Does this sound like neurodivergence or a sensitive temperament?

[kvazzy]

Hi everyone,

Posting on AIBU for traffic.

I’m trying to make sense of my DD’s profile and would really appreciate balanced perspectives, especially from parents of neurodivergent children or people who know this area well.

My DD has just turned 5 and is in Reception. Overall she is doing well. School are happy with her progress, she is developing well academically and teachers say she is on track. She also does well in structured activities such as tennis, ballet and singing. Teachers/coaches generally give positive feedback. She has a lot of energy, but can also concentrate.

What makes me wonder about neurodivergence:

• She is very emotionally intense and can get very upset over things that may seem small.
• She finds losing, being second, or another child being “first” very hard. For example, if another child overtakes her on a bike or runs ahead of her, she can become very upset and say she doesn’t want to be friends with that child anymore, although this does not last.
• She can take refusal very personally. If another child doesn’t want to play her game or do something together, she can experience it almost as rejection of the whole friendship.
• She can be quite controlling in play. She loves children and wants to play, but sometimes wants very intense, close interaction and struggles when the other child wants space or wants to do things differently.
• She has some sensory sensitivities: hair brushing, hair washing, nail cutting. We have to put a cartoon on while doing all these things.
• She can be perfectionistic. She has said things like “I am not good enough” and can become very upset if her writing or numbers don’t look right.
• She is very sensitive to criticism or correction and can become upset if we point out mistakes.
• She can resist everyday demands such as dressing, handwashing and stopping play. We often have to make these tasks playful or interesting for her.
• She can be very shy around other people at first, especially adults.

What makes me less sure it is neurodivergence:

• She is very socially motivated and has always loved being around children.
• She has rich imaginative play and creates lots of different scenarios and games.
• Her play is flexible in the sense that she invents new games all the time, rather than repeating one rigid script.
• She generally does well at school and in structured classes.
• She can follow instructions and wait her turn in after-school clubs.
• She has good language and can often explain her feelings afterwards. For example, after one big upset with friends and craft materials, she later told me she was scared the other children would take her things without asking.
• She usually recovers after meltdowns and can go back to playing happily.
• She seems very empathic and relationship-focused, sometimes almost too much so.

I suppose what confuses me is that she is not withdrawn or socially uninterested at all. If anything, she is intensely social, very imaginative, bright, energetic and sensitive. But she struggles a lot with rejection, losing, sharing control, and feeling that her things or her place in the group are at risk.

Does this sound more like possible neurodivergence, or more like a highly sensitive / intense / strong-willed child who needs support with emotional regulation and social flexibility?

All 3 of mine have ASD and ADHD. DD2 was very much as you describe about losing. We spent hours, when she was 3 or 4, playing games and modelling 'good losing'. Then helping her to correct her behaviour when she wasn't a good loser. We knew we had one when she didn't win a game and as I started to say 'and what do we do when...(someone else wins)?', and she pursed her lips, squeezed her eyes shut and clapped furiously. She's 18 now and still wouldn't choose to play a game she's likely to lose, but she can hold it together when she does!

Thanks! Why do you think your grandson has ADHD, if you don't mind me asking?

Thanks for sharing @Pileoftrash

Could you tell a bit more about the situation? Did the phobias and anxiety started quite suddenly? Or did she complain or you noticed and signs of it coming?

Thank you @Lougle

What were the main signs of asd that made you get them assessed?

She just turned 5. She’s still very very young. As an only child I’ve seen them seek more attention and want more attention.
I have my own 4 year old at reception. She will be 5 at the very end of August. She’s the youngest in her class. She also gets upset and doesn’t like losing (no child does), she has tearful moments and is rather a perfectionist.

just remember her age and let her be. Be there for her and don’t give in to demands or let her walk all over you.

I understand why a lot of parents are saying not to be on the look out for signs of neurodivergence while the child is this young, but the sad truth is that waiting lists for a diagnosis are typically 4 years from referral to first appointment and in some parts of the country 8 years. So basically unless you’re quick, your kid is going to be a teen before they have any support in place.
Obviously I know right to choose is an option to mitigate this, but it is not an option in all areas of the U.K. and it’s accuracy when diagnosing is already being questioned.

This is not true at the moment. There is the right to choose pathway which is giving people answers much more quickly.

My friends son is in year 3 - he just got diagnosed after a 4 week wait via the GP and right to choose.

I was diagnosed as an adult after I went for mental health treatment following a traumatic event and they screened me for ADHD and autism as part of the assessment.

My son was diagnosed at the beginning of year 2 through NHS RTC. The school also suggested an autism assessment but I haven’t done that yet. Tbh I only went for the ADHD assessment because it enables him to access medication and all the evidence suggests medication improves outcomes for children with ADHD.

‘It’s accuracy is already being questioned’ is not factual.
Right to Choose using itself an assessment service.

right to choose is a service whereby your GP can refer into a private assessor from a number of different assessors, many of which are very respected adhd / autism support services as well as assessment services.
GPs don’t have time to make bogus referrals to rubbish assessment services.

it is far better to have an assessment from a reputable private assessor than wait for years for an NHS one.
many GPs refer to both private and NHS at the same time.

There is a big wait in right to choose in our areas. Even ADHD takes longer than 4 weeks when it starts too with right to choose. Getting info from schools can take that long.

She may be on the spectrum - she may be highly sensitive and strong-willed. The only way to tell is assessment. Certainly no-one on here can tell you, despite the posters rushing to assure you she’s just “bratty”.

I understand your concern not to miss something so if you can afford private testing you could try that. It might be worth watching and waiting for a couple of years first.

I think that among children who may be suspected to have ASD there are:
1)children who very obviously have ASD
2) those who are complex so identifying whether ASD contributes is difficult and takes time
3) those who have clear traits of ASD but it takes time to decide if they just have certain personality traits
4) those who have ASD but compensate well, until they don't
5) those who have other SN that share features of ASD but don't meet the full criteria
6) those who are NT but need time to mature and develop

I have a 2, a 3, and a 4.

My '2' has always obviously had SN to me, but I was ignored and dismissed by Health Visitors and GPs until she was 2½ and started preschool. At that point she was flagged, given 1:1 support, then went to special school. She was 15 when they decided that the list of issues she had didn't explain all of her difficulties and she got her ASD dx. Ironically, it's her ASD that is now her most significant disability.

My '3' obviously had ASD to me, but again, I was dismissed and ignored. She developed EBSA at 5, in year 1, and she saw DD1's paediatrician who had a special interest in neurodivergence. He said she was very passive and he didn't see ASD. He was wrong, but not his fault. Everything was quite subtle and people thought she was just shy. She was 11 when she was diagnosed.

My '3' masked beautifully. She's a type A personality. She had lots of sensory issues when she was little, and developed OCD traits in year R, and school had to use reward charts to get her in the building, but it was all seen as highly strung. She was diagnosed at 15.

I've read your list and tbh, it could be ND, it could be only child syndrome, or it could be being 5 years old. The thing is, there is no treatment for ASD, so regardless, you just have to chip away at the difficulties and build the strengths.

Model losing. Teach grace in winning. Teach compromise. Make sure she doesn't always get what she wants, when she wants it.

Social stories are great for people with ASD, but they're also great for people who are NT.

What do school say?

My kids are ND; all very different. I was nodding along to all the characteristics on the less sure for my middle child who is going through ADHD diagnosis.

In my experience of primary school, if your child is not disruptive and average or above academically, they won’t want to intervene. I’ve experienced this even with a formal diagnosis.

Thanks, Aluna. It's just that the private assessment costs a lot - I hear numbers around 2-4k. I will pay this if necessary but I would like to ensure the signs are obvious enough for us to do that.

So far no one said to me that they were diagnosed based on the signs I posted - it was these signs + something else... Bit the problem is that I don't notice any other issues apart from what I wrote. Would you pay 2-4k if you were in my shoes?

It was autistic burnout due to a combination of things which accumulated. The interventions listed on her ehcp were at base level and no longer taking place due to her seemingly coping. Cognitively and socially things stepped up, there were a number of things that just got swept under the carpet because they were minimised. They repeatedly sat her next to a boy with strong verbal stims who persistently invaded her space. She had a brief period of illness (viral) and returned to her class to find her beloved TA had been moved to another classroom with no transition. There were friendship group dynamics that became increasingly difficult to navigate. Then the normal schoolday routine went out the window in the run up to Christmas.

Hi @Lougle

Thanks for taking time to explain it all so clearly. It's such a shame that even though you suspected autism from such a young age no one listened to you! It all sounds really unfair.

Was going privately not an option or did you want to go specifically through the NHS assessment?

All of the above are ADHD traits, but they can an also be a sign of a child who has just not developed yet, which is why they don’t test until 6/7. As. I said we have it in the family and as he is getting older he is not getting any better. Talk with the teachers and your health visitor. Read up lots and find ways to help her deal with life.

My daughter is autistic. Obviously it’s a spectrum and every child is unique but I wouldn’t flag up anything on your list as triggering me to consider your daughter on this. I think you need to work on her resilience and ensure she has plenty of safe opportunities to learn how to lose.

ASD is a lifelong diagnosis. The criteria have to be clearly met, otherwise it becomes irrelevant. DD1 is really complex - one of the diagnostic criteria is that the condition are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay. It's understandable that they wanted to wait and see if she matured.

DD2 is very passive. Even now, in a special school, they miss that she is on the verge of meltdown because it's so internalised.

DD3 even I didn't suspect until she was about 13. I just thought she was highly strung.

No they are not big issues. You are describing a somewhat compettetive child who is reaching all her milestones and generally doing well.

I would caution you against pathologising your daughter, and analysing her behaviour in such detail it, will not go well for either of you.

Yes, phobias - including emetophobia - are really common. My dd has the same following one bad experience where she felt sick in PE, came out to me after school and promptly threw up in front of her classmates on the playground. She felt embarrassed and her brain made the unhelpful association. She also has a fear of dogs (she was bitten by a small one when she was 3), and a really strong reaction to blood/ pain (even minor pain). She won't let me touch her to clean wounds - she has to do it herself so she's in control.

I would pay it if I thought there were issues that needed evaluating and if there were problems with school.

You don’t need to know she’s on the spectrum to make it “worth” testing - ruling it out is still money well spent. And depending on the type of assessment - educational psychology testing is really helpful regardless of whether there’s a spectrum issue.

No-one can make this kind of determination from words on the internet. The devil is in the details.

Many ASD kids meet developmental milestones (some even hit them early), this is particularly true of girls, who are better at masking and difficulties may emerge later.

This thread is like a satire.

Is your daughter also not very keen on vegetables and would often opt for Smarties instead?

I was the same as a kid and it turns out I have ADHD!!!