School is pushing for ASD assessment for my 8 yo

[Tiredofthis1]

I’m not sure whether this is the right place to put this, iv only ever done 1 other thread on here so I hope I’m doing this right,

A bit of a backstory, my 8 yo DD is in yr 3, she’s always struggled mentally, from being in pre school I was called up to the school for behavioural issues, my sister has ADHD and ASD so iv grown up around the signs but never thought about it with my own children.

Her school is wanting to see about getting her in to have an assessment for ASD and ADHD which iv given the green light for, the schools main concerns are her social life, she hasn’t got a group of friends, she’s never really had a best friend, she’s always on the outside looking in trying to inter grate herself within a group but can’t seem to manage to play the same way, she struggles with eye contact, she gets asked to do a task 3/4 times before she actually takes in what’s been said to her, she can flip and turn angry out of nowhere, she can’t filter her emotions but she is soooo caring to children younger than her, she has a little brother who is 7 months and is so inlove with him, she’s also above target for maths at school and is very bright in all her other subjects, especially art. She thrives for attention, wether it be good or bad but she’s a dream child when she is having 1-1 time with an adult.

I guess I just want a few stories or support on wether this sounds like Autism/ADHD? family members have suggested taking her to the GP plenty of times before but iv been in denial, but now I have the schools support I feel like I need to get her the help she may need, thank you for reading

I'm a training GP but shhhh don't tell anyone as I do tend to keep it quiet on here lol. I'm by no means an expert but I'm often approached by parents concerned about kids with ASD. First thing to say is that there's no way I can definitively say that a kid does have ASD or doesn't in 10 minutes. It takes several hours of careful questioning and monitoring and often observation over a long period of time before you can put that label on a child. That said, these are the things which I will quickly screen for in a 10 minute appointment

1. Poor or awkward social skills, particularly rigid thought processes and difficulty with things like making eye contact. It's important to remember though that many kids are a bit 'quirky' and might have different interests to lots of kids their age or just not be that interested in making friends or prioritise different values other than their popularity. We need these kind of independent thinkers in the world and IMO this shouldn't be discouraged. Of course how big an issue it is probably depends largely on whether we suspect that there's something inherent in their social skills that's stopping them being able to socialise and to what degree it is inhibiting them from getting what they want and need from life

2. sensory processing difficulties such as being fussy about certain tastes/textures/sounds/feels. This is a big one. I may be corrected by people who have children with ASD as they're the experts but I have always been taught in my training that if there isn't at least a degree of this then it's unlikely to be ASD that's the primary issue. Having said that sensory processing difficulties can also be due to completely different underlying issues as well so isn't in itself diagnostic

3. delays in early speech and communication. I will always ask a parent when the child first spoke etc as again I have always been taught that ASD is unlikely if they were on target with these milestones. This can be a difficult one to assess though as parents forget what age their kids did things and the delays might be subtle.

I consider ASD as a triad of the above. If there isn't evidence of at least a small degree of all of the above then I would consider it unlikely although I might still refer for further assessment if there was enough parental concern or there seemed to be a serious issue for all of the above.

ADHD is a whole other kettle of fish although the 2 are often linked but again I'd be looking for them to show a number of key indicators such as that their symptoms are occuring both at home and school, they are restless and also have a reduced sense of danger/increased impulsivity when compared to other kids their age, whether sleep is disturbed, whether they struggle to finish tasks before jumping to another etc. Ultimately I'd also be looking as well at how much it's actually impacting their life as this will be the key determinent as to whether they need support. To be honest I think if you'd tested me for ADHD as a kid I might have met the criteria but I'm also lucky enough that one of my main distractions as a kid was books which I think helped me perform ok academically

In a nutshell I hope the above helps guide your own diagnosis of your son but diagnosis is so complicated that it takes a great deal of thought and assessment. Remember as well that school will have a lot of experience about what is 'typical' so if they are sufficiently concerned then I personally would allow further assessment to go ahead. A diagnosis won't be made lightly. I hope this helps. Good luck xx

Thank you so much for your advice @Jannt86
eye opener, a lot of what you have put describes my daughter to a T, she had speech therapy in nursery and had play therapy in year 1 through to year 2 when lockdown started ( all done through the school) she really struggled during lockdown and finds half terms difficult without the structure of school, her attention span is poor and is always hyper/wanting to do 100 things at once, she gets really angry when there’s loud unexpected bangs as it catches her off guard, especially when playing a game and someone makes her jump, she’s always been classed as ‘the naughty one’ in school so she’s had her issues throughout the years, I will go ahead with the assessment especially as it was the schools idea as they see her social skills with other children a lot more than I do at home, it’s just heart breaking knowing she can’t find her place in a friendship group, especially as primary school aged kids seem to find it so easy to create new friendships

It’s an eye opener*

It sounds like an autism assessment would be helpful. This can be a long process, so getting things going and having an outcome before you get to high school will be so beneficial.

First thing I wanted to say is that your DD sounds like a wee sweetie! She has so many good qualities. Understanding the underlying causes that lead to her temper explosions will help you and the school to help her have fewer of them. And it will help her to make friends and feel more comfortable with herself and with other children too.

As Jannt86 says we can't say if she has ADHD or an ASC or not. But the things you're describing are quite similar to a lot of kids I've met who have ASCs including my DS though his personality is very different. He is not so hyper and doesn't have an ADHD diagnosis but he could get very angry seemingly out of nowhere. He wasn't so good with younger kids but when he was 12 he was a mentor and mother-henned some of the other children with social difficulties at school to take them to the youth club!

The big eye opener for me was the SALT. I thought he was a very articulate child and in some ways he was but she picked up all the difficulties he had in emotional expression and non-verbal communication, which had made friendships hard for him. So the assessments were really helpful for my DS. And afterwards got a lot of help with social skills and anger management and as a result he has made friends and done well.

Thanks so much for your replies, I’m drafting the letter up now with evidence of her behaviour at home ready to take to the GP on Tuesday, she’s wanting to see my daughter with how she reacts to someone knew although I don’t know how much the doctor is really going to get from a 10 minute appointment but hopefully this is the start of something that can give my daughter the support she needs, I will push for help for her as it breaks my heart thinking of her struggling so much and wondering why no one will play with her etc I understand it’s a long process but how long was it for you before your DS was diagnosed if you don’t mind me asking @AmaryllisNightAndDay ? The problem I think I’m going to have is that I don’t think it’s very obvious with my DD, she doesn’t show all the characteristics, it’s almost like she’s hidden in plain sight unless you spend the time observing her. Thank you again🥰

It was a long time ago and it all varies a lot from place to place... but we sat on a waiting list for 6-8 months, then we got appointments to see the paediatritian, clinical psychologist (we saw both of them more than once) and eventually the SALT. They asked for screening questionnaires from us and from the school. So his assessment was very thorough and multidisciplinary and it took a few months to get through all the appointments. Very worthwhile though.