ASD vs AD. Aibu to think they just want to blame me?

[Afflictus]

Hi, I have posted previously about 9yo DD who for the last three years has had violent meltdowns daily, was/is suicidal and lots of other issues.

I was open minded about what was causing this in the beginning but after several posters suggesting it on my threads, and having met other parents with HFA girls who suggested my DD sounds very much like their DC, I have seriously considered ASD as a possibility. I have read around the subject and decided it was at least worth pushing for an assessment.

After several years of asking for help and being denied, the school got involved and we were finally accepted to CAMHS and have other professionals like a social worker. A couple of these professionals who have worked closely with DD have agreed that there appears to be an underlying condition.

We were given 8 sessions with a CAMHS worker, the first two being spent going over our story to date, one session with DD and one session with me. Initially they wanted to spend most of the sessions with me so I'm assuming they think it's a parenting issue.

I have been honest in saying that my relationship with DD is severely fractured but this is in response to her difficult behaviour and I don't feel it's the other way round as I was very close to her when these problems initially manifested. The CAMHS worker was initially saying that he thought my DD was mimicking the abusive behaviour she witnessed from XH and that we had an abuser/abusee relationship. This isn't something I agree with.

At the last session, he went through the Coventry criteria with me and I felt that DD ticked boxes in both categories, ie. it could be either. At the end he said that 'we are both in agreement that she presents more as an attachment disorder'. I don't actually agree, I felt is was 50/50 at most and much of the criteria centres around presentation in boys (if I've understood correctly about presentation often being different for girls) but I struggle to challenge professionals.

I didn't really understand attachment disorder so read up when I got home and I am very upset to find that it's caused by insufficient attachment to primary caregiver, abuse or trauma before the age of 3. Have I understood this right? If so, it really doesn't fit as I was a totally devoted mother and did absolutely everything for DD spending her first 4 years as a SAHM. XH was abusive but she didn't see much of this as we didn't live together until she was older.

In any event, I still feel it's worth at least ruling out ASD via assessment but they seem hell bent on finding fault with my parenting. I have two other DC with no issues except one has dyslexia and the other very likely dyspraxia which are apparently associated conditions. ASD also runs in my family. DD also has hypermobility which I've read is another associated condition.

What do I do when they simply do not take my concerns or opinion seriously? I am so sick and tired of being blamed for this . Or do they possibly have a point? Anyone any experience on this and can advise please?

Why have you made this about you? The focus is on your daughter. If the experts think AD needs to be ruled out then you owe it to her to try. Also, AD can be caused by a number of different things not necessarily bad parenting.

I don't know Nuttynoo. They haven't said they will assess her for AD, they are saying this is what it is. The CAMHS worker has met her twice so this is based, I think, mostly on my answers to their questions. I also asked what happens next, as in what support will we get. 'I'm not sure' was the answer.

Push for treatment/CBT/anything for the AD and see what happens. At the least her behaviour warrants therapy.

I guess I will have to wait to see what they offer but I have a feeling it will be nothing beyond the parenting courses I am already on a waiting list for. I misread your first reply, it's not me making it about me, it's them. Of the 8 sessions, they wanted to spend just one with DD. I really don't see how that will help her unless it is a parenting issue which I strongly feel it isn't. I just can't understand why they won't put her on the waiting list for assessment (around 18 months to 2 years) while we look at other things. If she improved in that time, no problem, just remove us from the waiting list, no harm caused. But that isn't how they are viewing this. I have been judged at every turn. I just want help for my DD.

AD is NOT blaming about you as her parent. AD can and is often observed in children whose caregivers were themselves suffering depression or trauma / stress. You've said that your DD didn't directly observe any abuse directed at you because your X didn't move in until they were older... But if your X was abusing you, she may have seen the AFFECTS on you. No-one is blaming you - this is no more your fault than it is your daughters.
AD as a diagnosis, means treatment, that is specifically designed to help your daughter and therefore you.

I've got two dc with asd. Frankly someone of the "professionals" really aren't. Several of our local paediatricians still think kids can't have asd if they make eye contact. Regardless of whatever condition she has it is essentially a label do whatever you need to access therapy. Personally if you feel it's asd I'd parent her bearing that in mind. A friend of mine saw our paediatrician and mentioned she'd had depression and he basically said the issues her child had were down to her pushing her issues onto her child. Some are bloody useless.

With the hyper mobility and dyslexia and family history of asd I think it is TOTALLY reasonable for you to want asd to be considered as a possibility.

I would want an assessment too.

I am in your shoes but camhs are so stretched that I don't think we will get an ADOS either.

Sorry you've been made to feel bad by a professional who ought to have explained AD better. Attachment isn't 'insufficient' as such, it's categorised into different types (secure and 3 types of insecure), and sometimes even devoted parenting can manifest in one of the 'insecure' types. There is some very shoddily written stuff out there about Attachment - and despite what a lot of it seems to imply, it's not game set and match by the age of three. ASD and AD can look like each other so it's good that both possibilities are being explored.

Also Attachment style can change across childhood, so your daughter could have had a secure attachment as a baby/toddler and still develop an attachment disorder, especially if you've experienced some stressful life events - which it sounds like you may well have.

Tread carefully with this. I had a very bad time with my parents and no part of the help we received was effective because they would not engage or accept any part of their parenting was less than perfect.

I do feel for you in this situation as you've obviously been through an awful time and you've been doing your best and things haven't been easy. But several parts of your post are ringing big alarm bells for me. You seem to be very focused on DD's problems not being your fault and instead are trying to shift the 'blame' onto her and something being inherently wrong with her. The disfavourable comparison to her siblings is also worrying, especially as you are saying that them not having problems shows the issue must be with her. That isn't true as she is an individual with different experiences to them.

Nobody has to be be at fault in this situation, nobody has to be to blame. Things may have gone wrong during a difficult and traumatic time but that doesn't matter now. What matters now is engaging to make things better going forwards. Don't get bogged down with who's at fault here and deflecting 'blame' or pinning it on DD. Concentrate on moving forwards constructively instead.

can you afford a private assemssment with someone who specialises in autism in females?

I suspect that we are going to have similar difficulties with getting dd a diagnosis. she is hypermobile (lots of intervention there) I suspect dyspraxia and autism. I may try for a private diagnosis.

It's difficult to sum up in short posts my experiences so far of the professionals involved and why I feel that I am being blamed.

It wasn't just this one session, there is an implication in everything they do that it is a parenting issue. I do not compare my children as such, they are most definitely individuals, it's just to demonstrate that they are so keen to find fault with my parenting when it doesn't seem to have negatively impacted my other two. I'm very close to ds(17) and he tells me all the time that he thinks I'm a great mum, especially considering that I was only 15 when he was born and that his dad abandoned us and didn't bother with him after age 2.

It's not that I'm reluctant to accept a professional opinion, it's just that I felt he was trying to shoehorn DD into a diagnosis of AD despite lots of things not matching and also lots of criteria for ASD being true.

Unless you've been through the system, it's hard to understand. I certainly wouldn't have believed some of the incompetence until I'd experienced it. The sessions are dominated by him asking questions - there's no real room for me to talk about any of my wider concerns and if I go off topic from one of his questions, he is dismissive and moves onto his next question which very much have the feel of an overall agenda.

This happened to us and then as soon as dd was seen by someone who is experienced with autism she got a diagnosis. Professionals often have no clue what they are doing when it comes to autism im females.

Even though your ex didn't live with you, it seems more likely it's his influence that has been harmful, whether it was directly on your DD and/or through his abusive effect on you. That said, it may not have an easily definable external cause and their deduction may be inaccurate. It must be exhausting but if you feel they're wrong or shortchanging your DD please keep pushing for better help and support.

I think that ruling out AD is a valid point as they do present similarly. But so much of ASD in women doesn't fit into a tick box criteria. The way the man didn't let you talk and targetted the questions does sound like he had his own agenda.

I remember your other thread and am glad the situation has progressed from there. Just think of it as one more battle within the war, another obstacle for you to fight through. You're doing a great job.

I have a teenage daughter with asd. She was diagnosed at 14. At age 3 when I raised concerns her issues were put down to dh being very unwell at the time and 'chaotic' life. So we had no help. I read and read about female asd, we adapted our family, we did the courses, she had speech therapy, physio. And we coped.
At 12 she hit secondary school, fell apart and we tried again for an asd diagnosis. 2 years later it was confirmed. But because our family understand all her quirks and give her time and space as needed, and her school have also had everything in place already nothing changed.
Read up on female asd, put things in place yourself, and keep going. There is no treatment, it is just about understanding the way your daughter is.

I have had experience of very poor treatment through CAMHS so don't buy into all this the professionals know best business. Psychologists are really not best placed to diagnose ASD. You need a good developmental peadiatrician to start looking at this. You may be better off booking an initial appointment with someone privately. Daphne Keen is often mentioned on sn children threads as someone who works in both NHS and private. As far as camhs is concerned, try not to be too defensive as they are in my experience very difficult to deal with and v unwilling to change their views. You are entitled to a second opinion and could maybe simply say that whilst they are perhaps correct, you would like asd ruled out by a specialist as asd can present v differently in girls and be hard to distinguish from other disorders.

Misdee is correct that there is no treatment as such (& with rocketing numbers of HFA & cuts not much support either) so understanding what she needs & getting that in place is more important than the dx.

My friend had an adopted dd whose behaviour was similar to that you describe for your dd. She received a diagnosis of AD due, it was presumed, to her rocky start in life (extreme neglect). The struggled on for several years, seeing experts, theraputic parenting etc etc. Nothing helped until her dd was diagnosed with ASD age 12. That helped.

AD and ASD may present very similarly but the parenting required in response to them can be very different. I think you are right to be concerned about any apparent agenda in diagnosis.

OP,
I can't speak for AD, but can agree that autism in girls is totally misunderstood and until you see a behavioural paediatrician who has experience in girls you will not know if she has it or not.
I think your gut instinct is telling you that she needs to be assessed via an ADOS for autism. It's a shame they won't put her on the waiting list to rule it out. There are proffesionals who do it privately but obviously costs several hundreds of £.

Your story and others on here echoes my own story - Dd is 12 - was told it was probsbly reactive attatchment disorder (ie horrendous abuse between 0-3) by a cahms nurse who had 'read an article' when she was 6 - this was retracted but we were dropped by cahms. I have paid for private play therapy - and the therapists 1st question after their 2st session was does she have add? I have an older boy who is diagnosed with asd and while it presents differently as a parent I can see that the social and fixed mind issues are the root cause .

In some ways the cause is irrelevant and what you need to find out is what strategies they can use to support your dd and family. In our area support for children with an ASC is minimal by CAMHS even if they have associated mental health problems and you might get more support with an AD diagnosis. I guess the question is if it is an ASC rather than an AD whether the strategies used might cause harm rather than be of benefit.

I feel very differently to most of the posters on here. I totally understand how OP feels.

I'm very surprised by the responses. If this was in SN, I think the responses would be different. Maybe get it moved OP?

Parent blaming is awful. And it's rife!! Most of the well known posted in the SN section have had offensive remarks made to them by teachers, senco's, Health professionals, pead's etc, implying it's not ASD, it's not AS, it's just bad parenting.

And actually that is often very offensive.

So, how is this any different?