Possible ADHD in teenage daughter

[KR2013]

For years now my husband and I have wondered about one of our twin daughters potentially having ADHD. She's now 13, and it feels like all the traits we've noticed before are becoming so much more noticeable. My girls were born 7 weeks prematurely so we know that increases the chance of neuro diversity as well.
She constantly loses things, at least several times a day (and these are school days where she's not even at home that much between school and dance!) In the few hours she's at home, she'll have lost her phone, dance kit, dance bag etc and spend ages trying to find them. She gets really anxious about it, and totally recognises it, but this doesn't seem to lead to any change. She's also constantly forgetting the right dance shoes/right bag etc despite me seeing her sorting her bags beforehand, so it's not that she hasn't attempted it. Lots of leaving things at dance/school, it's become a thing that her dance teacher will see her and ask has she definitely got all her belongings 🙈
Her room is CHAOS. Every couple of months we'll have a sort out of it together and she'll be almost obsessively careful to keep it tidy for about 24 hours, but it descends into chaos again incredibly quickly (which I'm sure doesn't help with the losing things!).
She constantly forgets to brush her teeth and put on deodorant. She really takes pride in her appearance so I find this an odd one, it's not like she wants to be a mess or doesn't care.
She constantly interrupts our conversations (at home, in other social situations), and despite lots of being made aware of it, either by us or others, it doesn't make it improve (she's really well behaved generally in social settings, so it's not like she doesn't care if she's doing the wrong thing). She'll also constantly talk about something random during conversations about something completely different.
Definite lack of focus (noticed by us and others). She had a lead role in a local am dram show last year which she was so excited by, cared about it more than anything else she's ever done, but we still had various comments from the director about her struggling to focus (even when working with only two other adult cast members and the director). The director wasn't being unkind at all and didn't say it to her, she actually had a son with ADHD and said she reminded her of him, she said she could see it wasn't being done intentionally or because she didn't care. Unfortunately, with those who don't know her so well this can be assumed (we've had a few issues with school teachers commenting on her not paying attention recently). Her chaperone during the above show commented that it was like chaperoning Tigger.
Sleep is also atrocious, she's frequently really tired but can't get to sleep until hours after she goes to bed around 9pm (and has no screens in room, screen time finishes at 7pm at the latest , lots of physical activity most days).
We've noticed lots of these things when she was younger, but it seems to be now she's hit teen years and has more independence that they're really showing themselves fully. She's also really getting frustrated with herself now, and my concern currently is when she leaves home that the wheels could really fall off, and it could also lead to really poor mental health if she's beating herself up about it.
My concern is that school will just say she's doing fine academically, and no real behaviour concerns, so they don't think there's an issue. We're prepared to go privately for an assessment, but will they also want evidence of struggling in school?
Any experiences and advice would be so helpful, thank you in advance ❤️

She does sound very like my teen DD who has just been diagnosed at age 17. I would get her assessed. It will help her and you understand her behaviour a bit more. I wish I’d done it sooner.

Yes they will want evidence from school but struggling doesn’t necessarily mean academically.

My dd is diagnosed at 14. She fell apart about 12. Honestly sounds likely, just push for diagnosis.

I'd get her iron levels checked if you can. Low iron is a frequent (though not the only) cause of ADHD symptoms. If ferritin is under 100 and/or transferrin saturation is under 20% then this may be a factor.

A good place to find out more is the Iron Protocol for Iron Deficiency With or Without Anemia on Facebook. The group owner stopped needing ADHD meds once she'd optimised her iron levels.

That's really useful, thank you. We had a chat with DD last night as we had tears over leaving her dance bag at school and only realising when she'd got to her Nana's home (Nana was obviously totally fine to go back with her and collect it, but she was so frustrated with herself). I asked her whether she feels like she's struggling at the moment, and the floodgates opened. Turns out she's been frequently forgetting homework/not meeting deadlines (I can see she's picked up a couple of behaviour points for this on her school system over the last 6 months, but she said there's been lots more instances too but she's been allowed to bring it the next day etc). Also just a lot of being told she's not focusing in class etc, so hopefully will be something school can feedback on if I get in touch which would be useful for an assessment 🤞
I feel awful for not raising it sooner, she said she's been wanting to say something to us but didn't know whether she was just being silly (although I guess hindsight makes things seem really obvious, but it's only recently that the impact has been so clear to see).

Will definitely be pushing for an assessment, thank you. After talking to her last night, she's aware just how much she's struggling and really miserable about it, so one way or another we need to try and sort it for her. I'm going to contact school on Monday and also book in a GP appointment, and we'll go from there. Thank you ❤️

Will definitely have a look at this, thank you ❤️

Reading your post, I can completely understand why you're considering an ADHD assessment. What comes across most strongly is how hard your daughter is trying, and that she isn't doing these things on purpose. You sound really tuned in to her needs, and she's lucky to have parents who are noticing her struggles and looking for answers. Whatever the outcome, getting some clarity could be a huge relief for both of you.

Thanks so much for this (I've felt pretty awful this week for letting it get to this stage without doing anything, so it really is massively appreciated ❤️).

I'm glad you're going to look into assessment . I was goign to say that if the school is any good the forms they fill in won't be about academic achievement so much as how easy it is to keep her attention in class, homework, behaviour etc. and it sounds like she 100% is struggling.

I'd also think if you speak with them, they can start implementing Adhd strategies, even without a diagnosis yet - that's what they did for DS before he got the diagnosis. eg helping him bring his attention back into the room, movement breaks etc. if she struggles with things like equipment, they might have options for that too - for example, DS was a regular user of the teachers' equipment while we figured out how to get him properly set up in a way that works. Perhaps she can keep her PE kit AT school - in a locker or classroom - for example.

Your DD sounds a LOT like my DS. So less hyperactive and more attention deficit. The attempts to organise himself being a really good example. With the bags, with DS - he's got quite good at this, but when he first started doing it, I'd check in with him re what he'd put in them and then, the "scaffolding" (you'll hear this a lot once you start talking to professionals) would be me reminding him before he left to check if he had the right bag, for example. Similarly, if you can ask the dance teacer to ccheck she has picked up her bag.

Re sleep - such a difficult one. Worse I think for children who WANT to sleep (DS didn't at first). A few things you can try:
Once you have diagnosis (or if you can access it by getting someone to buy it for you in another country) - Melatonin. In the short term, possibly partly as a result of the power of suggestion, those sleep gummies you can buy in health food shops or Amazon were surprisingly helpful for DS.

Does she have an Alexa? DS has found white noise - he likes rain - very helpful. A friend's DD listens to audio books at a surprisingly high volume, but it really helps her mind to settle.

How quickly does she get tired if she isn't sleeping? I ask this as DS could function for a surprisingly long time so we used to accept later nights - not even bothering to attempt to go to sleep until 10 or even 11 - and then let him have one long lie in on the weekend to "catch up". This doesn't work for children who feel the poor night's sleep immediately though.

Screens is another interesting one. So, for us, letting DS have certain types of screens before bed is actually beneficial. Playstation/games - NO. But a bit of scrolling with his usual combination of cats videos and NBA games can help, or he'll watch netflix series that are light and easy in his room. (DD who is NT, cannot do this. And it's a constant battle with her to get her to be off screens before bed to help her sleep.)

mine was diagnosed at 17, so many clues missed in the years prior!
school disagreed despite the millions of behaviour points and detentions, so she had to undergo an extra test called QBcheck for the psychiatrist to be able to start meds.
after meds, the difference was stunning.

You could be describing one of my twin DDs.

As per PP she also had v low ferritin.

We went for a private ADHD assessment. Psych said not enough evidence for ADHD though some inattentive traits and processing issues. Suggested we get her assessed for ASD, which we eventually did.

She got her ASD diagnosis at 16. I wish we had done it earlier as it has been v positive for her. I had no idea she was ASD because both her sibs are and she is v different!

All of which to say: check ferritin and get her assessed if you can (RTC if not possible privately). All of my kiddos struggled through exams (got through but it was v tough).

My DD was diagnosed at 14.
We took advice, did the research and put her on cicardin (to help sleep) and methylamphenidate (sp) which helped her MASSIVELY at school and to get her through exams.
She only took it on weekdays.
She took herself off it (with CAMHS consultant knowledge/approval) about 8months ago. Her bedroom is still the room of doom, she still forgets and looses things and sometimes is like a talking Tigger but she’s doing great.
Not everyone approves of the medical route but during those difficult puberty hormone filled years it helped her hugely. She wouldn’t have got any GCSEs without it - she got 7.
Once she left school I gave her the option of not taking it - her having control over herself, her body and her autonomy was massive. So many people -my own mother included - were Pearl clutching when l asked the consultant to prescribe for her but it helped her so so much.
I suppose I’m sayimg push for an assessment and read up as much as you can on what help is available as therapy , while beneficial in understanding ADHD, does not help control it.
It’s a lot to expect a young teenager to learn to manage ADHD. I would never ever condem anyone for getting medication - anybody who thinks they are superior because their kids didn’t take anything are nasty . It doesn’t work for everyone but for my DD it was an utter godsend.
She also knows that if she ever needs it it’s there for her.

Edit - DD is also autistic.

All really useful, thank you.

White noise/wave noises playing is really help for DD too (or a fan being on in room, either seems to work for her). Although our Spotify frequently glitches due to rubbish internet connection so that the wave noises stop, and then this means she's up and down needing us to sort it 🤦🏻‍♀️😅 I was thinking about just getting a cheap white noise machine to try and bypass this issue as then not reliant on internet connection.

I think I've essentially been trying to do what you suggested re. Bags, but didn't know whether it was the correct method (modelling but also then trying to build in some independence with it). Sounds worth persevering!

I think she definitely wants to sleep, and gets very emotional when she hasn't had enough. May have a go at sending her to bed a bit later though and see if any improvement.

Thank you!

I am very intrigued to see what school come back with. Haven't heard anything yet, but I'm assuming there'll be a wait whilst the Senco speaks to teachers. Fingers crossed it's something productive and supportive rather than just a blanket 'there's no issue' 🤞🤞

Thank you, super useful. I actually suspect her twin could well have ASD, although not as convinced by this as by this one having ADHD currently. Currently just going by how much they're individually struggling and using that to guide whether an assessment feels sensible or not. No idea whether that's the right thing to do or not, but partly just down to how much we can handle at any one point 😬 I've had a couple of surgeries in the last few years too so it's all a bit of a balancing act 🙈

Thank you, really useful. Definitely wouldn't be against medication if a diagnosis was made. We shall see I guess!

It may be adhd but its very hard to get girls diagnosed as some arent physically hyper.

Wheether its asd or adhd might be what is distracting her? If its sensory things it maybe autism.

Mine doesnt lose that many things just cannot remember to take stuff like pe kit. The other day shewas telling me a story re her pen and i asked do you not have one now then? She didnt relly carried on about irrelevant story so i remembered to ask again later in evening and she didnt have any left. But hadnt remembered or realised that was the important bit.

We are starting meds in a few weeks and really hope it helps with motivation and classroom concentration

Re the bags and ither "scaffolding" techniques... i think one of the biggest barriers for children with executive function difficulties is this notion that they "should" know how to do something. Or that they will learn through trial and error. Thats like.saying if someone just reads enough books their eye sight will miraculously improve.

The point is to br helping them learn the tools and techniques they need to function. Because these things do not come naturally to them. So ifs completely fine to remind them. Where younwoild ve discouraging independence is if you did it for her, wothoutbher even realising. I used to help ds in the mornings by packing his lunch and water bottle and making sure his iPad was i there as well. But I would tell him what I was doing. And often would first rwll him to do it but only step in when I could see he was struggling.