Has my 4 year old got a mental health problem - does anyone recognise these behaviours?

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I have a beautiful four year old DD, very bright with an incredible memory, witty, friendly, loving and caring. But she's also so highly strung, anxious and insecure. She 'prefers' clothes with a certain type of label in them and can tell the difference between shops, she likes to stroke the labels when she feels anxious or upset. She has horrendous separation anxiety to the point it's crippling her, we had to pull her out of nursery and defer starting school. She doesn't like to go far from home and doesn't like people coming to 'her' home. She can't 'switch off' at bedtime and has to be exhausted to be able to fall asleep and then comes in to our bed during the night. She has a constant energy all day.

There's no trauma, bereavement, separation (DP and I are together), very loving and stable home life, we're very hands on and affectionate parents.

We've seen the GP several times but they keep telling us its general anxiety. But general anxiety in a four year old can't be normal right? Has anyone else experienced this and was there a medical condition (mental or otherwise) that turned out to be the root of the problem?

Google autism in girls and see if anything fits.

Leek Thanks for replying, she doesn't tick any of the boxes for autism.

Have you looked specifically for indicators for young girls?

Extreme anxiety is a symptom as is sensory issues as is being bright as is not wanting visitors in her home...

Sensory issues, needing familiarity, anxiety ... Are you sure she does not have a Spld or ASD? Has she been assessed?

The behaviours you describe tick a lot of boxes for autism. I'm speaking from experience.

Hello, I feel for you whether or not we have the same thing!! ♥️ My dd(5) has been id'd as a 'sensitive' child. This is a therapy thing. She feels the difference in clothing material like yours but also doesn't like bright sun, clothing labels - as they scratch her skin and is very home orientated. She is highly strung too. Maybe check out this? hsperson.com/books/the-highly-sensitive-child/

I'm sorry but autism was my first thought also. Girls present very differently to boys, and the vast majority of information out there is still very much based on boys.

My daughter is going through autism testing and her behaviour was the same at that age.

I don’t mean to sound patronising, but have you looked at autism in girls? Completely different from autism in boys. Sounds like she has sensory issues, which is linked to autism.

It does sound like my DS when he was little. Very very anxious about life in general. Obsessed with certain things eg, the colour red, he had to wear something red, if there was a choice of colour cup he would have to have the red one. Leaving him at nursery was extremely difficult and I only managed to do it in stages with the support of a wonderful experienced nursery worker. Same at school and his teacher said she had never come across such an anxious child, he needed to know the day's routine, be individually introduced to any new members of staff. He had huge sensory issues around food and would only eat 6 safe foods for a long time, he would run out of the room screaming if we put anything new on his plate.
However, we never had him assessed officially, we just accepted him and found ways to help him cope. We gradually saw improvements but never ever pushed him too far out of his comfort zone. Little by little things got better.
He's now a hulking great 15 yr old and he still has his ways, if you pushed me I would say he is high functioning on the autistic spectrum. He likes order, routine, he's very black and white, he struggles to read emotions. But he's also kind, sensible, well organised, bright, funny and amazing. He has a good close circle of friends. I wouldn't change him for the world.
That's a bit of an essay but just wanted to share my experience as I know it can feel overwhelming.

I'm afraid I'm another person thinking of autism. Does she have a special place she likes to be when people come into her home, somewhere she feels secure?

I’d say investigate for autism and sensory processing issues.

She sounds exactly like my DD. Pretty sure my DD does not have autism. She’s quite an introverted person though and self harmed for a while as a teenager.

As a 20 year old she’s actually very normal and sociable and adventurous.

Bright, anxious, sensory issues, prefers home environment, doesn’t like home disrupted by visitors, can’t switch her brain off, can’t separate to go to nursery?

Those are autistic traits. I’m also speaking from experience. Push for a referral.

Sounds extremely familiar... my daughter is 6 and has ASD with Sensory difficulties. We also have 3 autistic boys but I didn't " spot" her difficulties as autism due to the Male bias in symptoms/ awareness.

I took her to the GP for 2 years with poor sleep, sensory difficulties and anxiety that if in an adult would prompt immediate intervention... eventually we saw the peadiatrician who also saw our boys and explained how autism often presents very differently in girls and later on she was formally assessed and diagnosed.

In hindsight it should of been obvious... shes identical to me and I'm autistic

She sounds just like my daughter who is currently being assessed for autism. It’s very different in girls, especially high functioning girls. They can be bright, outgoing, have lots of friends and seem to know how to behave in social situations but that’s generally because they have learnt to mask.
The issue with masking (basically hiding your real self) is that it’s mentally exhausting and not maintainable which then results in a girl with high anxiety, stress, the inability to manage emotions and behaviour in safe places (home) and general mental health problems.

This might not be the case for your daughter but I wouldn’t completely dismiss it.

👋Frustratedandworried, I'm autistic too.
I thought autism too. Females have variations on the traditional ideas of what asc is. Anxiety is a comorbidity of asc. Look up characteristics for girls with autism. There could also be separation anxiety. Best to go to your gp to assess her. Asc has many good qualities it's not just bad news.

Sounds like my DD - she is 11 now and has extreme anxiety. We've just got the school etc to accept it is autism.

Yes, my DD has autism and was exactly as you describe at that age.

Adding to the crowd crying autism. In fact so much so I thought you were making it up at first, two perfect for female autism for someone who doesn't know the symptoms. I'm diagnosed.

Although I dont have children of my own so I may not be the expert, this sounds a lot like me at that age and I turned out fine. I so used to hold clothing tags when I was anxious as I enjoyed the feel of them, they comforted me. I called them 'creamy tags'. Lots of children have blankets, dummies or face toys as a coping mechanism. I was extremely shy and terrified of men and only ever wanted my Mum even though my DF has always been lovely. I used to wash my hands until they bled when I was 6 through some kind of OCD/anxiety about school. I think nowadays although the awareness around mental health issues is great for several obvious reasons, our awareness may blow things out of proportion sometimes in a way we wouldn't have done in the 80s or 90s. My parents never took me to the GP or anything and I naturally completely grew out of all of it and I'm a well adjusted, confident, successful adult. I hope that puts your mind at ease!

FYI - Autism does not = terrible terrible thing. Its a spectrum. Some autistic people have more difficulties than other. It’s not abnormal it’s a different kind of normal.

You are obviously doing a great job of understanding and scaffolding your daughter which is why settings like nursery, school, out of home where you and her dad aren’t there show up her difficulties.

A diagnosis is not a life sentence it is a tool to access appropriate support.

I agree with PPs and my own daughter has anxiety and sensory issues. She's very bright and pretty much masks it at home. I think she passes for quirky and sensitive to most people but I suspect she's on the spectrum. She is very private and won't even engage with a doctor so I haven't taken her to be assessed as she's happy.
School have never flagged anything.
I wouldn't worry too much, it's early to get a diagnosis but do trust your instincts and if her behaviour becomes a barrier to her being happy then don't be fobbed off.
She sounds like a lovely little girl and you sound caring and responsible!

I agree there are several pointers to Autism. The sensory stuff ( my son was similarly obsessed with feeling labels), anxiety and need to keep everything the same, and my eldest with Aspergers was also v bright and had a great memory. He also finds it hard to relax and sleep . I would see if you can get a referral asap .
Sorry if that is hard to think about and hope you get some answers and support soon x

Everything’s you describe fits autism. Anxiety can be part of it, btw.