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Dr Ketan Bhatt's avatar

I brought this issue up in a team meeting yesterday. If a parent creates a genuinely supportive environment — and a good primary school does the same — the child's presentation can be suppressed enough that the diagnostic criteria aren't met. That's not the system failing to see the child. That's the criteria doing exactly what they're designed to do, in conditions that mask the underlying difficulty.

The question nobody wants to answer is: what happens at transition? High school may not have the same support. The home scaffolding might struggle to overcompensate. The child hasn't changed. The environment has. And there's no diagnosis to trigger any provision.

An assessment that only captures a child in the moment they're being held up will always miss this. That's the real design flaw.

Chris Stephens, CPA's avatar

This feels exactly right to me. You’re not describing a failure of observation. You’re describing a design that only registers difficulty once support structures collapse. As you say, the child hasn’t changed at transition. The environment has. An assessment that only detects need when support is absent will always be late to that shift.

Dr Ketan Bhatt's avatar

I really feel for parents in this situation. A continuation of this can lead to overcompensation into adulthood. Working (silently) much harder than peers to reach the next stage in the education system can result in seemingly successful careers. But that situation is unsustainable, as other priorities - family, kids, life in general - also need to be balanced. The wheels can come off very quickly...

Chris Stephens, CPA's avatar

Yes. This lands very close to home. What looks like resilience or success from the outside is often sustained overcompensation, quietly absorbing load that was never meant to be carried indefinitely. It can work for a while, especially in structured systems that reward output, but it isn’t neutral. When life adds complexity rather than narrowing it, the cost finally becomes visible.

That arc is one I recognize well, which is part of why the transition question matters so much.

Dr Ketan Bhatt's avatar

The grey area between overcompensating and adapting in ADHD. It's why self-awareness is so important. Easier said than done, of course, when the ADHD mind is running at 100 miles per hour! It's what often leads to sudden burnout...and then retreat. A constant pendulum. Something I'll be discussing in next week's article.