Should this child be assessed?

[Boutrosboutros]

I'll post soon with my relationship to this child, but I would like to know if you think this child would warrant an asd assessment.

It's a girl, late primary age. No problems with speech - in fact she was early to speak and now has a very advanced vocabulary for her age. She struggles with friendships with children her own age, she can be bossy and precocious and doesn't suffer fools gladly. She tends to play with younger children at school. She struggles on playdates to not control the play and will often suggest 'reading together' as an activity to children who come to her house.

She's a high achiever academically but spends a lot of her time off in a dream world. She's obsessed with horses and ponies and will bring conversations back round to them where possible, although she can also have very high level, adult type conversations about life too. She's very easily upset and worries a lot about cruelty to animals and the environment.

She makes great eye contact and doesn't seem too bothered about routine or changes to it. Doesn't tend to have meltdowns and enjoys following rules and instructions.

YABU - this child may well be ND and it would be worth exploring further
YANBU - this is a normal but quirky child, wait and see what happens

Thanks for giving your opinion!

It would have been unreasonable had you asked "should this child be diagnosed", but isn't that exactly the situation assessment is for - to take a child who may or may not be ND and then assess if they are or not?

I'm going to get roasted for this but I really don't think ASD.

I'm thinking more NPD.

It’s hard to tell from that description but unless school are also raising concerns I would be amazed is she reached the cahms threshold for assessment.

Just like myself and my DD.

Definitely have ADHD and most likely have Autism too.

From what I recall from my DDs diagnosis, a key part of Autism is the emotional regulation (or lack of it). The child described doesn't seem to struggle with that, so sounds more quirky than ND.

Having read your update, I understand where you are coming from. Whenever I am telling my daughter she should or shouldn't do something I realise I need to follow my own advice! We are so alike in many ways. But I didn't have meltdowns as a kid. I have found myself questioning if I am ND. But I don't think I am

Sorry, yes I didn't mean outgrow autism, just either it wasn't asd or I have grown enough to manage it. I did very well academically but not sure I was at gifted level - although DS is very bright but struggles with the academics. I've done a bit of reading around the whole 'twice exceptional' concept and the lines seem very blurred don't they? Thanks for the comments, it's helpful to sound it out a bit to try and get my head around it all.

I love your last paragraph - basically sounds like my own internal commentary: I'm not ND. But I do have some traits. But I don't think I am. But, but, but...

I certainly don't feel like I struggle much in my adult life to warrant even thinking about a diagnosis, but having a child on the pathway does make you ask yourself a lot of questions!

Nothing to do with the thread but every now and then I find the words Butros Butros Ghali rolling round my head as a brain-worm. OPs username has placed it back in there.

haha!

Hi Op - something I find helpful to consider is that we are really in the foothills of understanding Neurodiversity. What it means - whether there is a 'cut off' after which someone is ND. Remember the whole 'diagnostic process' is a human invention fitted onto a lived reality.

One of my children is autistic - I have adhd - but there are some things I have in common with my daughter - my husband is not autistic but has family who are - he definitely has traits! But he would definititely not meet the diagnostic criteria.

Although people don't use the ' spectrum' idea in the sense that 'we are all on a spectrum ' anymore - it is clearly true that you can have some traits of the array of autism traits and not others - you can for example be 'monotropic' (hard to divert from single minded interest ) - without being fully 'autistic'

I volunteer to roast you. This is NOTHING like NPD.

You are describing me as a child, all of it.

I am in my early 60's and currently awaiting a referral for a possible autism diagnosis.

I would definitely say that ticks a lot of boxes for ASD. DS with Asperger's Syndrome doesn't melt down ever - but he takes time out after school to decompress and really enjoys his own company. His eye contact is good too - unless in a very intense/stressful situation, that's when it tends to drop away.

It sounds like all is good so I wouldn't worry too much either way, just accept that you might well be and that is probably why you struggled so much when you were young. You've obviously found your place and people and it's allowed you to thrive.

Yeah this is nothing like narcissistic personality disorder. Someone with NPD wouldn't even have the self awareness to question if they had ASD, they live in a completely delusional fantasy world where they are amazing in every way and other people are just pawns for them to use. They lie like it's going out of fashion and gas light you to kingdom come. They are shallow and selfish but do all they can to 'look good'.

Nothing the OP has said suggests NPD in any way shape or form.

Did you ever have sensory issues? Do you still have them?

Thank you. I think the way we understand this stuff will evolve a lot, and hopefully for the better as my DS grows up. I find the definitions hard to understand and start thinking myself in circles. What's clear is that I don't feel my life is negatively impacted now, so it's not a pressing concern for me - but it's definitely something I'm very curious about!

Assessed to what end? You sound like a functional member of society. I don’t understand this need everyone has to get themselves and others assessed when there’s no actual problem/reason.

Thank you! It did give me pause but when I googled it didn't feel like me! (Or maybe I'm a delusional narcissist!)

Yes I do - but then again I never really thought about it until DS' issues came up. It's just stuff like 'don't touch mummy when she's eating' or 'mummy has to bring her own cutlery because she doesn't like the disposable stuff' which when you list it does make me sound a bit odd 😅

What is AuDHD? Is that an actual diagnosis?

Don't worry, I have no intention of getting assessed for anything! My life is good. It was a rhetorical question really prompted by my own thoughts about my childhood - and I've been overwhelmed by how kindly everyone has answered me and helped me think through some of these philosophical questions about the nature of how we identify and categorise neurodiversity and how attitudes are changing. I shan't be clogging up any systems seeking a diagnosis.

I’ve had the same discussion with DH. DS1 is diagnosed (useful, necessary even though he’s an academic high flier). I probably met the diagnostic criteria at 9 but, having run into my crowd at a highly selective girls’ school for secondary, would probably have fallen back out of it by 14 because my social interactions had improved (learnt rather than innate…I still actively learn new behaviour when something fails) and because my friends were forgiving. And still are. But if I’d be unlucky enough to have higher demands on me then I’m certain I’d have fallen apart.

Absolutely this, people talk with such certainty about ND, particularly ASD as if the current diagnostic criteria will always be as it is, as if the current theory of what ASD is will always be as it is. It wont, its changed over decades and it will continue to change

Im well versed, both professionally and personally with ASD/ADHD and I can say with confidence that theres no way I would have been diagnosed with ASD as a child or teenager, but in different stages of my life I could quite easily have been diagnosed and I wouldnt be diagnosed now in much later life.

Ive worked with so many clinicians who, seeing the child they diagnosed grow up, have commented that they now wouldnt have diagnosed the child with ASD/ADHD if they knew then what they know now about the child's behaviour and development (which of course is impossible)

This.

there was an article in the guardian recently about Audhd

https://www.theguardian.com/lifeandstyle/2024/apr/04/audhd-what-is-behind-rocketing-rates-life-changing-diagnosis

also - a book called Neurotribes Ive been meaning to read