Feeling clueless - ADHD/ASD?

[Cuppateaneeds]

So, I’m feeling a little lost and could do with some guidance please.

I have a 13 year old son. Academically doing average so nothing highlighted by school but I’m increasingly noticing traits which I can’t discern whether they are normal age-related traits or not.

For example:

• needs heavy supervision to get on with homework - without being promoted every day/ multiple times of an evening it is last minute rushed or forgotten
• easily distracted - says he’ll go to work at the table but find him reading in bed because he got distracted by a book on his way to the room
• lies very easily about anything and everything (such as whether he’s eaten something that’s gone missing or whether he took either the bus or train home)
• finds any constructive criticism or intended guidance difficult to take and often blows up or is rude/defiant (such as closing the music book when his music teacher is trying to explain something)
• Sneaks sweet foods and then hides wrappings in any nook and cranny rather than putting it in the bin
• addicted to electronics - constantly trying to sneak onto them even though the general policy is get homework done and then it’s available after
• Constantly rushing/lack of care - writing is awful (used to be better when he was younger), homework bare minimum and not checked so silly mistakes, doesn’t speak very clearly (almost because he’s in such a rush he doesn’t use his lips to form ends of words)
• Doesn’t socialise outside of school and it doesn’t seem to bother him - doesn’t participate in any WhatsApp chats on his phone. His phone to him is for you tube and games rather than a communication tool.
• struggles with eye contact when speaking to people and has to be reminded

He’s had other sensitivities such as towards clothes textures and smells growing up but we’ve always managed to work through things. When he was younger I put lack of eye contact down to shyness and lack of friends as he got older to being because he’s an only child used to his own company. But I see others including only children growing up and I see a larger and larger gap in terms of maturity, organisation and social skills.

I’m wondering if ASD or ADHD might be at play here but am totally new to it all. Don’t know where to start or how helpful a diagnosis might be from a practical perspective. I’m seeing people refer to CAMHS, Ed psych, OT, neuro development consultants and I feel it’s all so over my head.

Can anyone help me know where to start, how useful a diagnosis might be, whether this is all just ‘normal’ behaviour or something I should be pushing to get considered by professionals?

My concern is that my son doesn’t meet his potential. I think he might be falling through the cracks because without doing much work he’s coping with school academically. However, because he does ok without much work and no revision, he has no work ethic, self-organisation or motivation or revision skills and I’m concerned that come GCSEs that’ll be when it comes to light. And if I can do anything to help him before then master skills that could help him day to day and long term then I want to do that.

Sorry it’s a bit of a long one but please do help! I’m based in North London in case of specific recommendations of people to try to see for diagnosis which is what I think would be of great help.

It's worth looking into seeing an EP to see what the problem may be. He may be dyslexic, however some of the things you've listed, in fact most aside from the friends one, are quite common in teens. If the friends one is a recent development, it might be nothing too. Kids go through phases and this might be one. Has he always behaved this way?

I personally wouldn't go down an ADHD or ASD diagnosis pathway without first seeing an EP. Have a look at the books 'Smart but scattered' and Brainstorm by Dr Siegel, they might help too.

You will have to wait for years for N London CAMHS. 3-4 probably. It took them 10 months to triage us and then they told us it's another 3ish years for a full psychiatric evaluation. This was late last year.
Privately for an ASD diagnosis you're looking at £1500-£2000. ADHD is in the region of £900.

He sounds like me. I was recently diagnosed with inattentive adhd.

I would see if gp will refer for adhd assessment or seek a private one so you have a diagnosis before y10. If it is adhd, medication may help. In the meantime there is a website called additude. It is very American but it might be useful as it has a lot on adhd and teens.

I would also consider a ASD diagnosis but would probably want to rule in/out adhd first as medication can reduce some of its symptoms.

Thanks - in terms of friends, he had plenty of play dates in primary school. But that was when they were arranged by parents. He seems happy enough at school - just really doesn’t seem to socialise or see school friends outside of school at all.

I’ve never thought about dyslexia - he hasn’t had problems reading and forms letters the right way. What are tell-tale signs of dyslexia? In terms of seeing an EP, is that done privately? Any recommendations of a person to see?Happy to pay privately if it gets quicker diagnosis/help. Just trying to work out if there might be something to diagnose. You mention some things being typical teenager and that’s what I’m uncertain about. Although he does also tend to fidget a lot when watching tv - pushing back and forth the battery cover on the remote for example.

That’s interesting - thanks. Do you think it would have helped you to get diagnosed earlier? How did you go about getting your diagnosis? What things might be put in place to help?

Thank you. It sounds like going through gp route might take years so I would need to look at going privately. I’m hoping someone might recommend an EP - I suspect even private ones might have a long waiting list. I’ll take a look at the website - thanks for the suggestion.

mom here with a ND family.. we've all got ASD/ADHD and varying co-morbids. (i have inattentive adhd)

I would take that list, compare it online to some of the diagnostics around autism and Inattentive type ADHD and go chat to the School SENCO about it.. and potentially your GP.

You'll find in the current environment that the school are unlikely to refer unless they can see him actively struggling, and needs more help/support than they can provide in school. HOWEVER, that doesn't mean you can't start to research and employ some of the strategies there are out there to support kids with Neurodivergence.

I don't know where in N London you are but I'll PM you.

Thanks. I’m not clear on the differences between ASD and ADHD and there seems overlap at times. If there is a diagnosis to be had I’m feeling guilty I haven’t pushed for it earlier. Do you have different people assessing ADHD to ASD so that you have to choose one consideration over another? Does one doctor or EP not just assess the child as a whole and then decide on the diagnosis from a range of possibilities? Sorry for being clueless - I feel very out of my comfort zone in knowledge on this!

Thanks. He’s doing ok academically or certainly not bad enough for school to have picked anything up with me. I just see his behaviours and how he deals with things at home and they strike a chord as not being quite as I’d expect (like the eye contact, mumbles speech, fidgeting, outbursts). And I’m unclear in my mind how school might help not being familiar with what resources they might help. Ultimately my aim would be to have strategies to support him both emotionally and work wise for revision ability etc. If he can do quite well with no revision I would think he’d go in strides if he actually had a strategy in place to understand the concept and be able to focus/ have a good method for revision.

Thanks - will look out for your PM

So in my area (midlands) you see community paediatrics for ASD and ADHD. They would normally take a history, and do questionnaires with you and the school to get an idea of which is likely. For ADHD, there's a computer based test they do. For ASD, you need an assessment by a speech and language therapist or educational psychologist to make a diagnosis (it needs to be 2 professionals).

I have adhd and I'm autistic. I would have been fairly similar to your son at that age.
It used to be the case that you couldn't be diagnosed with both but you can now.

I would have found a diagnosis helpful at a younger age, yes, especially for exams and university.

Now I have my diagnosis I get appropriate support and I went back into education, did an MSc and I feel like I'm where I 'should' be.

I didnt used to like it when people told me to make eye contact though- it felt a bit intrusive.

Luke beardon has some books that might be of interest re: being autistic.

An assessment which may or may not lead to a diagnosis would definitely be good idea. I have both and yes, a diagnosis when young would have made an incredible difference to my life. Please don't make him make eye contact, it's so uncomfortable!

Things that will help now:

Break tasks down into manageable chunks, one small thing at a time. For instance, rather than go upstairs, brush your teeth and get your shoes on, do brush your teeth. When that's done, get your shoes, put your shoes on, tie your laces.

Get your school bag, here's your pe kit, put your kit in the bag.

I use this method to keep on top of work and my house.

Don't show your frustration. He can't help it and it only serves to make him feel anxious and rubbish.

Homework - 10 minute chunks. Far more attainable for him, and positivity when he's managed each one.

A psychologist assesses autism and a psychiatrist adhd, the latter as they're able to prescribe. Adhd meds have transformed my life.

There is plenty of support the school can put in place to help, especially with helping to engage attention or any executive functioning issues/short term memory, they'll be used to supporting students with varying degrees of adhd/asd, even if its decided an EHCP wouldn't be required.

As someone who had late diagnosis, i went very much under the radar until i hit A levels, where the self-governed structure of education did not suit me at all.. i have 11 gcse's and no further formal qualifications as my ability to work under my own steam disintegrated. Had my ADHD been noted back then, i would have got the support through a levels and further education, and not ended up, as i am now, with massive self esteem issues because i've believed myself to be flawed/lazy as i couldn't achieve what my 138 IQ level says i ought to have been able to.

Its not uncommon for kids with Inattentive ADHD to fly largely under the radar until things suddenly go VERY WRONG very quickly, i'm not saying that to scare you, but as your DS approaches GCSE, if he CAN get any help/support from the school its REALLY worth doing, for his sake.

Thanks for this information. All very useful.

Thanks. This helps me know to push for an assessment/diagnosis now. How did you go about getting a diagnosis? Through gp or privately? How long did it take? Thanks so much for your insight as to behaviours at my son’s age.

Thanks so much for this and for practical tips which I’ll certainly try to do to make life easier for him. The practical difficulty is when I’m working and he’s at home - I can’t always manage lots of short timings whilst trying to keep on top of my own work needs. Oh, and noted on the eye contact!

Thank you so much for sharing your own experience. This is exactly why I’m more concerned as he’s in the year he’s deciding GCSEs and I’m worried with how he’ll cope with the study side and motivation needed. Should I raise my concerns with the school now (if so his firm teacher, head of house, pastoral?) or just have a private assessment, and wait for that result.

I’m midlands as well and my area paediatrics only see primary school age children, secondary have to go through cahms which takes longer, it varies from area to area

Sounds like my Autistic son, he’s always been above average at school so they’ve never really provided any support, tbh any support has been minimal and I’ve done most of the research myself.

Please don’t make him make eye contact it could be physically painful for him.

If your DS shows no difficulties at school then the school can only report on what they see. If they have never raised issues with you but you are seeing significant issues at home then ask to see SENCO and discuss as he could be masking his issues at school to fit in and then be exhausted from masking when he gets home.

Have you/his teachers never discussed concerns at parents eve?

Thanks. I’m a bit unclear on whether it might be ASD or ADHD as there seems some overlap with symptoms. Is your son at primary or secondary school? How has having his diagnosis helped? (Or has it not really in not having any support from school?)

On the eye contact note I’ve definitely seen that in various replies and am taking heed! He himself has always said it doesn’t bother him either way, he just doesn’t do it because it’s boring. Stock answer I think when he doesn’t know how to express his feelings.

This is true. I suspect he masks very well in school and with the number of children it might be hard to spot. As my son joined secondary school in the height of covid, we have only ever had online parents evening with each subject teacher. I’ve never brought it up as doesn’t feel the right forum with a set time per teacher. I’m thinking I need to possibly raise with his head of house for a face to face meeting, or find out who the pastoral or senco person in the school might be if that’s the appropriate person.