Are enormous meltdowns always ASD or ADHD?

[2kidsnewstart]

Hi,

I have a 6yo girl and a 2.5yo girl and I am at my wit's end. Really sad and despondent and just not sure what to do.

I am going to write most about the older one. She is exceptionally bright, thoughtful and kind. She is full of energy, quite extreme (ie climbs exceptionally high trees, cycles her bike fast) and sociable. In many ways she's wonderful.

But she also has the most enormous meltdowns whenever she's not at school. Even when being looked after by other family or friends. Sometimes they last for 3 hours. Other times they are every 15 minutes over the smallest thing all day. Sometimes she's fine for a couple of days. But she can be like this for 5 days on the trot.

She just returned from bowling and my friend called me several times as she was melting down so much - screaming, crying, throwing things, tantruming on the floor. For various reasons but all reasons the other kids had no problems with.

I've read a few books on how to help emotional regulation and the validating techniques don't seem to work. I am speaking to the school next week about help for me managing it. And the Explosive Child book is being delivered tomorrow.

She is v sensitive and can be upset by fairly ordinary playground things at school. She also wishes me and her dad would be with her all the time. We both work part time so she does see us a fair amount (IMO). But these things just aren't possible, for us to give up work and be there all the time.

The natural question is is she ADHD or ASD. But she really doesn't meet some of the usual diagnostic criteria (she has no problem with eye contact, can easily read others' emotions and is very sensitive to them, doesn't like solitary play and hates it in fact etc, not fixated on things). She has always had some sensory issues with clothes, noise etc.

And i don't want to wait for years on CAHMS or paying £3k for an assessment feels like a stretch when I am on the fence about how likely it is.

So the question is are some kids just big meltdown types and they grow out of it? Has anyone got experience in this? Any tips or advice or experience welcome. Or do the meltdowns mean she has neurodiversity, even though she doesn't really meet the other tests?

It's incredibly draining and isolating and I feel like crying most of the time when I'm with them. And sometimes I do cry and it makes the meltdowns worse.

I feel sorry for the little one who is shouted at and ignored. I hate my life. Thanks for reading. I'd be grateful for any advice. Dad also looks after them and she is slightly better for him. Def the worst with me. Terrible when we are all together.

I don't know I wish I had the answer when they don't fit in these boxes or tick all the questions

The behaviour you describe is outside what you'd expect from a neurotypical six year old. This doesn't mean she's definitely ND, but it does point in that direction.

I'd also have a think about why she's having these meltdowns. You say, she's fine with eye contact, fine with socialising etc. but something is causing these meltdowns and it's quite possibly the pressure of masking the fact that she isn't fine with socialising in all circumstances, that she isn't fine with eye contact etc. The bowling alley just sounds like a child completely and utterly overwhelmed by the situation, I don't think bowling is for her no matter what she might say or pretend.

Explosive child is a fab book.

Also I quite like neuro wild and Dr fisher for Facebook people to follow.

Autism central is quite good.

You can be autistic/adhd and have good eye contact and be social!

You cna be autistic and hyper sensitive to others emotions too.

No, obviously not

"she has no problem with eye contact, can easily read others' emotions and is very sensitive to them, doesn't like solitary play and hates it in fact etc, not fixated on things."

The above jumped out at me of the two female in our extended family with autism this is how they present. Both diagnosis received in young adulthood. Ideally, if we had it earlier it would have made life easier to navigate.

But how are those things a symptom of autism?
I know that autistic people don't always follow the traits that people immediately bring to mind but at the same time, those things aren't autistic traits either.
Yet they might be part of that person's personality might they, who happens to be autistic

I would say at that age it's very unusual and could well be ND. If she's masking all day at school it might explain why she meltdowns so much outside school. Bowling might have been a completely overwhelming experience for her, loud music, lots of kids running around and shouting. Sadly I wouldn't be surprised if school say her behaviour is fine there and you get told by the NHS that your parenting is the problem and it's your fault. This happened to a friend of mine whose child was finally diagnosed in his teens.

Exactly! I'm autistic too and everyone was surprised when I 'came out'.

The sensory issues stand out to me, too. Sound is a big issue for me. I can only properly understand speech in quiet environments.

It really is worth looking into OP. If I'd had a diagnosis in childhood it would have saved me loads of problems in adulthood.

Have a look at the autistic teacher on Facebook. She has some very good explanations on autism .

Following op for advice and experiences also have the explosive child arriving from Amazon tomorrow!

you can be social have good eye contact and be ASD particularly girls the meltdowns are likely caused by her masking it all day at school and holding it together issues with noise and sensory issues are common with ASD

@2kidsnewstart hey OP, she sounds incredibly like me DD(7) we were absolutely at our wits end with meltdowns. Like your DD she could go days being absolutely fine then weeks where we would have multiple meltdowns over seemingly nothing.

She is absolutely incredible in school and went into school multiple times who said there were absolutely no problems.

We reached a really low point last year where the meltdowns seemed constant and her sleep was absolutely terrible and we bit the bullet and went for an autism assessment as we were very unlikely to get referred through school.

I was very reluctant to do it as I hadn't noticed any of the "typical" signs of autism. (I always thought her eye contact was good, loved other children, doesn't like playing alone etc)

But she was diagnosed with ASD and likely ADHD too. After the assessment it all became a lot clearer, the assessor actually picked up on the fact that she only actually makes eye contact with me and her dad which I had never noticed before. She also realised that although she liked playing with other children it all had to be on her terms and was rule based on top of other things.

We now understand her a lot better and since the assessment can understand what might trigger meltdowns (e.g high masking in school and releasing when she gets home, people not playing her games properly etc) I was very shocked but I'm so glad we had the assessment as it really has turned our lives around to helping and understanding her more.

My best friends little girl is also autistic and is the most empathetic, kindest little girl I have ever met. I really do believe that the spectrum is so wide the typical sign posts are not as relevant the more we learn about the condition.

This may not be the case at all for you but thought id share my experience. Wishing you all the best of luck.

Mine was like this. Great eye contact, chatty, friendly, sociable. Talked early and well.

Diagnosed at 16
Refused school this time last year
Diagnosed ADHD at 17.
Meds made a big difference.
Still out of school with ASD burnout.
Now has an EHCP.

And she presented fine. Huge meltdowns and anxiety. But keen and hardworking at school. Lots of friends.

l WISH more than anything she’d been diagnosed when much younger. She’d be going to university in September if she had. Ibstead she’s still in severe burnout and can’t process reading. Even though she’s got 9 GCSE’s

Read the Autistic Girls Network.

I don't know why you wouldn't ask for a GP referral and get the ball rolling. If in the waiting time she grows out of it and starts to regulate her emotions better then no harm done but if she does have additional needs you can get help before secondary school.

She sounds lovely by the way and it's a shame she's struggling so much at times to manage her big feelings.

In my area you have to answer the questionnaire with all the questions surrounding autism/ADHD whatever you're going for. So if she doesn't tick enough boxes they're not going to refer/accept the referral.

Might not be relevant to OP but it sounded like that was what OP was saying in the post

In our area referrals don't go thru the GP. You ask school to refer you to the hospital child development centre.

Are there any physical things you need to check? Is she growing ok? Has she had a sight and hearing test? Does she sleep ok? Does she eat a good diet? Does she have any bowel issues?

For example i've seen this behaviour in a friend's DC and it turned out to be chronic constipation caused by a dairy allergy. He was in constant low level irritation and it made his behaviour pretty wild.

I think we're too quick to label children.

Some children, like adults are quirky. It doesn't mean that they're autistic or have adhd .

Does sound typical of ADHD rather than ASD (have experience of both). We've had private diagnosis for £1k, an ASD assessment is more involved and would be more like £2k. From what you've said I would follow up on ADHD.

And too often girls are missed.

And end up like my dd.

Sensory issues and anxiety could be indicative of autism. She could also have sensory processing differences, but not be autistic. She could be highly anxious, but not autistic. Has she had any major life traumas? How is her sleep, eating etc. it's not always autism, but in high masking girls it can look very different than in boys or lower masking autistic kids. That's why a lot of girls have historically had missed diagnoses.

All three of my children and myself can make eye contact.
I have a script in my head to follow that tells me when to look away, blink etc
My son uses his glasses to fake eye contact when he's actually looking at the top of his glasses.
One of my daughters defocuses her eyes
One doesn't have any issues with it.
All of us are autistic/ADHD

FWIW 2 of us are social, 2 less so.

IMO if you are at the end of your tether I'd be seeking assessment.

My dd had epic meltdowns around 7 yo from kicking in kitchen doors, throwing stones at the windows, climbing through windows and 'running away'. Someone told me that they have their first big burst of hormones at that age. We could go ages without a meltdown and then when she had them, they lasted at least an hour of full on fury. She was always remorseful after and that is when we talked about it. It did get better and then you start to notice that the meltdowns get fewer. There is ADHD in the family and there maybe other traits, but I haven't pursued any diagnosis.

Thanks. She has enjoyed bowling before but I agree it's the type of environment that might give rise to a huge meltdown.

Bowling alleys are really loud and the shoes feel funny. How often is she looked after by others?