DD ocd/autism? - Normal of not?

[sharkss]

DD (12) joined senior school last year and didn’t have a great year. Began to notice her mental health slipping, so we chatted to her head of year who recommended she saw the school counsellor. She has now been going for a short amount of time. She has always had a specific way of doing things, and has always got upset if someone interrupted her way, but it didn’t normally get in the way of everyday life. Since starting senior school all of this has got worse, she gets really upset when plans are changed, sticks to a few foods, has to serve her own food because they can’t be touching, sensitivity to noise, lights, touch, smell has got worse, she’s fidgeted a lot more, and more. I mentioned this to one of my friends who is a doctor, and she said that sometimes autistic kids stop masking when stress levels go up. Looking at it now it makes a lot of sense, but I also wonder whether she might have ocd? Her way of doing things is often strange, whenever she gets something out she has to tap it a few times, i’ve noticed her aggressively tapping the table and then rubbing her hand on it when she gets the rhythm wrong. Yesterday, I saw her colour-coding a box of tic-tacs. She picks her skin and her hair, and has gone back to a habit she used to do when she was younger - counting letters on her fingers and then adding in spaces and punctuation to make it an even number. As I am writing this, from the other side of the room she is tapping a pattern with different fingers, and shaking her hand aggressively when she gets it wrong. Does anyone know if this is normal? She has always done this on a lower level, but it’s got worse since stress from senior school has come along.

This sounds like possible autistic stimming, and she has sensory sensitivities that align with autism too. Can you talk with school to see if they can refer her for neurodiversity assessment?

Overlaps often.

good venn chart https://neurodivergentinsights.com/misdiagnosis-monday/adhd-vs-autism-vs-ocd

I sound like your daughter at that age. I was diagnosed with OCD when I was 18, and my son is autistic. I don’t think I’m autistic, but haven’t been assessed. I think definitely get her referred.

I have ASD, one of my stims is tapping and counting, it was worse at that sort of age, transition to high school can be difficult. I usually tap my fingers in 5s in specific patterns.

The other things also sound very ASD.

OCD usually needs some sort of accompanying thoughts, rather than just actions. Can you talk to her and ask her what would happen if she couldn't tap / spell the words / complete the pattern? Does she "need" to do it to feel right / ok, would something bad happen if she didn't do it?

ASD stims can serve a variety of different purposes, sometimes soothing or just to get emotions out if getting overwhelming by things. Might be worth trying to notice if it's happening in specific situations (at school assembly was the worst for me, too many people, sitting too close, sitting on the floor, I got through it by tap / count). Sometimes, stims can do the opposite and make you feel more, DS likes to spin and says he can use his imagination better while he's spinning.

I asked her about the thoughts - she told me that she always finishes them, and if she didn’t then she does that rubbing out motion that I described to erase it, but she says she gets a bit hot and sweaty and anxious if she gets it wrong. I also asked her about when she taps, and she says she always does it but more when stressed. I got her some new JBL headphones for Christmas, which have noise cancelling, so I think she’ll enjoy those and I’ll enquire to the school about her being able to have them in lesson.

Commenting mainly so I can come back later and read everything properly (I'm tired..)

My son is on the spectrum and exhibits things which m, to me, seem to cross over into both OCD and stimming. It's so hard to tell. Eg. Repeatedly and constantly sniffs his hands in a very specific way, lines things ups and is physically and mentally agitated if it's not his version of correct, clicks and flicks switches a set amount of times etc

I’m autistic with OCD and what you are describing is very familiar to me.

This is very similar to my DD who is diagnosed with Tourettes and autism. She also has OCD. I recognise your description about needing to do things in a certain way and becoming distressed if she can't. Plus lots of the sensory issues with touch, smell, lighting, taste, texture (food and fabrics), noises etc. Tapping surfaces is also something my DD does, plus pulling her lip. These are more stims (compulsions) than tics.

DD has had physical (and some quiet vocal) tics since around age four and they developed into sequences of tics at age 8. We saw a paediatrician who requested an ADOS assessment which confirmed autism.

As we gradually talked to DD she told us that she also has what she thinks of as 'thought tics' where she needs to go over and over something until it feels 'right', sometimes phrases or words. I talked with the Paediatrician who explained it sounded more like the compulsions of OCD than the tics that DD has with her Tourettes. A book I read on OCD said there are three types OCD compulsions, and DD has the type where she does things again and again until they feel 'just right'.

Nobody on here can say if your DD is autistic or has OCD but it's clearly painting a familiar picture for a number of us. Autism, OCD, ADHD and Tourettes all have overlapping traits so you'd probably want to request the school start a referral to the Community Paediatrics in your area for an assessment by a Paediatrician.

I meant to add that school should support children with their needs, even without a diagnosis. It depends on the school how much they do this though! You could speak with the SENDCO about trialling various adjustments to see if they help your DD to cope.