Is it ASD? Or something else?

[fc6362]

So I have had a 5 year old girl in my care for around 7 months - I'm a fc - and there is (imho) something "off" with her. She does have autism in her family I'd like to point out. It's hard to explain so I've made a list of the things that are bothering me and wonder if anybody can help identify the problem?

*Puts dirty pants back in the drawer with the clean ones. She's been told, she's even had consequences.
*Food - if it's beans on toast/potato she wants them separately. If I put them on top she'll very carefully eat the beans before the toast/potato.
*Cries over new food/food she doesn't like. Hasn't grasped that I refuse to cook separate meals.
*Forgets to wipe bum/wash hands most of the time.
*When she has been sent to her room for doing something wrong by the time I go to speak to her about it 2-5 minutes later she has no idea why she is in there.
*Cries over everything. Wants a crayon/doesn't like TV program/brother took a chip.
*Large head for age - body is in 50th, head is in 98th percentile.
*Says she can't find dress even though it's on floor near her feet. Looks around room aimlessly as if she's not really seeing anything.
*Over reacts to being nudged/hair brushed/pushed/siblings taking her things (brother took one chip from her plateful - she screamed like she was being tortured)
*Doesn't like TV too loud.
*Focuses on one bad event even if the rest of the day was good - will say it was a bad day.
*Needs to know what is happening/what we're eating the next day. Before bed every night says"see you on swimming/weekend/dentist morning" seems slightly distressed if there's nothing happening the next day for her to say.
*Constantly falling over - even standing still.
*Shouts when she talks - no matter how many times I tell her not to.
*Memory issues - will refer to things from over 6 months ago as yesterday.
*Wets bed every night.
*Can't do her top button (there's 3) and doesn't want to try.

I will point out also that she's doing great at school - she seems to learn academic things really quickly.

This could be Autism, however if she is in Foster care there could be a whole range of other issues. What support do you and she have? Does she have a social worker? You need to talk to someone and see if they agree she needs further assessment, and also if they can give you more support and advice.

She does have a sw. My support worker pointed out that a lot of times they don't want to "label the child" as they're obviously going to have emotional problems but that usually when a fc is insistent it's because they live worth the child and see what daily life is like. Her sw sees her rarely and so I don't think she is seeing the full picture. Also, her siblings have both settled and changed their behaviour a lot but she has not. I'm waiting for a paediatrician to see her at the moment

Good - because a paediatrician is the best person to help. If her siblings are older, they may be able to express things in other way, if younger they could have been less exposed. But do keep chasing the paediatrician, and if things get "worse" go back to your GP, there may be other routes they can explore or even more pressure might speed things up (if its a real need).

Some of these things sound like an attachment disorder which would make the most sense given the disruption she has experienced in her short life. Disruptions I'm attachments can cause developmental delays. ASD and attachment disorder have very similar presentations and the two are often confused, even by professionals.

Also, some of these things just sound normal for a 5 year old, eg not doing it a top button - this is really hard and requires the development of certain muscles in the hands which aren't developed by that age.

Why has she been placed in foster care? I imagine because she's either been abused, witnessed abuse, or is it something else? These experiences would tell you a lot about how traumatised she may be.

I would just try to be very, very patient with her and not express your frustration directly if possible, and seek professional help as you are doing.

I have a 3 year old who is being assessed for autism. Some of those things sound a little on the spectrum but as others have said a lot of it could be related to her background and the distress she must feel.

Also with the food issues a lot of those type of behaviours are very normal in children with no development issues at all. The reaction to someone taking a chip off her plate could be related to something in her past - what was the background with food in her homes before? Was food an issue?

I know you say you don't want to offer anything different but for now to encourage her to feel secure etc I would just not get into battles over food and offer something plain that you know she will eat. My son has massive issues with food and will literally only eat sandwiches and fruit with maybe the odd bit of pizza or pasta. If I offer him regular dinners or any veg he just won't eat it at all and would literally go hungry. In the grand scheme of things it's not worth getting upset about.

Wetting the bed at night at 5 isn't that unusual, especially for a child from a difficult background. I wouldn't necessarily say that was autism related.

Thanks everyone, no she hasn't been abused or witnessed abuse. I understand that a few of these things are normal for a 5 year old or for a child that has just come in to care, however she has been here 7 months now. There were behaviours with her siblings which have resolved - months ago in fact - but nothing is resolving with her. The odd thing I feel can be explained but it's when all of the things are put together, on top of the fact that she's the youngest and so has spent the least amount of time in that environment.
Fairlylee what made you think your daughter needs to be assessed? As in what stuck out for you? X

Ovumahead I have done lots of attachment training and there are some attachment problems there but I'm convinced that's not the whole problem x

For me the reason I thought ds had something a little odd (for want of a better word) were his obsessions! He is literally obsessed with road signs and isn't remotely interested in any toys - he wants to spend all day looking at screwfix and other work wear catalogues looking at the signs or go on my phone to look at images of signs (road signs, exit signs, toilet signs). If we go out anywhere he ignores everything else entirely apart from the signs - so for example we go to a zoo he is completely non interested in the animals to the point of getting annoyed us showing them to him but if he sees an exit or toilet sign he is off and will dart over to it oblivious of safety or us telling him no. If we try to pull him away from a sign before he feels he has "finished" then he will have a screaming fit on the floor and it will carry on until we leave and get home where he feels calm.

He is quite verbal (I know a lot of people tend to think autism is about lack of speech) but his speech doesn't always make sense. He will want to play with children but then get too close to them, literally in their face, and will repeat random phrases like "faster than 5" (relating to a road sign) over and over and over.

But ... He is only 3. So quite a but younger than your dd. I don't think there is any harm in asking for a referral if you are worried.

OP i would assume you'd have had some training in attachment given that you're a foster carer, however this isn't the same training that mental health professionals involved in diagnosis would have. She definitely needs a thorough assessment by a multidisciplinary team as there are so many issues you describe. Good luck with it all, it sounds stressful and I hope you get lots of support and answers.