Why Our Diagnosis Answered Less Than We Hoped
There is a moment many parents of neurodivergent children eventually face: the diagnosis.
When my husband and I realised our son was unusually hyperactive and struggled to sit still long enough to complete tasks most children his age could manage, our thoughts went almost instinctively to ADHD. We first noticed that his development and behaviour began diverging from other children around the age of four. Some parents are encouraged to seek a diagnosis as early as four to six years old, but we hesitated. Before the age of six, it is often difficult to distinguish between normal developmental immaturity and genuine executive function delays. Diagnoses made too early can be unstable and may shift as a child matures.
The same uncertainty applied to dyslexia. Before formal literacy instruction begins, reading difficulties are difficult to interpret. Without sustained exposure to structured reading, it is hard to know whether a child is experiencing a temporary developmental delay or a persistent learning difference. For these reasons, my husband and I decided to wait until our son entered Primary One. At that stage, the demands of school—sustained attention, classroom routines and peer comparison—made executive function difficulties much easier to observe. Teachers could offer clearer feedback, and patterns that had previously been uncertain became increasingly difficult to ignore.
At the end of his Primary One year, we finally decided to pursue a formal assessment. The waiting list was six months long. By the time the appointment arrived, however, something important had already happened. Long before we stepped into the clinic, I had begun building my own system of regulation for my son through nutrition, supplementation, traditional Chinese medicine, massage, acupuncture and carefully chosen extracurricular activities such as Shaolin, abacus, piano, art and swimming. I had even restructured my own work so that I could function as his full-time developmental support, creating rhythms, expectations and daily routines around him. That journey eventually became my book, My Child Is Not Naughty—Just Different: Raising an ADHD Child Through Eastern Wisdom and Modern Science.
We did not pursue the diagnosis because we were unaware that something was different. We pursued it because we hoped—perhaps irrationally—that once the problem had a name, it would finally become manageable.
When we told our son we were taking him to see a doctor, his first reaction was unexpectedly funny.
“Will I need an injection?”
On the day of the appointment, we arrived at the hospital and completed our registration. As we waited, the same question kept returning to my mind: could a doctor really understand a child in a single consultation? One session to assess ADHD, dyslexia and perhaps even dysgraphia, when I had already spent six months observing him every single day and putting an entire system of regulation in place? From both my husband’s and my own observations, our son had already changed—not dramatically or overnight, but through a series of steady, qualitative improvements that were unmistakable if you lived alongside him.
The consultation began on time. Like many paediatricians who see several children each day, the doctor first laid out a small play mat with a selection of toys and asked my son which ones he liked. My son chose a few, quietly removed his shoes without prompting and, within minutes, was lying comfortably on the mat, absorbed in an imaginary game between an aeroplane and a truck. While he played, the doctor began taking a detailed history. We discussed when we first suspected ADHD, how his behaviour presented at home and school, and what his teachers had observed over the past year. As the conversation unfolded, I explained the interventions we had already introduced—acupuncture, nutritional support and supplements such as magnesium, omega-3, choline and taurine. I also described his convergence insufficiency, which had initially led us to believe his reading difficulties were primarily visual rather than cognitive. Through vision therapy, that issue had since resolved to zero deviation, something I had written about elsewhere. I briefly mentioned my background as a pharmacist—not to claim authority, but to make it clear that these decisions were not based on internet searches or passing trends. They were interventions chosen after careful consideration of the available evidence.
The next stage was a literacy assessment consisting of picture-word tasks that gradually increased in difficulty. There were perhaps thirty to fifty items altogether. As the session stretched on, my son became visibly tired. His attention drifted, and even the doctor found it increasingly difficult to redirect him consistently. At first, he remarked that my son seemed able to read more words than he had expected and wondered whether dyslexia might not be present after all. To clarify the picture, he proceeded with a Bahasa Malaysia dyslexia assessment while continuing our discussion about executive function and behavioural regulation. I shared that one strength my son had always possessed was his ability to recover emotionally. He did not experience explosive meltdowns or prolonged tantrums. When he became dysregulated, he generally returned to baseline relatively quickly. I also explained that I had stepped away from my career so that I could support him full time, treating learning, nutrition, sleep and sensory regulation as one integrated system rather than as separate problems to solve. At one point, the doctor looked up from his notes and commented that it seemed I knew what I was doing.
The formal ADHD diagnosis was ultimately based on parental questionnaires, later identified in the report as the NICHQ Vanderbilt Assessment Scale. After nearly three hours, the results were presented. My son met the diagnostic criteria for ADHD. On the Raven’s 2 assessment, his non-verbal reasoning fell within the low-average range at the 21st percentile. His Bahasa Malaysia performance was below the expected level for his age, and the overall conclusion was a moderately severe specific learning disorder in reading and writing—dyslexia with dysgraphia. There was no formal assessment for Chinese literacy, as the doctor explained this lay outside his expertise, although he observed that my son appeared noticeably more comfortable reading logographic script than alphabetic or phoneme-based languages.
At the end of the consultation, I asked the question almost every parent asks.
“What do we do next?”
The answer was both clear and familiar. Ritalin was offered to improve classroom focus for approximately three to four hours per dose, with the explanation that appetite suppression and sleep disturbance were likely side effects. For dyslexia, we were referred to an Orton–Gillingham-based intervention centre.
I nodded. None of these recommendations surprised me.
Yet as we walked out of the clinic that afternoon, a quiet dissonance settled in. Ritalin might help him remain seated in the classroom, but what about the drifting that happened long before he left his chair? What about the restless fidgeting, his sleep architecture, or the slow, effortful reading that had already begun to improve through Peter and Jane? Could medication explain the progress we had already witnessed over the previous six months? Could Orton–Gillingham explain why he was beginning to acquire Chinese with greater ease than phoneme-based English?
As I reflected on the report over the following days, I realised it had answered one set of questions while leaving another untouched. It confirmed what my son had and gave us a shared language for describing his difficulties, but it did not tell me how he learned. It could not explain why certain interventions had worked, why regulation had changed so much before the diagnosis, or why his learning profile differed so markedly across languages. Those answers were not in the report. They would come later—not from another assessment, but from continuing to observe the child who lived with us every day.
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