To ask about ND masking in girls - school say she seems 'fine'

[seriouslynonames]

My DD8 is in year 3. Waiting for private assessment for ADHD (GP suggested quicker than NHS esp as infant school at the time saw no issues).

She is extremely anxious all the time, about lots of things, and it shows up in her body in the form of unsettled tum and nausea. She has short periods most days of seeming more relaxed and happy, but spends much of each day on edge, nervous, worried or angry.

She says she hates school, doesn't want to go. Being there makes her angry, makes her want to scream. She feels nauseous or funny tum most mornings (also for weekend out of school activities) and goes to bed feeling similar most nights. Says school is too loud, too many strict rules, being told what to do all day, can't concentrate, friendship issues make he'd upset or angry. She feels the need to move all the time. She only enjoys extra curricular activities before/after school, plus art. She isn't struggling academically so far. She also worries about feeling or being ill at school or others being sick in front of her at school. That's a big issue at the moment.

When I talk to school they say she is doing well, gets work done to a good standard, isn't disruptive, follows directions, keeps her desk neat, puts her hand up, takes turns, is polite and helpful, gets on fine with peers and adults etc. they can see the fidgeting but that's it. They have given her ear defenders and a wobble cushion after I mentioned a couple of things back in the autumn, but would not have offered if I hadn't raised it.

At home we see such a different side to what school see. Extreme anger, aggression, destruction. Very low self-esteem and very worrying negative self talk. Constant anxiety and physical symptoms/feeling ill with it. Always moving, can't sit still.

She didn't make it to school Monday to Weds this week. Said she felt sick and tummy felt jumbled up. Said it was worse than the usual nervous feeling she gets so I took it at face value and kept her off. Tried to go in Tues but ended up coming home before school started as felt sick and looked green. Then Weds she seemed better so got ready to go in then it was too much, she just couldn't leave the house she was too nervous about still feeling ill and absolutely would/could not go, hates school, doesn't ever want to go.

Spoke to school today (she went in today/yesterday after a struggle) who want to address the school avoidance but repeated that when in school she seems 'totally fine'. And to be fair to school, when she comes out at the end of the day she is generally ok. It's only later in the evening when it all goes to s*.

I just want some views on whether it's possible for a child to mask so fully that despite me having been pretty open with the school about what we see and what DD says to us, that school just don't see anything? Surely DD couldn't make up all this stuff she tells us about how school makes her feel? We know the anxiety is very real and the anger. And I believe what she says about how school makes her feel. But then I start to doubt myself when school say how completely fine she is!

Would welcome others' experiences of masking please x

I know you are getting her assessed for ADHD but I would look up ASD and consider whether that is more likely. There is a huge overlap but what you are saying sounds much more like autism than ADHD to me (I have daughters with both and am also autistic).

Girls mask very well and I don’t think many teachers have the time or resources to do too much to help them if they are getting through the school day.

I could have written your post word for word. We are at the beginning of the pathway to ASD assessment - but there is an 18 month waiting list for NHS where we are. School actually recommended we look into private diagnosis. DD, also 8 struggles so much getting into school that the Head lets her in a separate entrance where it's quiet and she can sit and regulate herself, it's just outside his office so he understands that although she is well behaved and academically above average, she is really struggling outside of school and that every day getting her in is a battle. So in answer to your question, I think girls 💯 mask very effectively, when they know they have to. At home, DD has violent screaming meltdowns at the slightest trigger, barely sleeps, has really restricted what she will and won't eat. But she manages to keep it together in school - which of course leads to overwhelm when she gets home and can let it all out.

I hope you can get her the support she needs.

Trust what you already know. It sounds as though you've been doing a great job advocating for her so don't let what school doesn't see put you off. My advice, if you can possibly afford it, is to get her some therapy with someone experienced in working with neurodivergent children. Don't wait for the assessment. As Snowy says,it could well be autism, or both, so contact the provider and ask if it can be converted to a dual assessment.

This sounds so familiar. My DD is a similar age and it feels like this year things have got really tricky and her issues seem to be getting so obvious and much more difficult this year.

even her report mentioned that she struggles to get to school but is fine once she’s there. But then she talks about how she feels and what she worries about and I feel unsure that I’m doing the right thing sending her in.

I have considered flexi-schooling, so she would have a certain amount of time off each week.

i have no advice I’m afraid!

Sound like my DD. Suspected ADHD and Autism

DD is 9 and in year 4 and the last 18 months have been brutal. She was really struggling at school, was constantly being physically sick at school, nausea, headaches, rashes. No allergies or anything and all only ever at school

Shes polite, engaged with staff and peers but comes home and is absolutely awful.

Our school has full classes and half classes so a class 3, class 3/4, class 4.

Me and school decided to change her from class 4 to class 3/4 and she has stopped being sick, rashes have stopped and have headaches. She still comes home and has her meltdowns but I understand,

I'm dreading next year when she has to go into class 4 or 5, I worry how she will cope

After school restraint collapse is a recognised phenomenon in ND children.
https://spaceherts.org.uk/2022/09/08/after-school-restraint-collapse/?amp=1

Dd hid ASD until she was nearly 16...

I’d also recommend looking up the Autistic Girls Network for further advice and support.

If school won’t support an assessment and you go via your GP, do you know about the Right to Choose route?

Thanks for quick replies! @TheSnowyOwl @MoMandaS the psychologist we have seen a few times (before getting on a waiting list) thinks she isn't autistic (something about her communication being good/not showing the communication difficulties you might expect with autism) so we didn't go for a dual assessment on that advice. I have, however, wondered about it as she does show demand avoidance - but not all the time. On what I have read, I am not convinced she will even get the ADHD diagnosis as it's meant to show in more than one setting - and school don't see it. And when I look at what assessments look at with autism, I don't know that she would meet the threshold. It's very tricky to navigate all this!
I need to figure out what kind of therapy might help, the sessions we have had so far have been helpful to us but it's hard to implement things with DD and it has been ad-hoc rather than regular. Thanks for both of your replies

Thanks @2020in2020 it sounds like school are supportive, good luck with the long wait. Violence is a significant issue for us at home too.

@Hunkyd0ry flexi-schooling sounds good. I need to look into the options, as I can't see DD getting through the next few years of primary as things stand... Wishing you all the best too

I performed well at school but was a massive school avoider. I was the under the radar child, should speak up more child, always reaching targets child, has awkward friendships child. I fell apart at secondary school. I still performed well academically but fell WAY behind socially. I avoided school and ended up in massive burn out before GCSEs. Look at ASD.
I also saw a phycologist during this time. They never clicked onto autism due to my masking. I'd spent so much time learning social cues I didn't even realise I was faking it all, and neither did they

Thank you, I will check out their resources. I think I looked before but when the psych said she didn't think any ASD, I have looked more at ADHD and how to handle the anger and anxiety.

Thank you. I will ask the provider we are using about possible signs of ASD when we get to the stage of actually talking to them (only been forms to complete so far). I guess it's entirely possible the person we have seen this far has missed it due to masking...

I may be very wrong here but I'm not sure that teachers are often adequately trained to spot signs of neurodiversity in children. It's just not their job.
They can obviously spot glaring things like meltdowns etc but I think a lot of the more subtle signs may go unnoticed. Particularly in a child good at masking.
We have just received an autism and adhd diagnosis for my year six son. Every single teacher he has ever had I have raised the question of autism, each and every one of them said they had no concerns.
I knew he was autistic, he hates loud noise, can't cope with a change in routine, when he was in reception and the lesson order changed for the day my son got really upset, the teacher told me herself that she had told him he was overreacting, he used to run away after flushing the toilet in school as it was too loud, we had a nightmare getting him into school for years, he would chew holes in clothing, doesn't make eye contact with people he isn't comfortable with, has obsessive interests, has struggled socially in the past. Pretty textbook autism, each and every teacher has said, no, they don't think he was autistic. Took him for an assessment, definitely autistic. As well as other things.

I'm not having a go at teachers at all. I'm simply saying I don't think it is easy for them to spot it as they aren't qualified to do so.

I would say with some certainty that she has autism alongside her ADHD. I'm a SN parent and this describes my son perfectly.

Thanks. Yes I have heard it called that. It's not an immediate thing, she can cope with an after school activity/club and actively wants to do them. It's usually only dinner time onwards that it all comes out.

Take a look at DefineFine, NotFineInSchool, MissingTheMark and Dr Naomi Fisher on Facebook.
They're incredibly informative and supportive spaces for children facing significant difficulties in education.
Wishing you and your DD well.

I also agree she sounds like she is autistic. The threshold for many assessments is geared at males so I would recommend finding an assessor who is experienced in assessing girls. It is not the same and not all professionals have kept up to date with the literature.
and I know dozens of girls with ASD who already considered ‘excellent communicators’. They have learned it to fit in socially.

As others have said it sounds more like ASD than ADHD if anything to me, but could also just be anxiety. ADHD is much more difficult to 'mask' and I would worry about paying lots of money for a private assessment and her not meeting criteria. Instead I would focus on getting the right support/environment at school. Support should be needs based and unless you would be looking to medicate a diagnosis won't change much. As others have said have a look at ASD resources and anxiety resources. At her age individual therapy for anxiety isn't that effective and parent led approaches are better. It sounds like she isn't coping with school environment but that doesn't necessarily mean she is Nd.

100% this is what girls with ASD do. I took my daughter to the doctor's and managed to get a diagnosis after about 2yrs. Went to the school for back up - they didn't notice anything different about her. This obviously made me question myself and doubt wether I was right. Girls mask so well and schools are so busy. You don't need backing from the school to explore potential diagnosis with for your child.

I agree. This was DD. School thought she was fine. No problems with communication. It was of course intense masking, which was exhausting for her. Her autism wasn’t diagnosed until after she left school.

Thanks for all the further replies. I am fairly sure about the ADHD but have flip flopped over the possibility of ASD as well. When the psychologist said she really didn't think so I took that on board. She said she didn't think there was evidence for a dual assessment but definitely for ADHD. I will contact the clinic we are booked at to find out either whether I can switch to dual or whether (if I can't without starting the clock again) if they pick up any signs it might also be ASD while assessong her for ADHD I can 'extend' the assessment to include ASD. Ultimately I just want to meet her needs whatever they are. I have done a few of the Naomi Fisher webinars and found them helpful in thinking about what the future might hold in terms of education. Will keep trying to nudge things forward. Thanks for all the wisdom x

I did ask could it 'just' be anxiety, but the psychologist thought not, her need to move was too extreme.

We have definitely also considered that she may not be ND at all, we started out down the path of our parenting just not suiting her, and how we could adjust that to suit her better. But that has never quite been enough and her needs have escalated as the demands of school and the world have done.

I can hear things kicking off now, so will be back later!

Thanks

Another voice added to say she sounds just like our 12 yo autistic DD.

Second the Not Fine in School and Dr Naomi Fisher recommendations

She sounds exactly like my daughter, diagnosed with autism after we went private, currently waiting on adhd assessment. We were never taken seriously when trying to talk to school about what was going on at home as she was a model pupil and very social. At home it all crumbled. They only listened when in year 4 we struggled to get her into school and they had a glimpse of what was really going on. Trust your gut, you know her better than anyone. In my experience, girls are highly skilled at masking but amazingly schools etc still seem ignorant of this. Best of luck to you and your daughter x

Exactly like my 8 year old DD. No one would believe me what happens at home as she was ‘fine’ at school.
I bit the bullet, saved up and she had her private assessment as few weeks ago. She is autistic and adhd.
now the school will listen to me. Just have to sort out the support she needs now