Our Lead for Disability and NEC member, Paul Burrows of Nottinghamshire Police, shares a blog on the assessment process for ADHD, as part of Neurodiversity Celebration Week 2024: "As I write this, my third blog, I’m still waiting to hear back from the assessment clinic for a date when I can have a chat! Even though I am going private, it’s like I can’t give my money away. Regardless of this minor hiccup, it gives me an opportunity to discuss my upcoming assessment for ADHD. Like my blog on autism, I will make you aware of the questions posed. If nothing else, it will give an insight into the process and how someone like me thinks and acts.
The Adult ADHD Self-Report Scale comes in 2 parts. Part A has six questions covering my behaviours in the last six months. If I score four or more then I should proceed to Part B which has 12 further questions.
The way to score a point on each question varies, though the scale remains the same: Never, Rarely, Sometimes, Often or Very Often. At the risk of giving the punch line away, I scored six out of six on Part A.
To the questions…..
First, how frequently do I struggle wrapping up the final details of a project once the challenging parts have been done? Well, absolutely, always! I love the deep thinking required to understand a project and planning a course through to delivery. But once the hard bits have been done, my interest can wane. I am not a completer finisher. Project end reports and benefits realisation reports are all a struggle. I’ve done the heavy lifting, it is time to pass over to someone with finesse!
Next, do I struggle to get things in order when I complete a task that requires organisation? This would be a very weak yes! I spend a lot of time thinking about a project, but also certainly find myself obsessing over whether I am presenting information in a logical order. My view on what a logical order is, isn’t always the same as others!
Whether I struggle remembering appointments or obligations. I absolutely struggle to remember appointments and must use my phone to constantly set diary reminders, even for in an hour’s time. I am not sure if this is down to age or just whether I get lost in a task with my hyper-focus (one of my autism traits). I am however time- obsessed, so the thought of missing something haunts me. I have said on far too many occasions that if I am late, you know something has happened. I have to remind myself all the time of where I am meant to be, but I do not miss obligations, if I say I am going to do something I will - whatever it takes. I am loyal to a fault and the thought to letting someone down just couldn’t be countenanced.
Do I avoid starting projects that require a lot of thought? Yes and no! I tend to map projects out in my head before I start and always start well in time, so am usually well ahead of any timetable. Compared to others do I prevaricate? Probably not. But I do work to a different regimen. If I am set a task, it needs completing yesterday, so even today is too late. I think this is a perverse mash up between my autistic self and possible ADHD self.
Do I fidget with my hands or feet when I sit down for a long time? Well in my world 5 minutes is along time, so yes absolutely! This is one of the key learning points I feel both the police service and society needs to take on board. Sitting in meetings for hours without a break may feel time efficient; however, I would argue it is not time effective. When I run neuro-divergence training with colleagues, we will set a timer and break every 25 minutes for 5 minutes. It is simply amazing how much more engaged everyone is. Why don’t we do this in meetings? The more self-reflective question is, when I chair meetings why don’t I do it? I think the only answer is that I still feel it is not something that is yet widely acceptable.
Further to this, is seating position, doodling and leg bouncing. I will always, given the choice, sit at the back of a room or to the edge of a room so I’m not hemmed in. This is so I can twist and turn in my seat as much as I need to without distracting people. Others will displace energy by doodling. I’m not a doodler myself. For many however, doodling is a sign they are paying attention to what is being said, not the opposite. It’s like fidget spinning, these devices will be deployed to retain focus; not as an indicator that I am not paying attention. My fidget spinner comes in the form of solitaire. If I’m commanding a football match and I start playing solitaire, it means that I have 100% focus on what is happening operationally, the distraction distracts the distractions – I hope that makes sense.
As to the leg bouncing. The problem many neuro-divergent people face is that it is not yet socially acceptable to get up and walk around in meetings or indeed have meetings that are held outside whilst walking around. Noisy places can also be really calming – it’s like white noise. I have a friend who will hold most of her meetings in coffee shops because this is where she best concentrates. I don’t feel however that we are anywhere near the position yet where this type of activity is seen as being normal.
The final question from within the initial six. How often do I feel overly active and compelled to do things, as if driven by a motor? I am quite simply metronomic. I must have a purpose each day. I need a list of jobs to do and can’t relax until they are done. I can’t abide prevarication, why put off something that needs doing, do it. The thought of spending a day doing nothing frightens me, wasting time frightens me. Is it easy to live with? No, it isn’t. We are hearing more and more about top achievers, particularly sports people who have ADHD, my sense is that understanding of this is only at the tip of the iceberg. It is that drive that ADHD can give you that spurs you on when others may quit.
If I score four or more I should progress to Part B. I scored six, so onward for a further 12 questions. The scale remains the same: Never, Rarely, Sometimes, Often and Very Often.
How often do I make careless mistakes when I work on a boring or difficult paper? I make careless mistakes in interesting and easy work. Though that may be my dyslexia. I must read an e-mail four or five times when I am replying, to make sure I’m covering every point and question in it. I don’t tend to make mistakes of substance, because I have thought through the logic of what I am recording, whether I am recording what I am thinking is sometimes the challenge.
Do I struggle keeping my attention when doing boring or repetitive work? Yes absolutely. If an e-mail comes in, then that will be answered first. If another more interesting task comes in, then that will be dealt with first. However, the task will always be done in timescale and to the best of my ability - it just might take longer than it should to complete.
Do I struggle to pay attention to people when they are speaking to me to me directly? Yes, particularly if I am distracted by something else that is on my mind. This is without doubt one of my greatest failings.
How often do I misplace things or have difficulty finding them at home or at work? Well, I don’t know! I live such a minimalist existence with no ornaments, plants, clutter or anything on a surface that it would, in fact, be a tremendous achievement to lose something. Everything has its place and it needs to be there. If it can be thrown away, it will be. This is where my autism overtakes my potential ADHD. By way of example, at home the toaster has to be in a drawer and if it made sense, the kettle would be in there with it. Well, it keeps me calm! It also makes cleaning much simpler.
How often am I distracted by activity or noise around me? The best example is that I was seeing a counsellor recently and got fixated on a gap in the wallpaper where it was coming apart. I mentioned this at the end of the session, and they agreed that because I’m autistic they would do something about it. If I hadn’t been, they wouldn’t have! I am constantly distracted by noise and will invariably be the first person to point it out. At which point everyone else starts to notice it. It is a key learning point when managing others that the physical environment is critical if you are to get the best out of those you lead and manage.
How often do I leave my seat in meetings or other situations when I am expected to remain seated? I don’t, although I want to in every meeting. The trouble is our etiquette means that we simply don’t do this. Consequently, I’m left squirming on my seat every minute or so, adopting different potions akin to Rodin’s Thinker, trying to expend my excess energy. The trouble is this movement is often seen as me being disinterested. It’s not, I simply can’t sit still. The other position I adopt when typing is sitting at my desk with my trouser legs rolled up. For some reason that calms me, you won’t be surprised to know I live in shorts!
How often do I feel restless or fidgety? Constantly, 24/7, I can’t sit still. My idea of a holiday is constant movement, driving or walking from one place to another. Sitting by the pool is purgatory, waiting for the next meal is purgatory. In fact anything other than constant mental stimulation is purgatory, even if that stimulation is the next cow passing the window of the vehicle I’m in.
How often do I have difficulty unwinding and relaxing when I have time to myself? Constantly. I’m like a wound spring, I must be tired physically and mentally to be able to even begin to relax. I can’t settle to TV programmes, and will watch even a 20 minute episode of a comedy programme in three or four sittings. It gets worse when I sleep. I always fall asleep easily, but then wake up between six and ten times a night – I know because I have an app that tells me.
How often do I find myself talking too much when I’m in social situations? I don’t. Again, this is where my autistic self comes to the fore. Put in front of hundreds of people to give a talk/speech – no problem, in fact I actively enjoy it. Put me on a table or in a room of four or five people that I don’t know, and I clam up. It is why I always sit at the back of a room as it is the best place to be anonymous. I don’t go to parties, Christmas dos, retirement dos. I love rugby, but the thought of going to watch an international match sends cold shivers down my spine. Too many people, too little control of my environment. It is one of the great regrets of my existence.
When I’m in conversations do I finish other people’s sentences before they can? Shamefully yes, I get bored too easily, join the dots (not always correctly), and then finish the other’s response. It Is not something I am proud of and do my best not to do it, but it is again one of my greatest flaws.
Do I struggle to take my turn when turn taking is required? Yes, queues do my head in. I am impatient to a fault. I will regularly leave a queue even with two or three people in it because I don’t have the patience to wait. People who get to the till in a shop and don’t have their card ready to pay, drive me to the point of distraction. I spend so much time planning in my head (autism over ADHD) that it drives me potty when others don’t. The flip and down of this, is that spontaneity at home can be hugely challenging for me. The challenge of highly dynamic public order situations where I have to think on my feet is engaging and something I thrive at, though perhaps because I spend so much time thinking about what I would do in a given circumstance.
How often do I interrupt others when they are busy? I would love to, but I don’t. I have learned that this really isn’t socially acceptable, though if someone’s office door is open, I will see this as an invite to speak to them. Otherwise, I will leave well alone.
There is no score threshold for Part B - the assessment awaits!
I hope by listing these questions and my responses, I’m giving an insight into the assessment process, but also into the reactions of someone who may well have ADHD. There will be many of your colleagues who can and will respond similarly, so my challenge to us all, is how do we change our way of doing business so that we can become more inclusive?"
