Neurodiversity in students; Diagnosis , Assessment, Support

What is Neurodiversity and Specific Learning Differences?

Student experiences
Pathways to assessment and diagnosis
Getting support
Additional supportive resources

Studying medicine, especially accelarated, seems to uncover struggles students have coped with for years - or which they weren't even fully aware of. Sometimes, it turns out that they're Neurodivergent (ND), or have a Specific Learning Difference / Difficulty (SpLD).

In fact, between 2011 and 2021, 24.7% of MB ChB students declared a disability - the most common being 15.4% declaring a Learning Difference (Revell, 2022).

Below are some experiences that led students to seek an assessment - if they're relatable, and you’d like to know more, you can read the assessment pathways listed.

You can also contact the Disability NetworkLink opens in a new window, your PT, or the Student Support Team for pastoral support during the process.

Neurodivergent vs. Specific Learning Differences

Being Neurodivergent (ND) or Neuroatypical just means your brain functioning deviates from what's socially ‘normal’. It includes SpLDs, neurodevelopmental and mental health conditions, and Learning Disabilities.

A Specific Learning Difference (SpLD) means this 'deviation' concerns how you learn and process new information - such as dyslexia, dysgraphia, dyspraxia, and dyscalculia.

Both are umbrella ‘labels’. You don't have to use these words for yourself, but it can help others identify with a community, without specifying their diagnosis. Although, you do not need a diagnosis to identify as ND.

Neuroatypical or Neurodivergent is an individual.

Neurodiverse is a group of people with different types of Neurodiversity.

ADHD

Attention Deficit Hyperactivity Disorder is a neurodevelopmental difference; generally, difficulty regulating how you react to stimulus. You may be easily under- or over-stimulated, have processing speed issues, and struggle with some everyday-tasks (Executive FunctioningLink opens in a new window).

It exists regardless of gender or age, affecting 3-4% of UK adults. It gets missed due to expectations of what's 'normal', or because you 'masked' - often without realising.

ADHD means you can be classically 'hyper' and 'inattentive', at different times; it's not one or the other! The better known 'impulsive' signs include fidgeting, talking loud and fast, 'whirlwind' thoughts, and having 'chaotic' energy. 'Inattentive' signs are struggling to initiate tasks, maintain motivation, hold concentration, ignore distractions, and keep track of everything - including the time!

ADHD is sometimes seen as an SpLD, but it's very different to the others. Attention Deficit Disorder (ADD) is an old diagnosis for inattentive-ADHD.

More information is on the NHS website hereLink opens in a new window, or with AADD hereLink opens in a new window.

Dyslexia and Dysgraphia

Specific Learning Differences involving language, affecting 1 in 10 UK adults. They're often seen together and assumed to be the same, but;

Dyslexia concerns your reading.

Dysgraphia concerns your writing and spelling.

It can impact people to different degrees; some use coloured overlays to help reading, and others need slightly longer to read or speak aloud. But, they don't affect intelligence.

More can be found on the NHS websiteLink opens in a new window, or with the British Dyslexia AssociationLink opens in a new window.

Dyscalculia Dyspraxia

Also called Developmental Co-ordination Disorder (DCD), it impacts how you physically navigate your space. It can affect your gross motor skills (playing sports, running) or fine ones (holding small objects), how you 'plan' a sequence of physical actions or learn new sequences.

More information is on the NHS websiteLink opens in a new window, or the Dyspraxia FoundationLink opens in a new window.

Autism / Spectrum Condition

Autism, or Autism Spectrum Condition (ASC), is an umbrella term for a range of neurodevelopmental differences affecting many areas of your life - broadly, in how you interact with the world. Though experiences are incredibly varied!

It is not a binary spectrum of 'high' to 'low' 'functioning'; it's multi-faceted, and everyone has different strengths and struggles. So, difficulties might involve social communication and interactions, over- or under-sensitivity to various stimulation, processing speed, having repetitive or restrictive behaviours, becoming hyper-focused or inability to focus, or doing everyday-tasks (Executive FunctioningLink opens in a new window). People often 'mask', but might not even realise - but it's emotionally, psychologically, and physically exhausting.

Autism is a communication, not learning, difference, though it can impact your learning - but it does not mean your intelligence is affected. It can occur with, or without, an SpLD, LD, cognitive impairment, or ADHD.

Asperger's is an old diagnosis for a 'type' of 'high functioning' Autism.

More information is on the NHS websiteLink opens in a new window, or the National Autistic SocietyLink opens in a new window.

Student Experiences

Below are quotes and common experiences from students either diagnosed whilst at WMS, or before attending. If they sound familiar, consider if a free ND screening with the Disability Team is appropriate.

This list is just to encourage self-reflection. Having the same experiences doesn't mean you're definitely ND, and there's other 'signs' too.

They're not organised by diagnosis as they can all be present in more than one of them.

Organisation, Time

"I was taking hours to get through one recorded lecture, far longer than what anyone else needed..."

"I could never finish the checklists"

"It's like time doesn't exist in my head... no matter what alarms or calendars I use"

"I cannot navigate Moodle, even after years and being shown multiple times"

"I have to have things done in a very specific way or it doesn’t get done at all"

"I made new revision notes as I went as it felt more effort to try and find those I had written throughout the year"

"Felt really unorganised, and struggled to keep up... may have been burn out"

"Finding information...remembering all the admin and paperwork tasks... it's all hard"

"I struggled to finish writing in exams, despite writing as fast as possible"

Focus, Motivation

"I zoned out a lot - I was vacant for most of even a short class"

"I realised lectures were so hard as I couldn't handle silence or sitting still... or concentrating for long periods"

"Often had to leave CBL to 'reset' due to restlessness"

"Heavily relied on music and phone games to keep me focused on lectures or studying"

"Procrastinating starting exam revision... when I finally could work, I'd hyper-focus and stay up too late"

"Couldn't focus in the mornings - so couldn't start to study till the afternoon, or the evenings"

"Can only study with imminent deadlines and late night working - brain is doing more at 11pm than 11am"

"I really wanted and needed to start the work but I just couldn't... I'd get upset as I couldn't make myself do it"

"I realised how much I'd been relying on sugar to 'wake' me up and get me through the day"

"I felt calmer, even sleepy, when I finally started drinking coffee - whilst drinking it"

"Far too easily distracted when trying to study - the content is interesting but studying wasn't"

Memory, Learning

"I can't remember even important deadlines - or names, or birthdates - until last minute"

"I couldn't recall any information after a lecture... or long-term"

"Easily learnt 'concrete' content - i.e. anatomy - but not the abstract ones - i.e. CTB"

"It came up in a lecture and I realised I matched the symptoms; my personal tutor had been similar, got diagnosed, so I sought one out"

"Working almost all waking hours... nothing more to give... still failing formatives and getting bad grades"

"Struggling to adapt to new routines, environments, or different learning styles..."

"I found examinations, venepuncture, the practical learning, so much harder to remember than everyone else"

Auditory, Listening

"I found it so hard to 'get' verbal instructions"

"Everything felt like it was going in one ear and out the other"

"Never been an 'auditory learner', but it just felt so much worse - I couldn't focus on any audio recordings"

"I'd speed up recordings as regular-speed meant my mind moved past it, but I'd 'zone out' every few seconds and need to rewind. Slowing it down meant it took far too long and I'd grow bored and still zone out."

"Needing absolute, solid directions, which I can follow to the letter - vague instructions don't make sense to me"

"It took me x4+ longer than others to listen to a lecture. I'd attend in-person ones but get nothing from them - I can't process what's being said in big settings"

Emotions

"Feeling exhausted and overwhelmed as teaching blocks went on"

"Frequent depressive episodes that seemed to come in waves"

"I really struggle with emotional instability, and it's not widely known as a common part of ADHD and ASC"

"I wasn't an emotional person but I'd have full-on melt-downs if I perceived rejection - and I'd avoid situations (when I shouldn't) where I risked feeling that way"

"When stressed or overwhelmed I struggle to speak at all... I was selectively mute as a child"

"Discussing compassion / empathy... I was explaining how to 'show' it but I don't understand how you can 'feel' what someone else feels... it's all very conscious thought processes"

Social Interactions Sensory, Physicality

"With examinations, I realised how hard differentiating left from right was"

"My handwriting was always illegible, even if I spend ages trying to be neat"

"Always had issues with excessive / loud noises, sensitivity to brightness, certain textures; but it got worse when I had to study so much"

"I've always been "clumsy" and uncoordinated, even though I could be great at some sports"

"I realised most people can't hear the 'hum' from electric devices when I said they were too distracting"

Reading, Speaking

"I mix up sentences and words... I got worse at getting people to understand what I was trying to say"

"I had to restart reading multiple times, forgetting where I was on the page"

"Had feedback that I wasn't 'bothering' to proof read and had 'terrible grammar' - I had proof read it, 3 times"

"I kept getting exam questions wrong, but always for not reading the question properly"

"Struggled with the UCAT verbal reasoning; couldn't remember what I was reading"

"I can't speak when I get overwhelmed, if the room was chaotic or I'd spoken to too many people"

Pathways to assessment, diagnosis, and support

Below is a description of each stage in the NHS and private (via the Disability Team) pathways for ND assessments.

Only ADHD, ASC, and dyspraxia can be assessed via the NHS for adults.

You are strongly advised to discuss this process with your PT, or the Student Support Team. It's a potentially overwhelming journey - especially when you’re already studying. Also, it shows WMS if more help is required.

Briefly

In summary, it’s just;

Request a screening with the Disability Team
If they agree it's likely, book and have a formal assessment
Tell the Disability Team the results and discuss your support needs
Or, just ask your GP!

There’s a lot of extra detail so you can be fully informed, and not get stuck.

You do not need to read all of this at once - it's just to make the whole process plain.

NHS Pathway

Ask your GP for a referral
- Be prepared to explain your ND signs and how they affect you to the point you’re seeking help
The referral should be to a local NHS specialist; an educational psychologist, psychiatrist, or occupational therapist

- If they don't understand, use this letter; if they refuse, follow this adviceLink opens in a new window

The waitlist can be months to years, but is free

- Check here for current Right to ChooseLink opens in a new window providers and wait times
- This letter can explain to your GP what Right to Choose is
- England residents can choose alternatives, like Psychiatry UK or ADHD 360
You get a referral acceptance letter, then an assessment date

Assessments are variable
- They can be hours, over one or several appointments, use formal screening tools, or require childhood information (maybe from carers)
You arrange a follow-up assessment, or discuss your results and next steps
Your GP is sent a summary letter - you should get a copy - then book to see the Disability Team for post-diagnosis support

Screening

The following tabs describe the pathway via Disability Team and private assessments

Request a screening (for one or more ND) on the Wellbeing Portal
- This isn't a formal assessment or checklist
- It's a conversation, guided by a few questions, about many areas that might be affected
- They can screen for ADHD, dyslexia, dyscalculia, dyspraxia, and ASC

They will tell you if your answers indicate an ND in the same appointment

- You then discuss next steps, and they'll send you a conversation summary
- If the assessor doesn't feel you would reach the diagnostic threshold in an assessment, you can discuss next steps if you feel you still need support

A screening is required to be able to claim back the £350Link opens in a new window that WMS-bursary-students are entitled to (in 2023) - full details are hereLink opens in a new window

Assessment

If they agree an assessment is indicated, the Disability Team will give you a list of possible assessors
It's not an exhaustive or restricted list; it only gives some local assessors used successfully by Warwick students
- You can choose any assessor accredited with PATOSS - register for a free account to see them all

When choosing an assessor, you may consider;

- Cost, availability, waitlist, clinical experience, location, face to face vs Teams

- - An educational psychologist can usually diagnose ADHD, dyslexia, dyscalculia, and dyspraxia
    - They cannot prescribe ADHD medication; you would need referring to an NHS psychiatric consultant, and the usual waitlists would apply
  - A specialist psychiatric consultant can usually diagnose ADHD and ASC
    - They can prescribe ADHD medication, but are typically more expensive, and medication and follow up appointments also cost extra
- WMS Disability Network, Student Support Team, and the Disability Team cannot tell you who to choose - but, you can discuss your thoughts with us

Diagnosis

Book and pay online or via phone
Your assessor may send you pre-assessment questionnaires to complete
- Some are brief, and some are extensive
- Pace them, and ask people who know you and you trust for their opinons

- Some may need completing by a parental figure / carer who knew you as a child

Attend your appointment, which can take 1-5 hours depending on the condition being assessed

- It can involve short tests of writing and reading comprehension, or in-depth discussion of your life experiences - birth, milestones, family, schooling, relationships

The assessor will tell you the results, and discuss next steps, which can include;

- Letter to your GP (you should get a copy)
- Letter of educational recommendations or similar support
- Medication and potential follow up appointments
- Support groups or further resources
You do not need to continue with any aspect you do not want to

Support Post-diagnosis

If eligible for the Warwick Bursary, you can claim back £350 of the assessment feeLink opens in a new window (in 2023); full details hereLink opens in a new window
- Submit an invoice that includes your name, date, and the assessors stamp
Apply for Disabled Students Allowance (DSA)Link opens in a new window - you must submit proof of condition
- If approved, they advise you how to book an assessment (fee covered by your DSA)
- This determines the educational support you need, i.e. assistive software, equipment (including laptops), printing costs, a Note-Taker, or a Mentor / Tutor
Request a Reasonable Adjustments appointment with the Disability TeamLink opens in a new window
- They write a Reasonable Adjustments Plan, share it with WMS, who agree or discuss implementation with you
- If your studies are significantly affected whilst waiting for an assessment, you can discuss interim adjustments - but they are not guaranteed
- They can support with Mitigating Circumstances, especially if support wasn't implemented until late
Library services have various accessibility optionsLink opens in a new window
- Email themLink opens in a new window for a library induction, or to discuss their services even without a diagnosis

You should tell the Health, Welfare & Professionalism group of a new diagnosis, or any significant changes
- Self-refer here; the process is meant to support, rather than penalise, students
You can speak to the Warwick Counselling and Psychological Interventions TeamLink opens in a new window anytime

If you encounter any difficulties with the screening or assessment process, contact the WMS Disability Network - we're students, not faculty, and will advise and advocate for you wherever needed.

Warwick Uni Resources

Warwick Library Productivity ToolsLink opens in a new window

WMS Mental Health Self-HelpLink opens in a new window

WMS Autistic Student SupportLink opens in a new window

WMS Assistive Software for Sensory DeficitsLink opens in a new window

Bonus:

goblin.tools - make a to-do list from one line, formalise your words, analyse their tone, create a meal plan...

Outside Resources

Bionic ReadingLink opens in a new window - free accessible font

Studying with ADHDLink opens in a new window - free Ebook

StructuredLink opens in a new window - free task-orientated app

ADDISSLink opens in a new window - ADHD charity

Studying as an ADHD med studentLink opens in a new window

Becoming a Dr with ADHDLink opens in a new window

Being an Autistic Junior DrLink opens in a new window

The Dyslexia Shop Link opens in a new window

This information was collected by MBChB student and Disability Network Secretary Charlotte Pemberton in 2022, with grateful contributions from multiple MBChB students. Thank you also to Kirsten Revell, Dr Ellie Powell, Dr Anne-Marie Chilton, and the Disability Team for their input.

If you’d like to discuss any of this content, related topics, or give feedback, please email Charlotte.Pemberton@warwick.ac.uk, WMSDisabilityNetwork@warwick.ac.uk, or Eloise.Powell.1@warwick.ac.ukLink opens in a new window. If you have new experiences to add, they are sincerely appreciated!