Loading practices
Loading practices
Areas › Focus, starting, and ADHD › Getting assessed and diagnosed
Ask parents what they are seeing rather than only what they have been told, and ask the young person directly and privately. Screening that rests on somebody volunteering how they feel will find the ones who volunteer. Keep the questions concrete: sleep, appetite, drinking, what they do when they are alone late at night.
'Suffering has truly afflicted me, but you are the Most Merciful of the merciful' (Quran 21:83). Job says it aloud, and part of this work is making a room where saying it is possible.
الأنبياء
۞وَأَيُّوبَ إِذۡ نَادَىٰ رَبَّهُۥٓ أَنِّي مَسَّنِيَ ٱلضُّرُّ وَأَنتَ أَرۡحَمُ ٱلرَّٰحِمِينَ
Remember Job, when he cried to his Lord, ‘Suffering has truly afflicted me, but you are the Most Merciful of the merciful.’
Qur’an 21:83read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
Two findings sit behind this. A systematic review of young people found stigma, embarrassment and difficulty recognising their own symptoms among the commonest barriers to seeking help, with encouragement from others among the things that made it easier. A review of gender differences in ADHD separately concluded that girls are more often diagnosed with the quieter inattentive presentation, which is easier to miss than visible hyperactivity. The second is about ADHD rather than mood, so take from it the general pattern, that the less visible presentation is the one that gets overlooked.
Gulliver A, Griffiths KM, Christensen H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review.. BMC psychiatry doi
Rucklidge JJ. (2010). Gender differences in attention-deficit/hyperactivity disorder.. The Psychiatric clinics of North America doi
Strength of evidence: one line of research. A single study, or a theoretical account.
A screen only catches what people are willing to say out loud, so the quieter half of the room goes uncounted.
Any disclosure of self harm or suicidal thinking goes straight to proper risk assessment and not into a screening total.
Choose the subtests that answer the question you were actually asked, and read whatever reports the family already has before adding anything of your own. Children arrive with thick folders, and they also arrive with nothing at all.
Where a relative has taken ADHD medication, take the details: who they are to your patient, what they were given, what it did, and what was tried and dropped. Then put it in the referral letter.
With gambling machines the pull may be the lights and the noise as much as the chance of winning. That changes what you actually need to stay away from.