@Multitaskingmadly
You sound like a fantastic advocate for your DD. It’s great that you managed to get an ASD/ADHD assessment and I’m not encouraging you to distrust it. On the other hand I think you are right though that reassessment can be required. For example, ADHD is known to manifest later in girls, and for that reason they extended the diagnostic criteria to include symptoms beginning from up to the age of 12. Another thing is that it sounds like your DDs anxiety was exceptionally high at the time of assessment and this could mask the symptoms of another issue, as any symptoms such as inattention or lack of eye contact could be fairly attributed to anxiety. Doctors are often following the “horses not zebras” paradigm of sticking to the simple explanation, which makes a lot of sense in general and is totally reasonable, but occasionally you do get zebras!
Just because you mentioned it, locking into a task that you are deeply interested in is known as “hyperfocus” and is widely recognised as a classic feature of ADHD, though not part of the official diagnostic criteria, as I think another poster alluded to. Just worth noting that ADHD often looks quite different in girls to boys - typically more daydreaming and less bouncing off walls. For ADHD and ASD, we know that girls do an incredible job at “masking” their difficulties, often without quite knowing that they are doing it. They may be working extremely hard at following the expected social cues and expressions with ASD for example, without necessarily realising that everyone isn’t working overtime on this. No wonder these girls burn out! The fact that you feel you may be on the spectrum is significant!!
I too had early onset OCD so I’ve got a lot of thoughts about this, forgive me! Feel free to take them or leave them!
Some other points:
-OCD I think is sometimes treated a bit like it’s just a flavour of anxiety, but when it comes to paediatric onset OCD it has potentially a lot in common with issues like ASD and ADHD, often accompanied by the same sort of side features like sensory issues, auditory processing issues, executive dysfunction and more. I think successful treatment sometimes needs to do better at taking this neurodiverse aspect into account. Early onset OCD is clearly associated with slower brain maturation - but we do get there!
-there is a decades long dispute about whether it is possible or common to have both OCD and ADHD, or whether they just mimic one another. No one really knows for sure yet. Whether you could get a dual diagnosis may well depend on the viewpoint of the particular psychiatrist you get.
-some medications have crossover in treating depression, ADHD and OCD like imipramine. Others may treat 2 of the 3. This might be something a doctor would consider in prescribing and may be worth discussing.
-in all of these conditions, there isn’t a clear and definitive delineation between having the condition and not having it. You could have several of the traits but maybe not quite reach the full threshold yet having those traits will still affect you.
-whether you have an official diagnosis of one of these conditions, you could still consider trying to implement the non-medication treatment strategies around them to see if this helps. Strategies around routines, sensory inputs, accommodating special interests, CBT approaches to ADHD-type challenges with executive function…any of these could make a small difference. Hopefully the new psychologist will be able to look at this angle but you may need to explicitly ask.
I hope soon you are all in a better place. It’s exciting to hear that your daughter is such a talented artist!