It's impossible to determine if it's trauma or ND

[Goldandpurplezebra]

...because psychiatrists who diagnose autism & ADHD aren't qualified to diagnose trauma and trauma therapists aren't qualified to diagnose autism.

Please correct me if I'm wrong. I just don't know how to go about working things out for myself. I don't know weather to invest my finances and my trust into trauma treatment or into getting assessed for autism and ADHD.

Regarding my ex, who had both, I was told by the therapists that there was no way to work out ND until the trauma had been dealt with. So the focus had to be on that first.

If you have had trauma, it would need to be dealt with first before moving onto any ND. If your trauma was at an early age, I'm not sure how to tell when you're reached that point though.... sorry.

How do you diagnose trauma?
Genuine question.
Is it via a brain scan?

There are definitely professionals who assess and treat both Autism and PTSD- for instance some clinical or counselling psychologists , some psychiatrists - but not all as although trauma assessment is part of a standard clinical training for most, autism assessment training is specialist and not usually included in a general clinical training. So you need to search for people who are trained with both ptsd and Autism- if you can afford to go private, you can start with the BPS.org.uk find a psychologist tab and then advanced search for both terms ptsd and autism and see who you can find near you.

I think anyone who is late diagnosed with any kind of ND will inherently have some trauma because of their experiences through life.

Maybe the question I'd start with is, when did the signs and symptoms start and what are they? Has it always been present or was there a precipitating event?

I hope you can find a good professional with understanding of both who will work through it with you.

Trauma vs ND can be a bit chicken and egg since ND makes you more vulnerable to trauma, but equally, significant complex trauma at an early age has an impact on brain development which could in theory lead to someone meeting diagnostic threshold for an ND who may not have in a safer environment.

To answer your question, there very much are clinicians experienced with both trauma and ND. Generally clinical psychologists due to the broad areas of working but also psychiatrics with specialist interests. I would argue that any clinician involved in diagnosing ND should have the knowledge to assess trauma and consider whether it would be a more appropriate explanation for the presenting difficulties, but may need input from clinical psychology or psychiatry to fully assess - trauma is one reason why the guidelines for ND assessment recommend a multidisciplinary assessment.

In your case, my suggestion would be to work out what the biggest difficulties are that you have or certainly what you feel is the priority to address. It's possible the outcome of an ND assessment would be to recommend trauma therapy if you're presenting with symptoms like flashbacks, dissociation or hypervigilance, as regularly triggered trauma symptoms can make it difficult to assess social skills for ASD and attentional ability for ADHD. Whereas the outcome might be different if your difficulties are more in relation to how you interpret and manage social situations, then an ND clinician might be able to help you tease out if those thinking processes are in line with ND or more in keeping with being a response to traumatic experiences.

This. Treat the trauma first, then if the issues are still having a big impact on your life get an assessment done. Even then if it comes back as you have ADHD but not Autism, sometimes ASD doesn't become obvious till the ADHD is treated, it can be a lengthy progress.

The thing is it's not clear cut trauma. I don't have PTSD, flash backs or anything like that.

I struggle to be on my own. I'm not sure if this is due to my parents leaving the country when I was 19. Or if it's an ND thing....that my brain struggles when it's not stimulated.

I don't remember being like that before my parents left but I was never alone as I lived with my parents and my mum was always in.

In my book it all stems from early trauma and that trauma can be very subtle.

@GreenBiscuitr well I disagree with that. People can definitely be born with ND.

I don't have any childhood trauma

Clinical Psychologist can help.

From personal experience if there is PTSD, they won't even entertain an ASD diagnosis as the PTSD can mimic some of the ASD symptoms. They would want to wait til you get to a point where the PTSD is 'managed' before looking at any other assessments.

It's way more subtle than PTSD. It's more like anxiety when I'm on my own

The Coventry Grid compares trauma and ASD, and is worth looking at.

However, it is quite possible to have trauma/attachment disorder and be autistic. Both my DCs have a dual diagnosis (from a consultant psychologist).
While they clearly have experienced trauma (both adopted) many of their difficulties can’t be explained by trauma/attachment such as echolalia, v literal language, stimming with their hands.

Also you ask if it’s trauma/attachment disorder or ND. Trauma v much is a ND - it affects the wiring of the brain and can result in life long difficulties. I find it quite frustrating when I hear people say (irl, not you) that it’s ‘just trauma’ . It makes parents of kids with trauma/attachment disorder feel very isolated as if we don’t fit in anywhere . NT clubs, groups etc can’t cope with the children yet they aren’t recognised in (some) ND clubs and groups either. I recently met a Senco who’d never heard of attachment disorder !

Sorry, I meant a clinical psychologist (as part of a mdt with SALT, OT and specialist MH nurse).

The did do MRIs of Romanian orphans and found more abnormalities in children who’d been furthest away from the door of their ward (so less contact and interaction with other humans). I remember this breaking my heart when we were doing our adoption training.

However in the UK now with children they tend to take a detailed developmental history and look for particular factors to diagnose attachment disorder/ developmental trauma. They also observe the child in story based role plays to look at attachment styles.

The Coventry Grid is worth looking at for a comparison of the two, but as I said above, you can tick boxes in both columns and have a dual diagnosis.

When I did my ADHD assessment there were screeners for other conditions. I recognised autism and narcissistic personality disorder and clinical depression but can't remember what the rest were. There might be something screening for trauma in that part? It came up in the screener that I should also be assessed for OCD for example. Because it was borderline, the doctor just said don't worry let's focus on the ADHD but I might go back to it in the future.

I think if the main trauma was being abandoned by your parents aged 19 I'd probably pursue the neurodiversity line. Not because that isn't traumatic but it doesn't sound formative like c-ptsd for example.

However, not a therapist. Might be talking complete bollocks.

It’s really challenging because a ND child may have had trauma before or after they were diagnosed as ND or an NT child may have had trauma before being diagnosed as ND and so it’s not possible to know whether someone was born ND or they became that way through trauma.

I would have thought an adult who had a sudden change of personality after certain life events would be diagnosed as trauma rather than ND though.

I work in a SEND unit for children and many are there because of trauma and there’s been a massive focus on being trauma informed in many schools which I think is really good.

For the majority of my students I couldn’t tell the difference between the trauma students and those born with ND.
There’s a chance they could also be both.

I always thought I was born ND but the more I learn about trauma and reflect on my childhood, the more I realise my behaviour could easily be a result of trauma.

How early do you want to go? Because a lot of parents can go back and pick out the signs from when their kids were months old. I've no idea what possible trauma happened to my DD in the first 3-6 months of her life or even in the first 2 years really because after 2 she started setting alarm bells of in my head.

Early childhood development is the key surely?

Attachment disorder can mimic some ND. You mention your parents "leaving" you, this makes me wonder if the fact you've mentioned this is telling you it was perhaps more significant than you thought. Were there any previous instances that made you feel unsafe or that your parents were unavailable to meet your needs. Some children experience this through parent being a carer, being long term ill, jail, addiction difficulties, mental health issues, grief. This in no way aportions blame to parents, it's circumstances.

This made my think of this blog post.

www.theplightofthesendparent.co.uk/separation-anxiety-and-the-send-child

DD struggles a lot being without me and I know if I left her it would mess her up, she's only little but I can see that still being the case at 19

Psychiatrists can work with trauma. What gives you the idea that they can't?

I am not a psychiatrist, but do read a lot of psychiatric reports in my job. What you’re describing could potentially be a ND issue or an anxiety disorder related to attachment issues. It doesn’t sound (to my completely untrained ear) like PTSD. But a psychiatrist should be able to make that diagnosis (or at least establish the most likely), that is quite literally their job, so I’m not sure why you’ve been given the idea that that’s not possible. If you don’t mind sharing, what’s the title of the person who told you this?

@bobbytorq @TreaterAnita ...because if I get assessed for autism & ADHD that's all they are testing for. It doesn't say anything about whether they are trauma informed or assessing for trauma too.
I've been looking at psychiatry-uk.com