What should we do to help DD10 (and ourselves!)?

[SeagullGirl]

DD(10) has always had some unusual emotional traits and sensory issues, which tend to come and go in severity. This last week (half term) has been really terrible for her and I'm wondering if I need to do....something? Not sure what.

Issues this week: Extreme anxiety over trivial triggers, panic attacks, screaming fits, insomnia.
Example 1: DH started speaking whilst having a sweet in his mouth ('talking with your mouth full' is a trigger) when we were in the car. DD had inconsolable rage, crying, kicking and proper screaming. It was really dangerous as I was driving on an A road and trying to negotiate a roundabout at the time.
Example 2: It is a beautiful sunny day on the campsite. There is a very light breeze. We are near some trees which are swaying very gently and leaves are rustling. DD is looking panicked and chewing her sleeve. She's worried that everyone is going home due to impending bad weather (the wind) and refuses to take off a woolly cardigan despite the fact that it is about 25c.

Something like this has happened every day, sometimes multiple times. No rational explanation helps. When she has a trantrum it is honestly like having a 2 year old again. Bedtimes and mealtimes are the worst. She is otherwise a very bright and well adjusted person, gets on well at school, has plenty of friends, etc. But her anxiety (if that's what it is) is causing the rest of us a lot of stress, and I now don't know what to do for the best.

Any thoughts/suggestions please?

[MsGee]

My DD has sensory issues (and ASD), so this is purely from my own experience.

The GP could refer for an assessment including sensory issues, in some areas there is more support for sensory issues but knowing what the issues are does help.

There is an National Autistic Society book on sensory issues which is brilliant, it pretty much helps identify the areas which are difficult and has practical steps to help. This could also help in talking to the school.

Talk to the school, if she is this upset at home, it is possible that it is worse at school but she holds it all in, which then makes homelife worse. At 10 she will also be tell you which bits of school are difficult. Even knowing that there is a quiet space she can go to if need be at school might help.

For my DD the sensory issues are the main source of stress in her life, it is just exhausting for her. Her sensory issues increase with anxiety (and vice versa) - at home we have worked to minimise sensory issues so she has some respite from things. Just reading up on sensory issues helped me a lot, and we are now very slowly able to address them.

I hope that this helps, I know it is stressful.

[MyNewBearTotoro]

Have you seen her GP? They might be able to refer you to your local CAMHS (Child & Adolescent Mental Health Service) or at least get you onto the waiting list.

Have you done any research into Sensory Processing Disorder - I'm not suggesting your DD necessarily has SPD but some of the advice, support and strategies out there for children with or parents of children with SPD may be relevant to your DD regardless of whether that would be a relevant diagnosis for her. There is a lot of information out there regarding how sensory issues can be a cause of anxiety for children and some of this may be helpful for you. You mention mealtimes and bedtime are also particularly difficult and again there is a lot of information out there surrounding SPD and these issues.

[SeagullGirl]

Thank you both - I will check out some more information about sensory issues. I've not spoken to a GP - I don't want to give her anything else to worry about (if that makes sense) but it may well be the way forward. I may try and speak to them on my own first I guess.

I've spoken to teachers about it (in general terms) in the past. They have never indicated and problems at school, but I've not mentioned anything to her current teacher so I'll try and do that this week. This recent uptick in anxiety has been relatively sudden.

[SeagullGirl]

I should add we already make a number of adjustments in everyday life (without a particular strategy), including allowing her to read at meal times, and have breakfast on her own, and she has earplugs at bed time.

[oldbirdy]

She sounds very black and white in thinking (mouth full incident) and anxious (leaves incident).

Black and White thinking: I would try to introduce some sense of scaling. What rules can you and she think of? Write them on post its. Cluster them in a sort of game: safety rules, politeness rules, tidiness rules, school rules etc. Which group of rules is most important? (Safety followed by school, probably) which least important (politeness). Then try to rank rules in the politeness group. Saying thank you might be near the top for example. Whereas 'don't talk with your mouth full' is a less important rule, like elbows off the table. Then scale them. Like say thank you is a level 3 rule; look before you cross the road is a level 5 (top level) rule, don't talk with your mouth full is only a level 1 rule and not doing it is not serious. So the reaction shouldn't be either if someone breaks that rule. Whereas "let the driver concentrate" is another level 5 rule. It doesn't make sense to break a level 5 rule because someone else broke a level 1 rule. Once you have this shared vocab you can just say "that's a level 1 rule, it needs a level 1 reaction".

Re the anxiety: normalise and rationalise. "Yes the leaves are rustling. I'm not surprised you feel worried about it as we haven't been camping in a breeze like this before since you were born. But Dad and I have done, and we know that whilst it sounds a bit weird it isn't as scary as it might sound, when it's Summer and there are lots of leaves it doesn't take much to get them rustling. Believe me if we thought we were in any danger we would take you home. I wouldn't keep you here if I was worried about how windy it is".

This post has taken ages to type and no doubt someone has said by now, but sometimes these sorts of symptoms are seen in girls on the spectrum, though not always; it could just be anxiety. If she has a difficult social history or any particular areas of specialist knowledge (most common in girls on the spectrum are animals, horses, literature, soap operas) then it might be worth considering if there is a wider picture at play here.

[Cagliostro]

I wish I knew :( my DD is nearly 10 and is so similar. We just stayed at mum's for a few nights and she ended up in my single bed with me for two of them because she couldn't settle. Bedtimes generally are horrific.

You say it varies in severity - does stress in some other aspect of her life trigger it? My DD is so much more extreme at the moment and has regressed a few years in behaviour because she is having a tough time with a friend bullying her.

A couple of weeks ago for example she got absolutely hysterical because of a sign in a cafe that said "unattended children will be sold to the circus". Normally she would have fixated on it "why is that sign there? Why are they lying? Why do they have that sign?" but on this occasion she also got utterly convinced that she couldn't even go into the toilets by herself because she would be 'sold'. She has also stopped sleeping and is far more sensitive to noise, light etc again. It makes her so angry, as does breaking rules, for example she was in a rage because a little boy was climbing on an arcade machine - normally she would have said it was rude/naughty but she got totally fixated on it.

The fact you have made adjustments already says a lot about how much she is struggling I think. She must be very anxious, I really deeply sympathise. It is so hard and with girls like mine who keep it all in (school never believed a word of what we said about her anxiety and she became so tightly wound there that we ended up having to home ed) it is a huge battle to get help.

She is finally seeing specialists for a 2hr assessment next week. Anxiety is the biggest issue by far for her but the paediatrician did see enough other issues to refer her to the social communication team.

[SeagullGirl]

Thanks again oldbirdy and cagliostro.
The rules thing. Yes that makes sense, but the reaction is so...visceral...it's getting the space for rational thought between the cause and the effect which is the issue. And the anxiety, yes we tried that it's just that somehow she knows what we say is true but she can't really believe it.
Regarding ASD, well to be honest I think a lot of the traits apply to both her and me (especially to a younger me). DH is more sceptical. Certainly beyond the types of issues which I've outlined above - which are reserved for family time only - she copes very well at school and with friends, although I think she has a good line in avoiding or withdrawing from tricky relationships/incidents. For example if someone is hurt she will keep quiet and keep a distance, whereas her younger sister is much more likely to offer sympathy or actually DO something. I can see a similarity in that I don't really know what to do with other people's emotions a lot of the time (I can certainly feel the emotion being expressed, but I can't always react to it). She doesn't have specialist knowledge really, but she does have absorbing hobbies which calm her down.
Whilst not seeing signs of ASD, DH is more concerned that she may have inherited some obsessive/depressive traits from his side of the family. Either way something is not quite right.

Anyhow regardless of any deeper cause which may or may not exist, it is the anxiety which is manifesting itself which we are trying to ease at the moment. Good luck for next week Cagliostro.

[oldbirdy]

The key step is the normalising (not dismissing) - agree with the concern, tell her it's no wonder she feels that way, and only then reassure.

The rules thing you need to do at a point when she is completely calm, as a kind of "we've noticed how upset you get when..., How about we make it clearer how these rules work?".

[Cagliostro]

Thanks seagull got to admit I am super nervous. TBH I am pretty sure she has ASD although they hinted at ADHD type problems. Like many girls though she can mask a lot of the issues. DS will be having the same assessment soon and I know his will be much more straightforward, they have already agreed there IS a social communication disorder - he is very 'classic' autistic boy IYSWIM, spinning/touching/repeating, problems with speech/language etc... he's much more 'low functioning' - paediatrician even described him as 'impaired' - and yet I rarely worry about him, because he's happy in his own little world with friends who are like him, and is really cheerful, not plagued by this raging anxiety and anger like DD.

Interesting you said about yourself too - I was diagnosed myself a couple of years ago :)

Really grateful for this discussion on rules - will definitely have a think about that for DD.

[Blossom789]

It doesn't sound like sensory issues as a stand alone concern but relating to anxiety or ASD. With you saying you have ASD traits yourself she could well have picked up on this and mimicks your behaviour. Ultimately you're not going to know until you have a thorough assessment - get to your gp and get the ball rolling.

[SeagullGirl]

We spoke to the teacher at school today. Apparently no problems there, though she is maybe quieter than normal at the moment. It seems like a good thing to have the school be aware what's going on. I guess GP will be the next stop unless things resolve again in severity soon.

[differentnameforthis]

Anxiety in girls with ASD ramps up around puberty with the onset of hormones.

she copes very well at school and with friends, Girls mask a lot. They watch others and mimic as to appear "normal" which is why they often fly under the radar, as they don't show traits at school, then it all kicks off at home, because it simply becomes too hard to keep that mask up.

I would seriously look into getting her assessed.

Look up Tony Attwood on facebook/youtube for a good guide on girls with ASD. My dd is 8, and recently dx, and so many of the things he highlights are her to a tee!