Your questions answered: ADHD in adults: What to look for and what to do next

There is no single duration that applies to every provider or every person. A high-quality assessment is more than a short questionnaire or a symptom checklist. It usually includes information gathered before the appointment, a detailed clinical interview, developmental and psychiatric history, consideration of functioning in different areas of life, and exploration of alternative explanations for the difficulties being experienced.

The appointment itself will usually take place in one session. Additional information may be requested before a conclusion can be reached. What matters most is not whether an assessment is quick, but whether it is sufficiently comprehensive to understand the whole person.

NICE advises that ADHD diagnosis should be based on a full clinical and psychosocial assessment, developmental and psychiatric history, and observer information where appropriate. Rating scales can contribute evidence but should not be the sole basis of diagnosis.

We currently usually offer an assessment appointment within two weeks. We ask people to submit questionnaires, and get someone who knows them well to complete one. We ask them to send us anything extra that may be helpful for the clinician to consider. The assessment appointment lasts up to 2 hours, and includes feedback on the clinician’s observations at the end of the session. There’s a full written report with clinical recommendations within two weeks of the assessment appointment.

Do not assume that this automatically prevents an assessment. School reports and input from someone who knew you as a child can be helpful, but they are not the only possible sources of information. An assessor may also seek information from a partner, close friend, sibling or colleague to understand how you function in other settings.

Bring whatever you have available:

• What you remember about school, friendships, behaviour and family life.

• Stories that other people have told you about your childhood.

• Reports or records from later childhood and adolescence.

• Concrete examples of recurring difficulties across education, work, relationships, finances and everyday life.

• Information from siblings, extended family members, old friends or other people who have known you for a long time.

• Evidence of the systems and support you have used to compensate.

ADHD is a developmental condition, so the clinician still needs to consider whether relevant traits were present during childhood. However, an assessment should be adapted to the information reasonably available rather than expecting every adult to arrive with a complete archive.

ADHD and autism can occur together, but they have different diagnostic criteria and require their own clinical consideration. Some services offer a coordinated or combined pathway, while others carry out two separate assessments. Oxford ADHD & Autism Centre and Clinical Partners offer separate ADHD and autism assessments.

A good initial triage should explore the person’s principal difficulties. For example:

• Persistent problems regulating attention, activity or impulses may point towards an ADHD assessment.

• Social communication differences, a strong need for predictability, sensory differences or restricted and repetitive patterns may indicate that autism should also be explored.

• Some people have meaningful features of both.

Even when appointments for both assessments are coordinated, the clinician still needs enough evidence to consider each condition properly. People should ask the provider exactly what is included, whether both diagnoses can be considered, what reports will be produced, and whether additional appointments or fees may apply.

Not usually. Dyslexia is a specific learning difficulty and normally requires a separate assessment using appropriate educational and cognitive measures.

ADHD and dyslexia can coexist. They can also produce superficially similar difficulties. Someone with dyslexia may lose focus because reading is effortful, while someone with ADHD may struggle to complete reading because attention is difficult to regulate. A broad ADHD assessment should consider whether another explanation or co-occurring difference may be relevant, but that is not the same as completing a formal dyslexia assessment.

ADHD and dyslexia can coexist, and the presence of one neurodevelopmental difference should prompt clinicians to remain open to others. However, they are distinct.

Dyslexia primarily affects skills involved in accurate and fluent reading and spelling. ADHD primarily concerns regulation of attention, activity and impulses. Both can affect learning, confidence, task completion and working memory, which is why careful assessment matters.

“High-functioning ADHD” is not a formal diagnosis. People sometimes use the term to describe someone who has achieved academically or professionally while experiencing substantial difficulty behind the scenes.

Intelligence and achievement do not rule out ADHD. Some people compensate through urgency, perfectionism, long working hours, extensive reminders, support from relatives or highly structured routines. The important clinical questions are not simply, “Have you been successful?” but:

• How much effort has that success required?

• Is it sustainable?

• What happens outside the area in which you perform well?

• What would happen if the support or structure disappeared?

• Are there persistent difficulties across more than one part of life?

A person can appear composed on the surface while expending an unsustainable amount of effort underneath.

That depends on what you hope to understand or change. There is no upper age limit at which self-understanding stops being valuable.

An assessment may help when longstanding difficulties continue to affect work, relationships, finances, confidence, mental health or daily living. It may also help someone reframe earlier experiences and consider support, adjustments or treatment.

However, an assessment is not compulsory. If a person is functioning well, is not distressed and does not feel that greater clarification would benefit them, they may decide not to pursue one. The key issue is functional impact and personal value, not age alone.

They can occur in ADHD, but none of them is diagnostic on its own.

Interrupting may relate to impulsivity. Concentration difficulties may relate to attention regulation. Oversharing may be associated with impulsive communication, anxiety, difficulty reading social cues or several other factors.

Clinicians look for a broader pattern that is persistent, has roots in childhood, occurs across settings and causes meaningful impairment. Sleep problems, anxiety, depression, trauma, autism, physical illness and the effects of medication can also affect concentration or communication. An assessment should therefore ask what happens, when it happens, why it may be happening and how much it affects the person’s life.

Trauma and ADHD are not mutually exclusive. Trauma can affect concentration, memory, sleep, emotional regulation and behaviour, which means it can sometimes resemble ADHD. A person can also have both ADHD and a trauma-related condition.

The distinction depends on a careful developmental history and the pattern of difficulties over time. ADHD begins during development, whereas trauma-related changes may emerge after particular experiences. A good assessment should not try to force every difficulty into a single explanation. It should consider timing, triggers, context and the possibility of co-occurring conditions.

Support should be based on the person’s current needs whether or not a diagnosis has yet been reached.

Access to NHS services varies by area, and Right to Choose applies in England rather than across the whole UK. Availability and local restrictions can change, so people should obtain current information from their GP, local Integrated Care Board and prospective provider rather than relying on an old waiting-time estimate.

Possible steps include:

• Ask the GP to explain the local pathway and whether the referral service is accepting new patients.

• Ask whether an NHS Right to Choose referral is available in your circumstances.

• Contact any prospective provider before referral to check current acceptance criteria, waiting times and whether treatment is included after assessment.

• Ask what support can be offered on the basis of current needs while you wait.

• If considering a private assessment, discuss possible medication and shared-care arrangements with the GP before paying for the assessment.

• If a referral has stalled, request a clear written update from the provider or referring service.

Right to Choose is an NHS pathway in England and is distinct from arranging and funding a private assessment independently.

Waiting-time estimates can change when referral volumes, commissioning arrangements or local funding change. You may want to consider asking the provider for:

• Confirmation that the referral has been received and accepted.

• The date from which the wait is measured.

• A current estimate rather than the estimate displayed when you applied.

• Whether further forms or GP information are outstanding.

• Whether assessment and medication titration have separate queues.

• The procedure for transferring or withdrawing the referral if you decide to explore another route.

Keep copies of referral letters, forms and provider messages. If the referral is NHS funded, your GP practice or local commissioner may also be able to clarify its status.

Potentially, but it should never be assumed.

We strongly advise speaking to your GP early. Once treatment is stable, a private specialist may ask an NHS GP to enter a shared-care agreement, but shared care is voluntary and the GP practice can decline it.

An NHS clinician should consider relevant information from a private assessment. But acceptance into an NHS service, repeat assessment requirements and prescribing arrangements can depend on local policies and clinical judgment. Neither a private diagnosis nor one undertaken by the NHS will automatically guarantee NHS prescribing by the GP, as commissioning of GP services varies widely across the UK.

Before arranging a private assessment, ask your GP if they will accept a shared care arrangement from a private assessment provider. You may want to ask the provider:

• Whether the assessment follows current clinical guidance.

• Who will prescribe if medication is recommended.

• What titration and follow-up appointments cost.

• Whether the provider can continue prescribing if the GP declines shared care.

• Whether there are annual review fees.

• What happens if medication becomes unavailable.

• Whether the assessment report will contain the evidence and recommendations another service may need.

If you request a private provider to commence a medication (titration) pathway, then yes, at least initially.

ADHD medication should be initiated and titrated by an appropriately qualified specialist. Once treatment is stable, a private specialist may propose shared care, under which a GP agrees to take responsibility for ongoing prescribing and monitoring. However, shared care is voluntary, must be supported by a clear agreement and may be declined by the GP if the practice does not feel it has the capacity, expertise or specialist support needed to participate safely.

If shared care is unavailable, the private specialist may need to continue issuing private prescriptions, with the patient paying the associated consultation and medication costs. This is why the GP conversation should happen before assessment wherever possible.

First, contact the diagnosing service and ask whether:

• You are on a separate titration waiting list.

• Any forms, physical health information or baseline measurements are outstanding.

• Another commissioned service is responsible for medication.

• There is a cancellation list.

• Non-medication support is available in the meantime.

It may also be appropriate to update your GP, particularly if your functioning or mental health has worsened. Most GPs cannot usually initiate specialist ADHD medication independently, but they can review other health concerns, help identify urgent needs and clarify the local pathway.

A diagnosis is also not the only point at which support can begin. Psychoeducation, workplace adjustments, sleep support, coaching or psychological therapy may be useful depending on the individual’s needs. NICE’s ADHD guidance covers information, support, medication, monitoring and non-pharmacological management. [nice.org.uk]

Assessment and medication are separate decisions.

A person should be able to seek an assessment to understand their difficulties without committing in advance to lifelong treatment. Medication is not suitable for everyone, not everyone wants it, and someone cannot make a fully informed treatment decision before they know whether ADHD is the best explanation for their experiences.

Sometimes referral forms ask whether someone would consider medication because a particular pathway is commissioned to assess people who may want treatment. That is different from requiring a binding promise to take medication indefinitely. If a form appears to make treatment a condition of assessment, you may want to ask the referring clinician or provider to explain:

• Why the question is being asked.

• Whether answering “no” affects eligibility.

• Whether “willing to consider” is different from committing to treatment.

• What non-medication support the pathway provides.

Treatment decisions should be made collaboratively after discussing benefits, limitations, risks, preferences and alternatives.

Support should be based on need, not solely on diagnosis. Depending on the person’s circumstances, options may include:

• Workplace or education adjustments.

• Occupational health support.

• Psychological therapy for anxiety, depression, low self-esteem or trauma.

• ADHD-informed coaching.

• Sleep assessment and advice.

• External reminders, visible planning systems and task prompts.

• Body doubling or accountability arrangements.

• Breaking tasks into smaller, explicitly defined steps.

• Support from family, peer groups or voluntary organisations.

• Reviewing physical and mental health with a GP.

Do not wait for an ADHD assessment to seek help. We are not a crisis service, so we recommend you contact your GP or the relevant urgent mental health service. Explain clearly how severe the situation has become, including whether you are sleeping, eating, functioning safely or having thoughts of harming yourself. If there is an immediate risk to life or safety, call 999 or attend A&E. In England and Wales, people can also call NHS 111 and select the mental health option where available.

Severe insomnia can substantially worsen concentration, emotional regulation and mental health. It therefore requires assessment in its own right rather than being assumed to be ADHD.

This depends on the medication, the person’s clinical needs and the prescriber’s plan. It should be discussed with the prescriber. Some stimulant preparations act on the day they are taken, whereas non-stimulant medication generally requires regular dosing to build and maintain an effect.

However, changing the schedule independently can affect symptom control, sleep, appetite, driving, work and side effects. Some people also need support beyond working hours, including for relationships, household tasks, finances and self-care. “Needed” should therefore not automatically mean “needed for paid work”.

Medication breaks or intermittent use should be discussed with the prescriber and documented as part of an individual treatment plan. NICE recommends that treatment be tailored to the person and reviewed, including benefits, adverse effects and the continuing need for medication. [nice.org.uk]

“Better tolerated” means that, across a group of patients or for a particular individual, a medicine tends to cause fewer, milder or more manageable adverse effects.

It does not necessarily mean that the medicine is more effective. One medication may produce a strong improvement in symptoms but unacceptable side effects. Another may offer a more modest benefit with fewer problems. The aim of titration is to find the best balance between benefit and tolerability for the individual.

Do not increase, reduce or stop prescribed medication without discussing it with the prescriber.

• A medication review may consider:

• Whether the original diagnosis and treatment targets remain appropriate.

• Whether the dose or duration of effect is suitable.

• Adherence and timing.

• Side effects.

• Sleep, diet, alcohol or other substance use.

• Other medication and physical health conditions.

• Anxiety, depression, autism or other co-occurring needs.

• Whether a different preparation or non-stimulant option should be considered.

• Whether non-medication support should be added.

Age alone does not mean treatment cannot be reviewed, but cardiovascular health, other medication and the person’s wider medical history become particularly important. NICE recommends monitoring response, adverse effects and physical health throughout ADHD treatment. [nice.org.uk]

This needs an individual medication review. Antidepressants and ADHD medicines treat different symptom groups, and having an ADHD diagnosis does not necessarily mean depression is absent or that antidepressants are no longer appropriate.

Some people take both under clinical supervision. For others, treatment is adjusted gradually. Antidepressants should not be stopped suddenly unless a prescribing clinician has specifically advised it, because withdrawal symptoms and recurrence of depression can occur.

The safest next step is to speak with the clinician responsible for the antidepressant and the ADHD prescriber so they can review diagnosis, current symptoms, possible interactions and a safe treatment plan.

There can be many reasons, including:

• Side effects.

• Feeling unlike themselves.

• Appetite or sleep changes.

• Anxiety about long-term treatment.

• Stigma.

• Difficulty remembering doses.

• Concern about dependence or controlled medication.

• A difference between what relatives value and what the person experiences.

• Feeling pressured or losing a sense of autonomy.

An adult with decision-making capacity has the right to make their own treatment choices. A helpful conversation begins with curiosity rather than persuasion: “What is it like when you take it?” or “What worries you about it?” Their prescriber can then help weigh benefits, concerns and alternatives.

Depending on need, this may include:

• Psychoeducation.

• ADHD-informed cognitive behavioural therapy.

• Coaching focused on executive functioning.

• Support for anxiety, depression, trauma or low self-esteem.

• Occupational therapy.

• Workplace or educational adjustments.

• Sleep support.

• Relationship or family work.

• Practical systems for planning, time management and task initiation.

The best plan is individualised. Medication may create enough cognitive space to use strategies more consistently, but it is not the only approach and it does not replace practical or psychological support. NICE recommends a comprehensive treatment plan that takes account of psychological, behavioural, occupational and educational needs. [nice.org.uk]

“Rejection sensitive dysphoria”, often shortened to RSD, is a term that many people find meaningful, but it is not a formal diagnostic criterion for ADHD. Intense responses to criticism or perceived rejection may also relate to emotional dysregulation, earlier experiences, anxiety, depression, trauma or autism.

Helpful approaches may include:

• Pausing before responding to a message or conversation.

• Checking the evidence for the feared interpretation.

• Asking for clarification rather than assuming intent.

• Identifying recurring triggers.

• Agreeing with trusted people how feedback will be given.

• Psychological therapy focused on emotional regulation, self-esteem or past experiences.

• Reviewing overall ADHD treatment when emotional impulsivity is prominent.

If perceived rejection rapidly triggers thoughts of self-harm or feeling unable to stay safe, urgent mental health support should be sought.

Try moving information out of passive memory and into active, external systems:

• Use retrieval practice rather than repeatedly rereading. Regularly test yourself on what you can remember.

• Study in short, structured sessions with a clear start and finish point.

• Revise new material as soon as possible after learning it, then revisit it at spaced intervals.

• Set one specific goal for each study session.

• Use practice questions, flashcards, quizzes or past papers, rather than passive review.

• Talk through material aloud, as if teaching someone else.

• Study with another person or use body doubling to help maintain focus and accountability.

• Reduce visible, digital and environmental distractions where possible.

• Keep all deadlines and appointments in one external system, rather than relying on memory.

• Build regular movement and breaks into study sessions.

• Ask your education provider about learning support, reasonable adjustments or assistive technology.

• Break large tasks into very small steps. "Read chapter 3" is harder to start than "Read pages 1-3 and highlight key points."

• Use timers (for example, 20-30 minutes of work followed by a short break).

• Pair studying with an existing routine, such as reviewing flashcards after breakfast or on the commute.

• Use colour coding, diagrams, mind maps, or visual organisers if visual information is easier to remember than text.

• Focus on understanding the material rather than memorising isolated facts. Information that is meaningful is usually easier to retrieve.

• Alternate between different types of tasks or subjects if concentration begins to fade.

• Use technology strategically, such as text-to-speech, speech-to-text, reminder apps, or digital flashcards with spaced repetition.

• Aim for adequate sleep, nutrition, hydration, and physical activity, as these can have a significant impact on attention, learning, and memory.

• Be realistic about your attention span. It is often better to complete several focused 20-minute sessions than to spend hours trying to force concentration.

If difficulties are mainly related to reading, spelling, processing speed or written expression, a specific learning assessment may also be worth considering.

Yes. Start by describing the difficulty and the practical change that may help.

Examples include:

• Written as well as verbal instructions.

• Clear priorities and deadlines.

• Regular check-ins.

• A quieter workspace.

• Noise-reducing equipment.

• Protected focus time.

• Breaking large projects into interim stages.

• Advance notice of changes where possible.

• Flexibility around start times or working location.

A diagnosis can sometimes provide helpful supporting evidence, but employers should consider the actual disadvantage and the effectiveness and reasonableness of the proposed adjustment. You may want to consider also focussing on what helps the person perform well.

It can make needs easier to explain and may support an occupational health recommendation, but it does not automatically entitle someone to every requested adjustment. Equally, a lack of diagnosis does not mean an employer cannot make helpful changes.

In the UK, legal protection is based on whether a physical or mental impairment has a substantial and long-term adverse effect on normal day-to-day activities, rather than simply on the name of a diagnosis. The practical emphasis should remain on:

• What difficulty is occurring?

• How does it disadvantage the employee?

• What change could reduce that disadvantage?

• Is the proposed change reasonable and workable?

ADHD and depression can occur together. Depression may be an independent condition, or low mood may develop after years of overwhelm, criticism, underachievement, relationship difficulties or repeated burnout.

There can also be overlap in symptoms. Depression may cause poor concentration, reduced motivation, sleep disturbance and difficulty initiating tasks. ADHD can produce longstanding executive-function difficulties that may look similar from the outside.

A thorough assessment considers timing. Lifelong attention and organisational difficulties may suggest ADHD, whereas a marked change linked to a period of low mood may point towards depression. Some people have both and benefit from treatment that addresses each condition. Adult ADHD reviews recognise mood and anxiety disorders as important co-occurring and differential diagnoses.

ADHD is associated with an increased risk of substance-use problems, but most people with ADHD do not develop an addiction. Risk may be influenced by impulsivity, reward seeking, emotional distress, social factors and attempts to manage sleep, anxiety or restlessness.

Addiction can involve alcohol, nicotine, illicit drugs, prescribed medication, gambling or other behaviours. A person should disclose substance use honestly during assessment and treatment. The purpose is not judgment. It is to make diagnosis and prescribing safer and to ensure both ADHD and the addictive behaviour receive appropriate support. Substance-use disorders are recognised as an important comorbidity in adult ADHD. [mdpi.com], [cambridge.org]

A combined profile is sometimes described informally as “AuDHD”, although this is not a separate formal diagnosis.

Treatment should be individualised, taking account of both ADHD and autistic characteristics. For example:

• ADHD medication may improve attention, hyperactivity, and impulsivity but will not remove autistic differences.

• Some people find that autistic traits become more noticeable once ADHD symptoms are better controlled. This does not mean that medication has caused autism, but that previously less visible autistic characteristics may become easier to recognise. Sensory sensitivities may affect which workplace or study strategies are practical and sustainable.

• A person may seek novelty and stimulation while also preferring routine, predictability and familiarity.

• Communication differences may affect how information is provided and how therapeutic approaches are delivered.

• Written information, additional processing time and clear expectations may improve accessibility.

• Executive functioning difficulties can affect planning, organisation, emotional regulation and task initiation, even when a person is highly capable intellectually.

• Support strategies should address both ADHD-related and autism-related needs, as interventions that help one area may not always help the other.

The aim is to understand a person’s full neurodevelopmental profile, and develop support that addresses their goals, strengths and areas of difficulty.

ADHD does not cause autoimmune diseases, hypothyroidism or haemochromatosis. Experiencing fatigue, stress or the demands of living with ADHD is not believed to directly create these conditions.

Some research has found associations between ADHD and higher rates of certain physical health conditions, including some immune-mediated and autoimmune disorders. However, these associations do not mean that ADHD causes these conditions, and the reasons for any relationship remain unclear.

Physical conditions can produce symptoms that overlap with ADHD, including fatigue, poor concentration, memory problems, sleep disturbance and low mood. Thyroid disease, iron-related disorders and other medical causes may therefore need to be considered during assessment.

If cognitive difficulties first appear in adulthood, fluctuate significantly over time, worsen unexpectedly, or are accompanied by significant physical symptoms, medical assessment is important. Clinicians should consider physical health alongside psychological and neurodevelopmental explanations rather than assuming all symptoms are attributable to ADHD.

Research into relationships between the gut, immune system and the brain is evolving, and there is growing scientific interest in how these systems may influence neurodevelopment, behaviour and mental health. However, the gut-brain-immune axis is not currently an established diagnostic framework for ADHD, nor is it a primary target of evidence-based ADHD treatment.

Evidence-based ADHD care remains centred on a comprehensive assessment, education, occupational, environmental and psychological support, and medication where appropriate. While some dietary interventions and nutritional supplements have been studied in ADHD, their effects are generally modest, inconsistent, or limited to specific groups.

Claims that a restricted diet, supplement or gut treatment can diagnose or cure ADHD should be treated cautiously.

Anyone considering supplements or significant dietary changes should discuss them with a clinician or pharmacist, particularly if they take prescribed medication, are pregnant, have another health condition or are considering treatment for a child.

Being born prematurely is associated at a population level with a higher likelihood of later neurodevelopmental differences, including attention difficulties. That does not mean a premature baby will develop ADHD, or that prematurity alone explains an individual person’s symptoms.

Diagnosis still requires the usual clinical assessment of developmental history, current symptoms, functioning across settings and alternative explanations.

Many women report that attention, working memory, sleep and emotional regulation become more difficult during perimenopause or menopause due to the additional effects of hormonal changes. This may make longstanding ADHD traits more noticeable or reduce the effectiveness of coping strategies that previously worked.

However, menopause does not itself demonstrate that someone has ADHD. ADHD is developmental, so an assessment looks for evidence that relevant patterns existed earlier in life. It should also consider sleep, mood, physical health and the direct effects of hormonal change.

A woman experiencing new or worsening symptoms may benefit from discussing both menopause and possible ADHD with an appropriately qualified clinician, rather than assuming that every symptom belongs to one explanation.

Not everyone will immediately understand or accept a diagnosis. Some people may have misconceptions about ADHD or autism, while others may struggle to reconcile the diagnosis with the person they have always known.

You do not have to persuade everyone that your diagnosis is valid. It may be more productive to consider focusing on your experiences and needs:

• “This is the difficulty I experience.”

• “This is what the assessment helped me understand.”

• “This is the support that helps.”

• “You do not have to understand everything, but I need you to respect my experience and boundaries.”

Some relatives may become more understanding when they learn more about ADHD or autism from reliable sources.

Sharing a short, reputable resource or relevant section of the assessment report may help if the person is genuinely open to learning. If conversations become dismissive or harmful, it is reasonable to limit them.

It can also be helpful to remember that a diagnosis is a clinical opinion based on evidence gathered during an assessment. Its value lies in helping you understand yourself and access appropriate support, not in obtaining universal agreement from others.

Begin with the difficulties you can both observe, not the conclusion you want them to reach.

For example:

• “You have said that work is exhausting. What part is hardest?”

• “Would you like help thinking through options?”

• “Is there one practical thing that would make this week easier?”

Avoid using ADHD as an explanation for every disagreement or trying to force the person into treatment. Adults with capacity make their own decisions. You can offer information, practical help and encouragement, while also maintaining boundaries around behaviour that affects you.

If the person is at risk, severely depressed, unable to care for themselves or expressing suicidal thoughts, seek urgent professional support.

Start by asking what help is wanted. Even well-intentioned support can sometimes feel critical, controlling or overwhelming. A useful conversation might cover:

• What is causing the most difficulty?

• Does the person want advice, practical help or simply to be listened to?

• Which responsibilities belong to them?

• Are there shared household standards that need to be agreed?

• What support can the parent offer without damaging their own wellbeing?

Possible collaborative approaches include body doubling, agreeing one small task, using a visible checklist, arranging practical support or exploring occupational therapy or coaching.

Support does not have to mean rescuing. Parents and partners are also entitled to boundaries and support for their own mental health.

Depending on your relationship with the person, it may or may not be appropriate to ask them. The report belongs to the person and contains confidential personal information. They do not have to share it.

Depending on what they’ve already disclosed to you, other starting points could be:

• “What would you like me to understand?”

• “Are there recommendations you would like us to use?”

• “Would it help to share only the relevant page or summary?”

• “What kind of support would be most useful?”

Consent should be specific and voluntary. If you are supporting someone in a professional role, follow your organisation’s confidentiality, data-protection and safeguarding procedures.

This requires specialist legal advice rather than general clinical guidance.

Possible steps include:

• Speak to the solicitor handling the case, any current legal representative or a solicitor experienced in criminal appeals.

• Ask whether specialist advice from a lawyer with expertise in disability rights, neurodivergence and criminal justice should be consulted.

• Gather diagnostic reports, educational and healthcare records and other evidence that may demonstrate the person’s needs at the time of the proceedings.

• Consider whether communication difficulties, sensory needs, suggestibility, impulsivity, difficulties understanding questions, or problems processing information may have affected the person's participation.

• Ask whether appropriate adult, expert witness or other specialist support should have been considered.

• Contact an appropriate legal advice, advocacy or disability-rights organisation for guidance.

A diagnosis does not by itself determine whether a conviction is safe or unsafe, nor does it automatically mean that legal proceedings were unfair. The key question is usually whether the person’s neurodevelopmental differences affected their ability to understand, participate effectively in proceedings, give reliable evidence, or receive appropriate support and adjustments. In some cases, concerns may relate to police interviews, fitness to be interviewed, the availability of an appropriate adult or intermediary, understanding of legal rights, participation during trial, or the information available to the court when sentencing.

Because appeal deadlines and evidential requirements can be strict, obtaining advice from a suitably qualified solicitor as soon as possible is important.