Treating Specific Symptoms of Autism or ADHD May Help Children, Even Without a Diagnosis

For people with mental health challenges, early access to support services and effective intervention can change life. However, to access these services through the health system, most facilities require an official diagnosis.

But what about those who show symptoms, but don’t quite meet the criteria for a health diagnostic? These people can be overlooked by the health care system, despite having symptoms that can be treated.

In most cases, a diagnosis should meet the criteria for Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5). For example, a child suspected of having attention deficit hyperactivity disorder (ADHD) must have six or more symptoms that affect their performance. Here are some examples of these symptoms:

• Often wiggles or pats hands or feet, or squirms in seat.
• Often has trouble organizing tasks or activities.
• often interrupts or intrudes on others.

This checklist serves as a line in the sand. If six boxes are checked, a diagnosis can be made, but if fewer are checked, no diagnosis can be made. People in the latter category are often unable to access services, although they could probably benefit from them.

In addition, mental health issues are not always clear and easy to identify. Two children with the same diagnosis can have very different symptoms, and their daily lives can be affected in very different ways. To complicate matters further, factors like gender, age or have more than one diagnosis can impact how symptoms present and whether (and how quickly) a diagnosis can be made.

Since symptoms can vary from person to person, there is no single treatment plan. For example, some children with ADHD may benefit from programs aimed at improving language, while others may benefit from attention-focused programs. This variability is not limited to ADHD and is present in most if not all mental health problems.

Symptoms and function vs diagnostics

These factors have led some researchers to view mental health problems in terms of specific symptoms as opposed to diagnostic categories. For example, one might focus on attention difficulties regardless of whether a person has ADHD, a different diagnosis, or even no diagnosis. The most used framework for this is the search domain criteria or RDoC approach, where symptoms rather than diagnostic labels are used to understand an individual’s mental health difficulties.

As development researchers, we use the RDoC approach to examine how symptoms of ADHD and Autism Spectrum Disorder (ASD) in the general population can affect functioning. In two recent studies, we found that people with increased symptoms of ADHD and ASD (but without an official diagnosis) had more learning, language and social communication difficulties.

These results tell us that we don’t need someone to be functioning at the lowest level to benefit from treatment. Those with varying levels of these disorders who are not yet diagnosed may also benefit.

Full adoption of an RDoC approach to mental health care would require a complete overhaul of the diagnostic system and, in reality, is unlikely to happen anytime soon. However, taking this approach in terms of research and support systems could lead to immediate improvement for people with symptoms.

This would include people who fail to reach a diagnosis, do not fall squarely into a specific diagnosis, or are awaiting evaluation. And in Canada, the time between referral and diagnostic assessment can take up to a year. The good news is that there are resources available and steps parents can take to provide support that can help overcome specific challenges.

• Gather information: You know your child better. A doctor can only note the behaviors observed during the visit. Stand up for your child and let doctors and specialists know how they interact at home, at school and in the community.
• Learning Programs: There may be programs within your community that support early learning and help children develop linguistic and social skills regardless of the diagnostic status. These programs can also be helpful in helping your child transition to school system. Many of these programs include Speech language or professional therapists who can help with specific difficulties.
• Participate in research: as development and Language researchers, we administer a wide variety of assessments. By participating in research, you can gain a better understanding of your child’s mental health and the impact of their difficulties on their functioning. Participants are often paid to participate in our research

We believe that the best way to understand mental health issues is to go beyond the simple binary choice of having a diagnostic or not, and to focus on the varying degrees of symptoms in the general population. Adopt this approach in terms of research and support systems could lead to improvements in individualized and targeted care and a better quality of life for everyone mental health difficulties.

This article is republished from The conversation under a Creative Commons license. Read it original article.