MH issues in 5 year olds other than ASD?

[Flyingwasp]

If anyone has a child around 5 with a diagnosed MH issue thats not (typical) ASD. Could you pls tell me about the most telling signs (or quirks) that prompted the specific diagnosis?

My 5 year old seems to be struggling a lot and it has really impacted our lives. It’s been going on for years and I gave up on hoping he’ll outgrow it. Of course, I thoroughly read up on ASD and ADHD but quite frankly these don’t seem to fit (even at a stretch).

I know I’ll need a professional to diagnose him but I’d at least like know what direction to look. Any kind of professional diagnosis will be years away as he’s high functioning and it’s normally the “wait and see” advice I’m getting.

Family members think it’s only due to bad parenting and I agree that’s very much a possibility. But, still, there’s a possibility he has some underlying problem that would need a specific approach to manage, so I’m just trying to gather more info.

@Geneticsbunny thanks, i think it could be that for whatever reason his tolerance to these “annoyances” is very low.

Unfortunatelly, I don’t know how we could lower expectations any more, the rules are just the most basic ones.

@PumpkinPatchingUpdate i need to get this book, heard it’s very helpful.

Having read a few more of your responses, your son sounds very much like my son was. He did turn out to have ASD with high anxiety.

He also did not respond to reward charts (increased anxiety), couldnt be bribed and couldnt care less about removing toys.

Things that have helped him have largely been about understanding sensory issues and responding to them. An OT was essential for this because we didnt know about proprioception and interoception and that has been key to helping him regulate.

We also had to wrap our head around our chatty child actually having communication issues. Once we knew he had social communication issues we could support them. And once we knew he had receptive language issues we could make sure he really understood what was happening. Doing only one or two step instructions, 'now and next language' use visuals to support things etc.

We also found that uncertainty and too much choice made him anxious. So although he didnt need routine. He did need to know things like what a building might look like before we went. He might need to rehearse situation in advance.

At his worst he was in a permanent state of fight/flight and the stress all came from his mainstream classroom. Which was noisy, chaotic, too much information to process etc.

Can’t have a safe space for calm downs as he wouldn’t stay in there, he comes after me trying to hit. If I keep a door shut between us he tries to break it down and gets even more stressed and violent. His room is pretty empty it still doesn’t work. It’s also quite nasty to keep him in a room against his wish when he’s clearly upset so it’s a last resort.

Whatwasthepoint that all sounds very sensible but if this child is neurodiverse or has some sensory issues which are causing the meltdowns (very probably a combination of these or more), your suggestions would not help and would just be punishing a child who can't help their behaviour.

Whatever is triggering the behaviours needs to be unpicked first... and this could take some time, even years and will probably need a lot of support.

As I've already said my child is likely neurodiverse and these all help with resolving their issues. A safe space to meltdown, an understanding of how to process emotions, an explanation that big feelings are normal but we need to learn how to manage them because smashing things up is not acceptable. Whether a diagnosis or medication is involved is down to the OPs professionals.

Dysregulation is absolutely not their fault but what is our responsibility is to guide them to safely manage their emotions to function as best they can as they grow. Being a ball of rage at 5 is one thing, being a 6 foot 15 year old ball of rage is quite another. It's up to the OP to gather all the support she can and unpick these meltdowns to the level she can see one brewing and step in with a coping strategy before the rage ball fires. Whether she finds the techniques in the book that's been recommended (and I'm going to buy that too it sounds good!) Or via official channels or trial and error is up to the OP to weave through. I'm simply articulating my experiences and what has worked for us.

ASD is a neuro developmental condition not a mental health issue… and a 5 year old with bi-polar? 😫 poor child.

Also don't forget a lot has happened for a 5 year old. They've started school, they've met dozens of new people, they have new behaviours and skills they're expected to learn and master that all come with consequences. They may be impeccable at school and the exhaustion coupled with anxiety and when they get home the mask slips and it's meltdown central. It's very nearly Easter holidays poor kid is probably shattered and may benefit from an earlier bedtime

Go back to basics.

I dont think you should rule out ASD - it doesn't necessary present as you might imagine.

have a look at this - its very good at explaining why ASD can look so different in different people
https://themighty.com/topic/autism-spectrum-disorder/rebecca-burgess-comic-redesigns-the-autism-spectrum/

I also don't think you should rule out Autism. Some of my daughter's traits only became apparent as the gap widened between her and her peers. E.g. her social skills weren't really out of sync at 5 but it was obvious by 8 that she was missing social cues. I think you've mentioned enough on this thread for it to be worth considering a referral.

Have you looked at the Coventry Grid which compares attachment difficulties with ASD traits? I was looking at this when DS's first therapist thought he could have attachment difficulties because I had been a single parent (🙄) but it is helpful to understand more from a possible diagnosis front.

DS was hugely aggressive with screaming meltdowns until age 10, when he could start to take more control over what he does when (eg set his own timetable for getting ready for school). He is autistic with an avoidant profile.

@Luckymummytoone thanks, that was most helpful… I’m obviously not a medical professional and all I was asking in my OP is a couple of stories/anecdotes as to what other kids this age have been diagnosed with based on their main symptoms. Just to know a bit more about alternative diagnosis to ASD. And lots of the replies have been very informative.

@Whatwasthepoint thanks and you made a lot of great points. I know something has to change and will need to try getting him to learn to calm himself down better.

@Spendonsend thanks a lot for your reply, this is very much the case with my Ds in terms of bribes, etc. For some time, even positive reinforcements didn’t seem to work, he hated rewards for good behaviour at some point (although it works a bit sometimes). The communication issue of your child is very interesting, can you give an example of what was a challenge for him to communicate? Our DS is very chatty too and his language development seems brilliant but i think there could be a few things he struggles to communicate with words…

Do look at a SafeSpace or similar. Sometimes they can be funded via OT. There are also charities that can help fund them or loan them.

What support is DS receiving via school? Does he have an EHCP?

@AceofPentacles attachement issues can be a part of our problem maybe. He’s had very strong separation anxiety and is clingy.

I actually find it hard to explain the communication issues. He is a teen now and it still working on identifying and labeling his emotions/feelings. So he didnt have the language to say a lot of feelings because he didnt know what they were. To him sad, anxious, angry, hot, hungry, tired, hurt were all just one thing. Excited and frightened felt the same. Hot and cold feel the same.

But his main issues are about understanding others so their tone, takes people literally. Cant follow lots of instructions in one go. Group conversations move to quick for him so its very frustrating for him. unwritten rules like everyone just knows are not clear to him.