Autism, ADHD, dyspraxia? 5 year old boy

[Twounderfive83]

My DS is 5 (nearly 6).

In the back of my mind I've always wondered if he's not quite typical, I also have anxiety and know I have fixated on ASD since he was born.

We got a referral through the health visitor when he was 3 to a Community Paediatrician to assess him, for some "odd" behaviours at his pre-school. We had a virtual appointment with the Paediatrician last year when he was 4 and she discharged him without concerns.

I am still convinced he isn't NT, I'm not sure if this sounds more like it could be ADHD than ASD at this stage. The reason I doubt ASD is because it's a social communication disorder, and DS is in tune to others' emotions, he easily picks up if one of us is angry at home or the atmosphere (eg if DH and I have argued). And whilst he isn't in a big group of friends at school, he has made three close friends and when I hear him talking to peers he has to me what are normal two-way conversations. He often makes friends at the park or on holiday, and when we have bumped into children from school, even from other classes, he seems to chat to / play with them perfectly normally. He doesn't seem to have any noticeable issues in this area.

However he does have some ASD tendencies, he's noise sensitive (not hugely, for example he will be fine in a noisy soft play, but he hates fireworks, still hates hand dryers, and his teacher recently said that he sometimes complains it's too noisy in class). He also seems to have odd behaviours that could be classed as stims, mainly vocal ones. He makes silly noises, says silly words, especially when he's nervous. He does it as he is going into his class, and his teacher has complained of him making silly noises during quiet time in class too.

Other odd behaviours he displays at school is he is very distracted, never looks like he's listening, always fiddling or looking the other way, however his reception teacher said he must be taking it in as he then knows what to do. He also wanders off to the toilet a lot and will spend ages there.

I'm also starting to get concerned about his motor skills as his drawing/colouring and writing skills definitely seem behind his peers, although his reading is good. He was late to walk (19 months) and always seemed a bit behind as a pre-schooler, however he learned to ride a bike without stabilisers when he was 4 and is great on a scooter.

Does anyone have a child with similar behaviours/heard of this before, and what it is? I've tried to set up a meeting with his teacher and the SENCO but I haven't heard anything back yet and I'm feeling pretty powerless.

Go to the GP and set up an appointment with an educational psychologist. I have a child with ASD and a child with ADHD and these days, ADHD is seen as a spectrum disorder not unlike ASD in some ways.

He could also have both.

Being socially skilled is not always missing in children with ASD too. My ASD child is extremely socially intelligent and has a lot of friends.

Thank you. The GP is also almost impossible these days, my surgery are only giving out same day appointments which are always gone by about 9:30am! I'm so annoyed that we didn't push the Paed last year but I mainly thought he was fine (I often still do).

Can i ask what made you seek diagnoses for both your DC?

Their teachers. My child with ADHD didn't get diagnosed till she was 12 as it's trickier to spot in girls.The one with ASD when she was 8 and a new teacher suggested it.

They're both sociable and have lots of friends...they're hard work though!

Speak to his teacher...sometimes school can get an ed psych in. And post on the Special Needs board here on MN. Lots of knowledgeable people there.

I presume now he is 5 you can't go through your HV again?

You know, I would be tempted to write to the paediatrician. Squeakiest wheel gets the oil.

I think at the very least it might get read at an MDT. Gather and provide all the evidence. State the struggles you have with the GP and how school are struggling to see anything due to his ability to mask his social communication problems. Plead to their better nature, basically.

I had such a time of it with my son's diagnosis. We knew from 5 months. We were under a paed at 6 months. He wanted to discharge us. He even wrote in his letter "first time anxious parents, mother obsessed with milestones".

I was encouraged to fight for him to stay in the system so I refused to let him be discharged. For all the good it did. In the end I emailed an out of area team and pleaded to their better nature. This was when he was 2 years old. They took him on and informally diagnosed him within 10 minutes of seeing him. They were going to formally diagnosed at the age of 6. But school couldnt/can't see it so they brought it forward to 4.5 years old.

No one can see it with my son. He is occasionally seen as being shy, but that's it. He has friendships. He has one very best friend (apparently common with autistic children, mostly because they can't navigate the intricacies of a dynamic friendship group). He laughs and jokes and plays and is a bit of a class clown (to mask the fact he has no real idea what's going on). He is amazing at numbers and letters, so they think he is academically ahead of his peers, but actually he rote learning is his preferred way of learning so he is quids in at this stage.

My son is the same with the silly noises. Fortunately, his current teacher is superb and is receptive to suggestions of how to help him. So he has a chew toy at carpet time. If he is particularly fidgety (he likes to roll around the floor a lot) he is given some 1:1 time with the TA to help him so some of his sensory diet. Apparently he is getting better at putting his hand up during carpet time but not so good at waiting to be asked to speak. So the teacher said it's almost like a compulsion that he has to get his words out there and then. She has tried all her tricks like "wait for Mrs T to finish talking and then you can talk" etc. One of his team suggested giving him a sensory object to hold while he is waiting so that his thoughts can be held with the object and then when it's time for him to talk, he can hand it back with his words.

He comes across as ADHD because he is so fidgety and always on the go. But that's just his proprioception and vestibular senses being dysregulated. Once they are in check, he can be a lot calmer. He concentrates much better when he is looking away from whoever is talking.