Combined Assessment
Autism and Attention Deficit Hyperactivity Disorder (ADHD) are two distinct neurodevelopmental conditions that can co-occur in individuals. Research tells us in around 30% children. While both autism and ADHD have unique features, they also share some commonalities, such as challenges with executive function skills and difficulties in regulating emotions. Proper diagnosis and understanding of these conditions are crucial for tailored interventions and support to enhance the well-being and functioning of individuals with autism and ADHD.
As both conditions are assessed in similar ways there are advantages for both the child and professional when looking at them together. For the child it means less assessments overall and for the professional it means that a holistic approach can be taken considering all of the child profile at one time. This can offer a cost saving opportunity in the private sector.
Many families opt for a combined assessment because they just aren’t sure which symptoms mean what. Children with autism and ADHD can be complex and because they don’t fit ‘neatly’ into either diagnosis they may be misunderstood as naughty or ‘out of control’.
Guidance for Diagnosis in a Combined Assessment
NICE GUIDELINES and DSM-V DIAGNOSTIC CRITERIA
The National Institute for Clinical Excellence (NICE) is an independent organisation in the United Kingdom that provides evidence-based guidance and advice to healthcare professionals, policymakers, and the public.
NICE aims to reduce variations in diagnosis and treatment across different regions or institutions.
During a combined assessment both the NICE Clinical guideline [CG128] Autism spectrum disorder in under 19s: recognition, referral and diagnosis and the NICE guideline [NG87] Attention deficit hyperactivity disorder: diagnosis and management are followed as much as practically possible. The focus on multidisciplinary assessment is important to get a full understanding of a child’s abilities. To do so any existing reports will be taken into consideration and then further assessments may be recommended.
The DSM-V, also known as the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, is a comprehensive and widely used classification system for disorders. It provides guidelines and criteria to help clinicians diagnose and classify various conditions.
The DSM-V 299.00 and DSM-V 314.01 criteria are used to plot the child’s profile against and demonstrate whether they meet the criteria for a diagnosis of autism spectrum disorder and ADHD individually.
To date schools and other NHS services have accepted the private diagnosis made by Dr Sarah Mills because of the clear and thorough reports provided during the assessment.
Combined Assessment Process
Step 1:
Neurodevelopmental Assessment
Information is gathered about the child, any concerns, past medical history, development and school progress.
Step 2:
Observation & Examination
During the assessment the child’s behaviour will be observed and a short physical examination will be carried out.
Step 3:
Assessments
Recommendations will be made regarding whether further observation and which assessments are needed.
Step 4:
Feedback
Following all of the assessments a feedback session is planned to discuss the findings and further recommendations.
What Happens At an Assessment?
The whole process is child led, your child will be encouraged to share their experiences and participate as much as they wish.
We will talk through concerns, educational progress, medical and family history. Information will be gathered on your Childs development from birth to now and specific symptoms.
Any existing reports or assessments completed on your child are used to inform the process.
The sorts of specific assessments completed as part of the assessment are:
Home questionnaires on ADHD symptoms, communication styles and day to day abilities (online links sent out)
School questionnaires for further information and on ADHD symptoms
QbCheck is a computerised assessment looking for ADHD symptoms in the child (usually done at home)
Communication and interaction assessment, maybe required from a specialist speech and language therapist. This is used to gather further evidence of a child’s strengths and areas of difficulty.
Autism directly observed schedule (ADOS-3) assessment, carried at an additional appointment. This play based assessment looks specifically for signs of autism in a child.
What Happens After an Assessment?
Following the feedback session, the reports will be compiled and shared with you securely via email.
There is the opportunity to review the report to ensure you are happy with it, it will then be shared with your child’s GP. You are welcome to share the report with nursery, school or other professionals involved in your child’s care.
Included with the final reports is the invoice. This is payable by bank transfer within 28 days. If card payment is preferred this can be arranged and a card link will be sent. All major debit and credit cards are accepted. It is possible to pay by instalments leading up to or following the assessment, please ask for this to be arranged. If you have health insurance, Dr Mills is registered with a number of providers please contact us to discuss further.
There is a post-assessment final discussion included in the assessment fee, this is arranged by video consultation around 8 weeks later. Here we can discuss any further questions or concerns prior to discharge.
Combined Assessment Cost
ADHD Assessment: £1,350
ADHD can be diagnosed from age 6 onwards. This is to allow for the early years developmental period to pass and for higher executive functions to have developed.
This package includes:
A neurodevelopmental assessment
Gathering all of the home and school based information and ADHD questionnaires
Qbcheck assessment
Feedback
Combined Assessment: £1,850
If you are concerned that ADHD may be present with other conditions or just aren’t sure it may be worth completing assessments for a range of conditions at the same time.
This package includes:
A neurodevelopmental assessment
Gathering all of the home and school based information
ADOS assessment
ADHD questionnaires
Qbcheck assessment
Feedback
School Age ASD Assessment: £1,650
For children of school age this assessment package includes
a neurodevelopmental assessment
gathering all of the home and school based information
ADOS assessment
Feedback
As part of the assessment additional assessment from a specialist speech and language therapist may be recommended. This can be completed within the NHS or private colleagues.
Payment terms: You will receive an invoice with the final reports. This is payable by bank transfer within 28 days. If card payment is preferred this can be arranged and a card link will be sent. All major debit and credit cards are accepted. It is possible to pay by instalments leading up to or following the assessment, please ask for this to be arranged. Dr Sarah Mills is registered with health insurance providers, please contact us to discuss your requirements.
Frequently Asked Questions
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Autism is often, but not exclusively, linked with learning disabilities, ADHD, Obsessive Compulsive Disorder (OCD), epilepsy and mental health difficulties.
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Most commonly, ADHD occurs with mental health difficulties like depression and anxiety, Obsessive-compulsive disorder (OCD), Autism and Learning disabilities. Children with Fetal alcohol spectrum disorder commonly have ADHD.
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Because autism and ADHD may share similar factors, including genetic links and brain structure differences, it's not surprising both can occur together.
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As both conditions are spectrum disorders they will present differently in individuals either alone or when present together. The import part is when both are present that they are recognised, otherwise the strategies put in place to support the child may not be as successful as they could be.