Very anxious 8 year old

[Newuser82]

Hi, I’ve posted this in child mental health but would really appreciate some advice or experience.

I have an 8 year old boy. He is gorgeous and the kindest loveliest boy however we do have some difficulties which I’d appreciate some other opinions on!

He has been diagnosed with dcd and sensory processing difficulties. I do also have some suspicions about autism. He doesn’t like loud noises or busy places becoming visibly anxious (chews clothes and sticks close to me). Hates change , even to the extent of getting new furniture! Is very into history and exceptionally knowledgeable in this subject. Has never liked being away from me and have had trouble in past getting him into school (again once back part time after lockdown). Has had panic attacks in past when talking about staying somewhere by himself or when actually doing it. He worries a lot about getting told off or doing something wrong. This is despite us not putting pressure on him and always praising him for effort. He lives in a very calm environment so I’m a bit at a loss as to where the anxiety stems from and believe me myself and husband (His dad) have done a lot of soul searching about this. He bites his fingernails and sometimes scratches his skin. He is currently receiving ot for dcd and waiting to see a private counsellor for anxiety but I’m just wondering are we missing something And maybe need to get him assessed for autism? Teacher is very good with him but doesn’t suspect autism but I want to make sure we have everything in place for him and getting the right help.

Any advice or experience would be appreciated!

Sorry no advice but wanted to say you’re not alone. It’s been so hard on many kids this recent shit storm so interested what advice others may give. Poor little lad, hope things get better soon.

@irisnotadaff

Sorry no advice but wanted to say you’re not alone. It’s been so hard on many kids this recent shit storm so interested what advice others may give. Poor little lad, hope things get better soon.

Thanks so much!

Anyone else?

Firstly as hard as it is don’t blame yourself. I have been there and beating yourself up for something that is nobodies fault doesn’t help.

From what you have said I would certainly push for a referal for an autism diagnosis, for us the process was actually highly useful as it helped us to understand him more.

My son also has anxiety on top of his autism and other diagnosis, he is medicated for that now which has helped but obviously is a last resort.

Have you tried using visual aids and social stories to help him? May make things clearer for him to process.

It sounds like you are doing a fantastic job.

Has he been exposed to scary things on tv or video games that could be making this worse? Do you give him lots of opportunities to mix with other kids and kind of let go of his worries or is he on his own alot? I have a 5 year old boy who usually is quite relaxed but he's started nail biting since the start of lock down. I'm a nail biter myself though!

First off, just echoing what @Sirzy said - it sounds like you're doing a fab job with him, so please accept credit where credit is due!

I would push for a diagnosis from the docs for sure. OCD and anxiety often go hand in hand (I was diagnosed with the former at 15 and anxiety around 5 years before that). People often find there is also often a 'link' between autism, anxiety and OCD too, so your suspicions could well be right.

Get him an appointment as soon as practicable, and just carry on being you. You and your husband both sound very supportive, which will greatly benefit your son. Good luck.

Thanks for everyone’s replies, it’s really helpful and we are certainly trying our best.

I’m going to have a chat with his ot this week and ask her some questions then again with his teacher in deciding whether to go for an autism assessment.

Yes he has a younger brother as well as regular meet ups with friends and family such as cousins. He is also back at school part time .

We don’t have any consoles and he won’t watch anything that could possibly be scary so I think I that’s fine.

It’s actually dcd he has been diagnosed with (dyspraxia) not ocd but I do know those two are also linked.

Just want to make sure he gets all possible help.
Thanks so much

@Sirzy

Firstly as hard as it is don’t blame yourself. I have been there and beating yourself up for something that is nobodies fault doesn’t help.

From what you have said I would certainly push for a referal for an autism diagnosis, for us the process was actually highly useful as it helped us to understand him more.

My son also has anxiety on top of his autism and other diagnosis, he is medicated for that now which has helped but obviously is a last resort.

Have you tried using visual aids and social stories to help him? May make things clearer for him to process.

It sounds like you are doing a fantastic job.

Thank you. No we haven’t tried those and actually don’t know much about them so that’s something I can look into. Hope your son is managing better now?

A lot of what you’ve said in your OP (including the clothes-biting thing) should help make your case for a referral. If the teacher isn’t convinced, you could speak to the school SENco or your GP. Some children can mask quite well at school so teachers don’t always appreciate the full extent of the situation.

Hi, I’d echo what Ktay said. My son was diagnosed finally aged 11. Not one of the teachers he’d had mentioned it until I spoke to the SENCO about my concerns and when I looked back post diagnosis I realise lots of things I had flagged up were signs he had, but he’s not a very typical presentation and I think if I’d never asked, it might never have been picked up.

We tend to assume that teachers will just know, and in hindsight, there were lots of clues, but among a class of 30 children, lots of his behaviour probably wasn’t unusual, but most other children probably don’t have ALL those behaviours, if you see what I mean.

If you are concerned then push hard for a referral, children can and do mask, and I truly wish I’d been more persistent early on.

Thanks. Can I ask possibly a very naive question? He is very a kind and empathetic boy. His teacher has said he has a very high level of emotional intelligence . A lot of the stuff I have read about autism says this can be something they struggle with. Would this discount him being assessed/diagnosed? Thank you and sorry if this is a stupid question

Not stupid at all - there’s a saying ‘if you’ve met one autistic person, you’ve met one autistic person’ (or something like that - probably pithier) meaning it presents in so many different ways, making it hard to pin down. I’m new to this as my 8yo was only diagnosed in Feb (I encountered polite scepticism at school/nursery the few times I raised it - fortunately CAMHS picked it up when she was referred for anxiety) so am far from expert. But apparently it’s a common misconception that autistic people don’t feel empathy - they can feel it very deeply, sometimes overwhelmingly so.

Not a daft question at all. My son is very empathetic and kind, he is the one who goes and get a tissue for any peers who he sees upset. He struggles with his own emotions but that’s just him!

My son is very sensitive and articulate. I think there is a tendency to think of Autism on a linear scale, where really, it isn’t like that. You can have lots of autistic traits, but without the Triad of Impairments, you aren’t autistic.

I found this info really helpful when we were undergoing the process of diagnosis, it helped me to understand why so many teachers said well he doesn’t seem autistic to me, and yet when speech and language assessed him, there were lots of quite obvious things she picked up.

the-art-of-autism.com/understanding-the-spectrum-a-comic-strip-explanation/

Sounds very much like my DS who is nearly 9. We were told for years that he was not autistic because he can have conversations, is empathetic etc but his anxiety has got a lot worse in the last year. Lots of finger and clothes biting, refusing to leave the house, refusing to participate in sports he previously loved. He has always had OT for priprioception issues but his behaviour at school was getting more bizarre so I asked for an Ed psych assessment. The Ed psych suggested an autism assessment so we did that and he was diagnosed. He is at an independent school and I pay for all his OT and all the private assessments and will continue to pay for all the help he needs. The GP totally dismissed me on more than one occasion even though I now realise it was obvious that he has Autism.

Thanks that’s all really helpful and gives me a lot to think about. I’m also wondering 1. How was the assessment process? And 2. Has it been helpful ? He is doing great at school (once he gets in!) and has friends, it’s just in certain situations he struggles!

We went for private assessment in the end as the pathway here can be a couple of years. I would say at 8 it wasn’t a particular issue and we knew he was a bit ‘quirky’ but thought not too much of it. Watching a film when he was around 10 brought it home to me, along with some social things that happened around the same time. I thought he had language issues, it turns out it was a greater issue than that. I am very glad we went through the process. Regardless of how the world outside sees him, it helped us to understand and be more patient when he chewed through his 4th school jumper in a year.....

I think we were lucky as it took 6 months from first CAMHS appointment to diagnosis. A few questionnaires initially (DD didn’t register on the quantitative ones initially but I accompanied these with a letter detailing my concerns and put lots of thought/evidence into a follow-up ‘last resort’ qualitative questionnaire. The CAMHS neurodevelopmental (I think?) team put her through for an ADOS assessment on the back of that, which involved an interview with a clinical psychologist for DH and me (developmental history), a meeting for DD with a speech and language therapist and paediatric nurse (this was the assessment that got her taken seriously) and a v perfunctory report from her class teacher. I think we were lucky that CAMHS were pretty open-minded/perceptive in the early stages and diagnosed her even though she didn’t quite meet the cut-off in two of the three ‘triad of impairment’ areas mentioned above as they felt it was in her interest to have a formal diagnosis and acknowledged that these things aren’t always clear cut with girls.

The timing meant she got diagnosed just as specialist parenting classes, support groups etc were closing down (Coronavirus) so we haven’t had much formal support yet but school have been great at putting things in place to help ease her transition back to school, so it’s been really helpful in that respect, also in terms of cutting her some slack when she struggles to cope with ostensibly simple requirements. Got to go and help her with home learning now!

Both of mine started to have difficulties around the same age and were diagnosed with HFA at ten.

With the benefit of hindsight:

Ask for referrals to SALT (may be language processing difficulties). ds1 and ds2 were very articulate but had real processing difficulties particularly when anxious. Simple, one step instructions helped with this or written instructions.
It might be worth checking if he can read facial expressions. ds2 was really bad (and still is not great at doing this). Imagine how difficult it is to communicate effectively with your peers if you can not do this & how anxious it must make you.
Establish a routine at home so your ds has some security & knows what to expect each day. Make sure in this schedule he has lots of down-time to destress. Although people mentioning visual timetables as a solution gives me the rage they can be a helpful tool.
Start making a journal of when he has good and bad times. This will help you identify what the triggers are for his anxiety & will be helpful if you enter the diagnosis process.
Acknowledge the anxiety but do not pander to it. You do not want to dismiss his feelings but at the same time you do not want to escalate them. Easier said than done a lot of the time. It is really hard with all the doom and gloom going on in the world for some of it not to be picked up by the children.
Open up a dialogue with school and ask for their help. Although at first my ds's school did not see any issues some specific questioning did highlight issues. E.g. If you asked did they have friend the answer was yes but if you asked who their friends were they could not come up with a name.

Thanks again! We have a lot to think about!

When you say you're 'at a bit of a loss where the anxiety comes from', there might not be a clear reason or cause. You might find looking for it is fruitless though I understand why you might be trying to identify it to presumably remove it and reduce you child's anxiety.

I'm not trying to be difficult but children's personalities are complex and often don't have clear, certain causes and effects like you may be looking for here. IME, when people think they have identified a clear cause and effect then they are often wrong. It can give them comfort if they think they are 'not to blame' or be a cause of hurt if they think they are but it usually isn't helpful in moving things forward with respect to the child's behaviour.

Good luck.

@Zilla1

When you say you're 'at a bit of a loss where the anxiety comes from', there might not be a clear reason or cause. You might find looking for it is fruitless though I understand why you might be trying to identify it to presumably remove it and reduce you child's anxiety.

I'm not trying to be difficult but children's personalities are complex and often don't have clear, certain causes and effects like you may be looking for here. IME, when people think they have identified a clear cause and effect then they are often wrong. It can give them comfort if they think they are 'not to blame' or be a cause of hurt if they think they are but it usually isn't helpful in moving things forward with respect to the child's behaviour.

Good luck.

No, I understand what you are saying and it makes sense but it’s a bit soul destroying to see your child fall to pieces over making a mistake with school work for example when really all I’m bothered about is if he is happy. That’s what I mean. And if we were always screaming at him or whatever. Say if we were the type of parents who put a lot of pressure on him to always get things right I could understand it. But I understand what you are saying. Thank you

I’m not looking to absolve ourselves of blame , I’m just wanting to understand him and help him as best as we can.

We were told about something called "The Stress Bucket" to explain why little things sometimes cause out of proportion issues (and also why something one day will cause an issue and not the next). Basically it means you can only stand a certain amount of stress in the day. So going to school might cause a certain amount of stress, then finding out you've got a supply teacher might add a bit more, then someone in the playground accidently brushing into you at morning break puts a bit more into the stress bucket so it's nearly at the top so that when you go back into the classroom and you get the answer wrong to the question the bucket of stress overflows and all hell let's loose. When ds1 got good support at school (he ended up a special school but this should not be necessary) we found he was a lot more able to cope with things like making a mistake in his school work whereas it would have caused a major meltdown prior to this.

OP, I understand it is soul destroying. I suppose your later post hits the nail on the head - rather than trying to absolve yourselves of blame, I was trying to say you may not be to blame at all. Sometimes personalities just are. One way of explaining it might be to say although some siblings with the same parents have similar personalities, some siblings have wildly different personalities with no difference in parenting and no traumatic event. I know two friends where their siblings have someone very outgoing and someone incredibly anxious/with MH where the siblings themselves and their parents can't 'figure out' why.

I'm not saying parenting has no effect, nor that genes have no effect nor that traumatic events can't have an effect but sometimes personalities differ. You seem to be a caring parent and I know it will be distressing for you but don't be certain you'll find something you've 'done wrong'.

Good luck.