believe we are imagining our own differences, looking for an excuse, or over-reacting. We may finally start to understand why we may have found becoming a parent so challenging, or make sense of our unique pattern of strengths and difficulties.
Understanding ourselves better can help us to reflect on our own experiences growing up, and rewrite the narrative we have of ourselves, which can often be positive for our mental health and identity - as well as for our parenting.
So what should I do next?
Ultimately, the path that is right for you as a parent and right for your child will unfold in front of you. Timing is often a crucial factor, and what feels right this year may change by next year. It’s often a case of trusting your instincts, as well as weighing up the pros and cons outlined in this article and discussing with your support network, and perhaps even with your child.
Take your time in thinking about the path that makes most sense for your family.
Where can I find further information and support?
If this blog resonates with you, you might be looking for what to do next.
Child neurodivergence assessment services
Depending on where you live, you can request a referral for your child within the public health services via your child's school or their GP.
If you are seeking a private assessment, our partner Neurodiversity Unravelled provides gold-standard assessments for both autism and ADHD, and dyslexia, and comes highly recommended.
Parent community support
If you are neurodivergent yourself, or wondering if you may be, join our supportive community The Neurodivergent Parent Space.
You will find a library of evidence-based, tailored resources for neurodivergent parents, and monthly free webinars on topics that matter to you. Join our village of warm and non-judgemental parents who "get it", plus get access to experienced clinical psychologists and our parent panel.
There's a free trial, so why not check it out?
1:1 support
If you would like to explore and reflect on whether you or your child might be neurodivergent before you move towards a formal assessment, this is something I often discuss with parents, alongside thinking about parenting approaches.
I do not offer child assessments online and so there is no pressure from me to decide one way or the other. I do offer adult autism and ADHD screening and assessments online, but find that parents often prefer an informal exploration first, often as part of wider work around your wellbeing and identity as a parent.
Online information
If you are exploring these topics online, here are some trusted websites with more information and resources to explore about neurodivergence, autism and ADHD:
I hope this article has given you some food for thought if you are navigating similar questions about yourself, your child or family. Please feel free to leave a comment below if you found it useful.
I'm Dr Jo Mueller, a British clinical psychologist specialised in working with parents around parenting and mental health, and neurodivergence.
You can follow me on Instagram @drjothepsychologist for regular tips for parents.
You can follow me and my colleagues @theneurodiversitypractice for more neurodiversity content for parents.
If you'd like to work with me 1:1, you can book a free 15 minute consultation here.
Thank you! It’s so true the length of time and wrangling over: are they, aren’t they, is it a phase, it’s it something we’ve done wrong… As a parent of a teenage girl who has increasingly struggled over the last few years, we’ve gently had conversations to open up the possibility that she may be neurodivergent and eventually agreeing that an assessment would be useful. Then to receive a letter out of the blue from CAMHS to say they have triaged her based on written information sent by her school (which we didn’t see) and they have decided there ‘isn’t enough evidence to suggest neurodiversity’. This has left our daughter bereft, feeling sad, confused, weird and wondering why she feel…