Behavioural or possible diagnosis

[whyyougottaplaythatsongsoloud]

DD is 12 and always had some social difficulties which I've always just accepted as how she is. She struggles to recognise others feelings and can come across as odd/random with things she says or just isolate herself and ignore others. I encourage her to think about others feelings by talking about them but she just doesn't get it.

In school she's a very high achiever (achieved full marks in 2/3 SATS and predicted 9s in GCSEs) and a very strong reader. We always get feedback on parents evening about her fiddling/faffling/doodling in class (at primary this varied by teacher: one said she was constantly fiddling with her hair/pencils/clothes and described it as 'infuriating' another said she fiddles lots and it looks like she's in a dream world but said he didn't tell her off as when questioned she is listening) Since starting high school this seems to have escalated and all teachers on parents evening reported some level of fiddling/doodling and mentioned that she's not 'always quite there' Nobody seemed especially concerned but all mentioned it.

She's suddenly having lots of low level friendship issues which is a new thing as she's always had her head in the clouds and never noticed the fallings out that happens with her friendship group but now she's having lots of issues and twice told me she's pushed someone as they tried to hug her and she doesn't like that. She's had the same friendship group since preschool but now they tend to leave her out of evening and weekend plans and she doesn't get invited. I believe this is due to her behaviour - the difference in her behaviour and theirs is more noticeable now they are all going through puberty as some as now quite grown up and into boys/makeup and DD is still very childlike and awkward. The girls live on the same road and are nice kids and handle DD really well but it's wider friends that she is clashing with.

At home her behaviour can be aggressive but it is manageable provided I leave her when she starts to escalate then come back and address anything that needs it once she's had time to calm. She has a temper and will slam doors and in the past has damaged her own things (mostly throwing in a temper) but since we've given her the cooling off time before dealing with stuff it's been better.

She's always been very clumsy but this seems to be exaggerated by when she's feeling awkward or the focus is on her - so will trip over her own feet, fall off a chair etc. School have always reported this too.

Her half brother is 5 and recently been diagnosed with ASD, ADHD, DCD and hyper mobility - we've always said how similar they are in their mannerisms/behaviour and clumsiness as a joke but now DD's differences are impacting on her more I'm worrying that I've ignored something that I should have considered more.

Or am I overanalysing and she's just a bit different/maybe puberty is exacerbating issues? Or should I speak to teachers/GP in case she needs something more?

When you say ‘needs something more’ what do you mean? Are you thinking of support in school? Support with understanding relationships? What would you want school to do.

If you had a diagnosis, would it help you as a parent?

@Foxyloxy1plus1

I don't think a diagnosis would help me as a parent at all.

My main worry is DD not achieving as she's getting into difficulties in school due to the fiddling/doodling/being dreamy (plus this conflict in her friendships) and despite the teacher's best efforts this is getting worse not better. I have been talking to her about it but it doesn't help (and I'm not at school when it happens to issue all the reminders)

If there is a medical reason for it then school would potentially be more understanding.

If there isn't I'm not sure what to try next.

From your post I pick out "fiddling" "fidgeting", unable to understand social clues, clumsy, and I'm thinking asd. How is she with change? Sensory issues e.g. dislike of seams in clothing, tags etc?

@Ohhgreat
She is fine with clothes. Will only wear one style of clothing(soft t-shirts and leggings) but will wear multiple variations of. Won't wear tights and lots of styles of knickers due to seams/elastic but always seemed reasonable to me.

Change wise I can take her most places but she'll usually be insular while we are out, mostly she takes a book and will read wherever we go. Food wise is fussy and won't eat anything wet so everything (pasta/rice/potatoes) is dry, no butter/sauce which makes me question her tastebuds! Changes to routines she will resist/gets angry but I can introduce things slowly and she will accept it eventually and normalises it fairly quickly.

The only wearing soft clothes is another asd characteristic, ditto problems with elastic and seams.
Dislike of textures of certain foods is also a characteristic of asd.
Ditto resisting changes /liking routines
If she's at secondary can you contact the senco with your concerns? Girls are historically underdiagnosed as they present differently to boys, but your senco should be aware of that and be able to give you their thoughts. If you want to do more research, look up triad of impairments, it will give you some idea of how they assess for autism (I'm sure you know this anyway with your son!)
For what it's worth - I have an autistic son who is on track for all 9s at GCSE, and is genuinely awesome!

It's probably worth reading up on how asd presents in girls. Tony Attwood has a lot of good information on aspergers, typically for girls they cope well until they reach puberty when friendship issues become more obvious. The fidgeting could be due to lie level anxiety, or it could be something else. I'd read up on it with your daughter. Whether or not she ticks enough boxes to get a diagnosis, or wants to pursue a diagnosis, just becoming more aware of autistic traits and how to cope with life could be helpful.

low level anxiety

@Ohhgreat that's great to hear that your son is doing so well!

I guess I'm questioning if I'm making excuses for her behaviour as at Christmas my Dad and Uncle passed comment several times on her 'rudeness' saying that I should 'not let that slide' She is abrupt and random in conversations and can ignore people which can be frustrating, I encourage her to join in but she just doesn't get it.

It feels like more and more people are now noticing her behaviours and I'm worrying that she'll get into difficulties as it's nothing 'recognised' so people aren't understanding of how she is.

School won’t do much as she’s achieving

She has many signs of social communication difficulties, which is in effect of the triads of ASD. I would talk to her about how to be polite with people, not when she's in that situation but when she's calm and receptive. The fiddling/ fidgeting shouldn't be a problem as long as she also gets her work done. It's known as stimming and is used to help with stressful situations.

Greentulips I disagree - my son is a high achiever and his school have been awesome! Movement breaks, allowing a fidget band to be worn (normally against uniform rules), extra time in exams if he needs it, anxiety workshops, I could go On!

My dd is autistic and she shares a lot of characteristics with your dd, but autism diagnosis also requires a communication element (dd was non verbal until 4 and struggled with comprehension). They can be quirky without a diagnosis of course.

The only other thing is having a diagnosis doesn't make any real difference at school, services are provided on need not bits of paper so if she's struggling ask to speak to the senco

The more information you are giving about her - from her social awkwardness to her need to "fiddle" to her sensitivity to clothes to her sensitivity to certain types of food, are all suggesting it would be worthwhile getting an assessment for Autism. There is a genetic link, so the fact your ds has a diagnosis makes it more likely, statistically. Girls do present differently and generally tend to be better at masking than boys. Girls historically have then started to struggle in their teens / once they and their friends start going through puberty. Often there have been years of MH difficulties before it is established they may have autism.
It might well be that the school won't make major adjustments for her, if she is achieving well, and masking well at school, but it might help her immensely to understand why she thinks and sometimes behaves differently from her peers.
If she were my dd, I would certainly go to the GP and ask for a referral for an assessment (is done differently in different parts of the country, in terms of CAMHS or CDC or Paediatrician, etc).

Obviously none of us can begin to diagnose over the internet, but the number of areas of difference she is displaying would certainly warrant an assessment.

@Soontobe60
That's really helpful thank you. She has recently had some negative behaviour points for doodling in class, both times the same teacher. I have spoken to her a few times about it (later when she is calm is always key) but it seems worse once she's gotten into trouble for it. at present once she has an issue with a friend/teacher then she seems to behave worse/become more awkward around that person and it's how to break the cycle,

I'm never truly sure how much of it she can control but I have ways of managing it which work such as tackling things later when she's calm, only addressing key issues etc whereas at school the boundaries vary by teacher so she struggles in some more than others.

OnTheEdgeOfTheNight thank you I've just bookmarked some of his videos to watch

Sounds very like my dd who is awaiting assessment for ASD having been referred by her school. Her younger brother also has ASD.

Have a look at the Limpsfield Grange website for lots of good info and advice.

limpsfieldgrange.co.uk/autism/information/

@Backforgood

I didn't know about the genetic link or that girls tend to present issues later than boys - thank you for taking time to post.

I will phone school this week and chat with SENCO. I think she'd struggle if I took her to the GP and refuse to speak to them.

To clarify it's not my DS who has recently been diagnosed , it's DD's brother on her Dad's side. He is really struggling and his needs have become really evident in the last 12 months - DD has never presented as severely or violently as he is.

@123bananas
That link makes fascinating reading. DD has always been absorbed in pretend play and even now (at almost 13) spends hours sat in her wardrobe making imaginary worlds for her sylvanian families, she makes them houses from shoe boxes and I have to admire the very many room set ups as she explains every last detail. I've been waiting for her to grow out of it but it's showing no sign of abating.

My DD 13 is very similar, brother 12 is ASD. A psychologist talked to DD for 10 mins and said NT but I am not sure at all. Very bright, has friends but copies everything like she has been to 3 different schools, 3 different accents from day 2. Very hyper and impulsive, daydreams, acts without thinking. Top of year at grammar in maths and languages but found English harder. Getting neg behaviour points at school and disorganised. Seems unable to distinguish between sensible kids to be with and ones who will get into trouble. Preference for boys though sensible with boys.

Have you read about PDA? (Pathological Demand Avoidance) sounds like an autism thing. It ramps up at secondary when the pressure gets up.

Dd is nearly 10 and makes vast play lands from houses made from shoe boxes involving Sylvanian families, paper characters and other figurines. She also does the same with Lego. She then makes videos of them and talks me through complex sets and story plotlines.

It's hard to say for sure but yes it does sound as if it could be Asperger's / High Functioning Autism, and that was before I got to the bit about her brother. I don't think you've ignored it, it's more that autism varies and the differences between a child with autism and other children can seem more obvious at different ages. Your DD has got by so far but sounds as if her development is starting to diverge more from the others just now. 11-12 is quite a common age for this to happen, with the transition to secondary school, and puberty. I think the time to get it checked out is the time you start to notice a problem.

One of my DS's teachers said to me that my DS (diagnosed ASC age 6) changed all the time, and he did well so long as the demands and expectations on him fitted his development and abilities. The trouble came when there was a mismatch. It does sound as if you have been making quite a few adjustments and allowances for DD compared to other girls her age, and the differences are getting more noticeable. Another thing about my DS was that a lot of his abilities were blunted rather than totally missing - like your DD he could adapt to change with the right preparation, or he would cope with a change but be really horrible afterwards because of the stress. My DS has also done well in school. He went through a bad patch socially from about 12-15 but he coped, and after that he matured and he was in classes with more like-minded teens, and things got a lot better. He is now happily at university.

Your next step would be to talk to the SENCO and to your GP. You are more likely to get a referral if the school support it, but it's not always essential. If your DD does have an ASC then getting a diagnosis can make it easier to get simple adjustments in school, for example DS was allowed to have a fidget toy in class when other kids would just have been told not to fidget. And if you are taking a long view it's better for a youngster with an ASC to go to university with a diagnosis than without. There can be good support at university but adult education is bound by disability legislation and without a diagnosed disability your DD wouldn't qualify, and it can take months or years to get a referral and diagnosis from adult mental health services. By that time students have often really struggled and are pretty miserable. So I do think there are good reasons to look into it sooner rather than later. If she doesn't have an ASC, or if she has some other condition such as dyspraxia, that would be useful to know too and that would be picked up in the assessment process.

This is so interesting - my DD shares many of the traits you talk about, fiddling, daydreaming, seemingly not listening, but if questioned knows exactly what was said... she also has social skills which are less mature than her peers, and is quite insular (plays the same game, but more alongside than with her friends). Her friends who have known her from pre-school are great with her, and she is popular, but I fear for her going to secondary in a couple of years because she will be with new people who do not know her and might not accept her as well. I am hoping she will find like minded people (a bit geeky, readers, etc) but who knows.

We have been to 3 paeds for diagnosis when she was young, all said she was NT and would grow out of all symptoms by age 7. Didn't happen. I am thinking of getting her diagnosed privately over the summer of year 5, not because I think the school will do much but because it might help her understand herself better and therefore help her to cope at secondary.

Thing is she does not have any sensory issues (clothes, food, etc) and no issues with change or special interests (at all) she also has no anxiety, so there are parts of the puzzle missing. Maybe I should look into ADHD a bit more, I always assumed ASD.

She sounds like she is what's known in "gifted" circles as "twice-exceptional" or "2E" - i.e. very bright but with additional needs. A useful author in this area is James T Webb who has written a lot about social and emotional needs of the gifted, and the crossovers between gifted behaviours and various things like ASD, ADHD etc.
A lot of what you've said suggests ASD to me: the relevance of a diagnosis might be that teachers who get cross about doodling/appearing inattentive could be told they have to accommodate her need to doodle; and if she were aware of specific differences then she could possibly work on areas that might make her social interactions easier (NB i am NOT trying to say "she should mask so she fits in", I'm trying to say "awareness of specific differences can help with theory of mind and thus social interaction").