Does this sound like neuro-diversity?

[Chattymumma]

I'm looking for some advice about my 7 year old daughter. To be honest, I'm really struggling with her, but I'm unsure if the issues are behavioural only or if she is perhaps neuro-diverse in some way, such as adhd or autism. Here is a list of the issues we are having:

• She is constantly moving, jumping, climbing and fidgeting. She can't yet sit still at the dinner table and is up and down like a yoyo. However much physical activity she gets, she never tires and seems to need more. She seems to need to bash into people and things to get some stimulation and therefore loves rough and tumble and soft play!
• She is never emotionally calm. She is very highly-strung, cries and whines very easily at the smallest things, often because she can't get what she wants or she is feeling jealous of her younger sibling. Whether happy or sad, occupied with an activity or bored, she is extremely intense in her mood. She is able to focus if interested in something, such a lego, although does so in an intense manner!
• She absolutely cannot cope in noisy or crowded environments and responds by becoming completely hyperactive. She often complains about noise.
• She struggles to have a two-way conversation and is much happier if she is telling you everything she knows about something. She has struggled to make friends in the past although seems to be doing okay now. However she does seem less socially developed than her peers and they 'baby' her a bit or tell her what to do and how to behave as she is often being silly or hyperactive.
• She rarely says thank you or 'I love you' although she does do occasional big gestures like a picture or a card saying 'I love you' and likes big cuddles, holding hands, physical play and doing activities together
• School say she is very good and obedient and is thriving academically. They haven't noticed any issues that would suggest neuro-diversity. But I wonder if she masks and then lets it all out when she comes home.

I don't want to medicalise her if this is simply her personality, but I don't want to miss something and not get her the support she - and we as a family - need. However, I appreciate that this probably sounds very mild compared to other children and we would be waiting a very long time for support. Also, we would be very unlikely to medicate her so perhaps we just need some coping strategies. Thank you for any thoughts, advice or tips!

I also had problems with the school recognising that my DD needed more Support than they were offering.

I would head on over to the SN Children section to get some advice on getting her assessed but I think for now she would benefit from you reading up on how ASD and ADHD present in girls, some regulation and work on emotions in school and a referral to an OT.

Has the school SENCO assessed her yet? And have you spoken to the school Nurse Service?

How does she do on this simple progress checker?

Thank you so much for your response, interesting that you had problems with the school recognising that your DD needed support. Thanks for the link, I'll take a look and also see if I can have a meeting at school to explore getting more support.

I think if they behave well in school, particularly girls, their needs can be largely overlooked.

How did she do with the progress checker?

Yes I've heard that can be the case. The thing is, at school she knows exactly what she's supposed to be doing and she fits into the structure. I think the challenge comes when the rules are less clear cut, like social situations or big groups of people, or when there are other options, such as bouncing rather than sitting on the sofa, despite the fact that everyone else is tired and needing to relax, for example. The progress checker highlighted that she may need some support with understanding, social communication. I'm just not sure how to help her with it, as it's such an instinctive thing. Her brother who is 4 just seems to naturally be able to read other people's moods and the general atmosphere, take turns in a conversation and be considerate and empathetic. I feel so sad that she's lacking in those areas as they're so important relationally. Other family members think it's more of a behavioural issue so I'm really conflicted. I have followed a very gentle parenting approach and I wonder if that hasn't helped. She can be extremely rude to me at times and I do need to work on boundaries but I don't think that's all that's going on. Do you mind sharing a bit more of your story and if your daughter had any similar challenges? Completely understand if you'd rather not!

Ok so if the progress checker says that she needs help with understanding and social understanding then she does need some referrals.

I would definitely speak to the School SENCO, DD doesn’t have to be there when you do this.

Explain about the results of the progress checker, if you took a photo of the results, you could show them.

DD will need a referral for a Hearing Test, which is just standard practice, and also a referral to SaLT.

I would also tell them that you think that DD might have ASD and you want them to observe her.

We found huge resistance to this idea as DD presented as compliant at school.

We eventually got a referral to the ASD Pathway through the GP.

And you don’t have to do all of the support yourself. Did Speech & Language UK send you any resources?

Did you know that you can book an appointment with one of their SaLTs? Although it is a charity so you might want to make a donation.

Head on over to the SN Children section too. They can tell you about getting an ECHP, a referral for assessment, what ASD looks like in 7 year old girls and generally how to navigate all of this.

It is a lot for you to do but you can get through it and help your DD to thrive

Talking at people is typical of ASD, I used to use it to my advantage when ds was young to get him out - 'come out for a walk and you can tell me all about X, Y or Z'. Struggling to take turns in conversation also typical. Sensory issues such as issues with noise/crowds also common - the bashing and rough play may also be sensory.

Struggles with emotions and regulating them are common with ASD, constant movement and hyper focus are more common with ADHD but can be seen in ASD - the constant movement may be a way of stimming/regulating. Being more emotionally immature than peers is typical and often becomes much more obvious at secondary school - not uncommon to be 3 years behind.

DS rarely said thank you - or hello. He found obvious social conventions like those really difficult! Coping well due to the structure of school is not usual but can become more difficult at secondary school.

To me it sounds like she's really ticking a lot of boxes for ASD - what would in the good old days have been Aspergers syndrome. There's no medication for ASD and with her low levels of need I doubt school would pick up on her - schools report for DS's assessment made him sound like the perfect pupil! IME I wouldn't expect school to be interested in putting in very much to support her (or anything!) even after diagnosis. DS wasn't picked up till 10 - no one had even ever suggested it before then. School weren't really interested.

Things that helped DS - being sat at the front of the class as he couldn't block out distractions and would miss chunks of input. Coming home and having a snack and a very relaxed chilled time after school - time to decompress in his room or I would read to him. Lots of space from her sibling - as she gets older her own room will be really important IMO if she doesn't already have one. Ear defenders if she'll wear them may help her cope with noisy places and gentle reminders to say thank you. I would also really recommend reading up on ASD to hopefully help understand where she is coming from.

Thank you so much, I really appreciate your advice and kindness. I will start to take some steps as I'm not sure I could describe her as thriving right now but I think with the right help we could get there!

If she won’t wear ear defenders then have a look at Loop Engage.

And if she had the need to move, I would try and get her to the park or on a trampoline before school.

We found a weighted blanket helped as well. How is her sleep normally?

Thank you for all the advice and tips. Her sleep isn't great...as in I'm currently sitting outside of her room because she can't fall asleep without one of us outside her room and she often doesn't fall asleep until 10ish. She still comes into our room and gets in with us almost every night at some point. She has eczema, food allergies and possible asthma too. She has an incredibly itchy skin condition which has developed from the eczema and this has caused a skin-picking condition so she can't really be alone at the moment because she will pick her skin to shreds.
A couple of questions: is there a difference between ASD and autism? Where would be the best place to read up on this? Many thanks again!

ASD is Autism spectrum disorder.

I’m probably not the best one to help with links but I’ll have a go anyway

Autistic Women and Girls

ASD and food allergies

ASD and sleep.

Like I mentioned before though, you might want to ask in the SN Children Section for tips on getting school to listen and put in a referral

If she’s suffering with the allergies so much, is it CMPA that she has and is she completely dairy free?

Forcthe sleep we found that sport helped to wear her out and a weighted blanket also helped but ultimately the only thing that we had any real success with was Melatonin which was prescribed after diagnosis.

Thank you, DD's consultant (for eczema and allergies) did mention melatonin as an option for us so I'll consider that. She's fine with dairy but allergic to egg and sensitive to a few other things although we're half way up the egg ladder now. The skin conditions are apparently unrelated. Thank you for the links, I'll take a look and also browse the SN children section 🙂

Does she have a daily probiotic? There is some research I’ve heard mentioned recently (although I’ve not read it yet) that link gut health with allergies.

Yes we've recently started her on one and her normal eczema and the allergies have definitely improved, it's just the nodular prurigo that's really difficult to shift...

Glad that the probiotic is helping.

Nodular Prurigo isn’t something that I’ve heard of before but reading up on what might cause it thyroid problems struck out at me as this can be an autoimmune disease which again can be associated with ASD.

Had she had her thyroid levels checked?

And was her current Consultant offering to prescribe the Melatonin? If they were I personally would try her with it, not just to get some time back in the evenings for you to relax but to help her catch up on her sleep and relax

I hadn't thought of thyroid levels but I do sometimes wonder if there is something physical underlying her issues, such as a very fast metabolism or some hormonal imbalance. I will mention it to her consultant next time. Thank you again for taking the time to give me your thoughts and advice, I really appreciate it! : )