Does he have SEN/Autism ??

[Gafan]

Hi.
So story is I have a 9 year old AS who came to me at 2.5 years.

He has always had regulations issues, meltdowns, he is so much better and most days on. an even keel.

At school he's fine academic wise hitting targets etc there is no real problem there however he does have emotional problems that we both at school and home work with.
He has a calm club where there's a small group of children who learn to play together problems solve and to chat about the emotions the whole group aside him either have autism, or under an assessment.
He goes to a sensory session with one girl again who is autistic.
He seems to be catalogued with these groups of children when there has been a argument, he dies extra things within class as mentioned and his teacher advocates for a couple of relationships he has both girls both with sen .

So we have had a private assessment done via post adoption 2 years ago by a professional and her opinion was he's not autistic the parallels with attachment disorder are very similar and was given this diagnosis and we have had therapy since which has now stopped.

His teachers in year 2 believe that he had some autistic traits but a exam type tick box things said no. He's now in Year 4 and the teacher hasn't expressed issues however her son has some traits and she sometimes compares in a conversation when she says to me I understand the battle.

My sister is a senco supply LSA and her daughter has Asperger's and has always commented my son has these traits and she believes he is on the spectrum.

My question is do we need to get him reassesessed as it's common to be diagnosed at his age, is there anyone on here with advice with experience.

Is he just showing signs of attachment disorder and like I said it's similar to the autism traits.

I just feel if he wasn't my child and I didn't know he was adopted and a friend or relatives asked my opinion I think a huge part of me would say yes I would get him reassesessed as he does show symptoms and behaviours.

Thanks for reading.

@Gafan

Have you heard of the Coventry Grid ?
If not Google it and download the form.
It's a series of questions and will compare ASD traits with attachment.
When I did it for my son I took a very quick fire, instant reaction approach. He came out around 95% ASD. I then did it second time, taking more time to consider the detail of the questions. He came out at around 90% ASD.
It won't replace an assessment by a clinician but will give you some idea of how differently ASD and autism present over the same issue - children with ASD may have very restricted food likes, dislikes, children with attachment may hide food, binge eat etc. So both have food 'issues' but they present very differently. It will also help you think beyond the 'classic' traits and think more widely about behaviours.

It is incredibly difficult to separate out early trauma from other conditions.

In my experience, if you see an early trauma expert, they are likely to diagnose early trauma.

If you see a psychologist, they will diagnose asd.

It is really difficult to find someone totally independent.

My elder daughter was diagnosed aged 15. By then she had had lots of therapy and none of it had made a bit of difference and the psychologist we were seeing at CAMHS told me she was happy to diagnose autism because she would have expected some movement with the therapy.

My younger daughter had been diagnosed 7 years earlier. I still hadn't realised her elder sibling was asd as they both present so differently (younger daughter has PDA).

Anyway, it IS a struggle to work out what is what. Some children don't have either - it's foetal alcohol syndrome or a genetic deletion or simply highly disregulated sensory systems.

My daughters used to score for everything they were tested for. In the end I used diagnoses strategically. I found autism diagnoses brought the most help. No one is interested in an early trauma diagnosis - there are autism units in school, people understand it. With early trauma people can be dismissive and a child might be put in a behavioural unit.

So I personally would follow up the asd diagnosis.

There is lots of overlap, but 8/9 is also the age you start to see clearer differentiation with peers where ASD/ADHD is a factor. Our CAHMS service has a neurodevelopmental unit that basically assesses for everything in one process, does your area have anything like that?

I agree an autism diagnosis is more readily recognised by schools etc in terms of support but some aspects of trauma do need a different approach - merely dealing with everything under an autism banner isn’t necessarily helpful.

There's a real limitation of the ASF that it's so attachment focused- an attachment assessment will find attachment disorder. An autism assessment is likely to find autism. What our children need is someone really clever who can hold all of the diagnoses in question, and apply the ones that apply. Because often it's not either/or, it's both/and.

Can you reapply to ASF, on the basis of two years since your last assessment, and use one of those rare providers that consider ASD, attachment, FASD, ADHD and everything? Because that's what's needed.

I wanted to add, when I adopted, attachment disorder was the new explanation for everything. Therapists from the States would come over and we adopters would go along, then try to get professionals to take us seriously. Some professionals were terribly excited about it. My girls got seen at the Post Adoption Centre when they were 4 and 5 and they were given attachment based diagnoses.

But I was never convinced and the years brought new diagnoses. And other adopters found the same. By the time our kids were in their teens, adhd and asd were more commonly being diagnosed.and genetic deletions. Then FASD.

Anyway, the feeling back in the day was that if you fixed the attachment, the other problems would fall away.

My elder daughter had a Statement (later ehc plan) for emotional behavioural difficulties which she got in Reception. Everyone at school was convinced she was bright enough (the ed psych had scored her on the 66% percentile). I wasn't convinced.

I contacted Family Futures in london and asked if I could use their ed psych privately. He was incredibly eminent- he had been president of the college of Ed psychs but was now retired and helping FF, seeing some of the most challenging children in the adoption system. So I reckoned he was perfect.

He ran all the tests then called me in and told me my daughter had a learning disability. IQ of 56, which put her in the bottom 1%. He said "I'm not picking up attachment disorder at all, she is delightful".

So, we changed tack completely. Got her Statement changed to mld and she went to a mld school.

Later she was assessed by the genetics clinic due to a medical condition. She was found to have a deletion on one gene which is connected to learning disabilities. Her sister has the same genetic deletion but isn't affected in the same way. Apparently boys with it are more badly affected. They were both assessed there for FASD but we were told it was unlikely.

Later on she was diagnosed with autism at CAMHS by a psychologist- we were having another go at therapy due to her jealousy over her sister. And the therapy made no difference whatsoever, which is one of the reasons the psychologist diagnosed asd.

Years earlier she had been diagnosed with adhd at CAMHS by a psychiatrist.

My other daughter has a similar tale of various diagnoses.

So what I'm saying is, you can get multiple diagnoses over the years depending on who you see and their expertise and area of interest, flavour of the month etc.

You can only do what you can. Personally I would ask for a genetics assessment, a FASD assessment and an asd assessment. Also ask school for a speech and language assessment if possible. And keep an open mind about any diagnoses you get.

@Arran2024

I feel this so much.

I realise how how naive I was looking back- I learned everything about attachment, and thought fixing attachment would fix everything! I did all the courses. And we saw attachment experts who said "they appear to have aspects of secure attachment. But they're adopted, so Attachment Disorder it is!" When you have a hammer (and potential ASF funding for ongoing therapy) everything looks like a nail.

We have genetic issues, underlying LD, etc. Which is obvious when you think about it- birth parents are likely to have "something", because people with everything going for them in the genetic lottery rarely lose their children.

Love doesn't cure everything, and neither does a trauma based approach. Our kids are complex.

Exactly. I remember reading " The boy who was raised by a dog" by Bruce Perry - i also saw him speak - and these were kids with proper attachment disorder. And I recognised it in 2 kids of friends who frankly I found really scary even though they were only about 8. And I realised my two were nothing like this at all.

Thanks for all the replies.i will have a look at some research and the Coventry Grid as not heard of that.
It's a bit of a minefield 🙈