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.

X post!

They're what comes up when I Google autism symptoms. I was under the impression there was quite a firm diagnostic criteria for assessment and as she doesn't meet lots of common traits that's why I was hesitant to go through it.

But sounds like there's more to it.

Hi OP
She sounds like my nearly 6 year old & we are currently awaiting assessment for ASD / ADHD which was prompted by various issues at school with concentration and social issues.

My DD is very similar including the tree climbing & cycling! I never thought she had ASD when she was younger as she spoke early (full sentences at age 1) and was super confident & social. She loves other kids.

But now at nearly 6 it’s obvious she’s emotionally immature and her social skills are a bit off. She’s very dominant. She also still has almost toddler-style meltdowns at times.

I’ma massive believer in early intervention and have sadly seen the fallout from a now adult relative who was never diagnosed or helped. Determined my daughter won’t suffer in that way.

Yeah I agree. Did they go private in the end?

I've got high hopes for this book!

@coolcoolcoolcool

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 this is my daughter too

Hmm, I don't think so

DD is highly strung, let's say, but she's 7 now and has recently got much better. Less crying, less emotion.

I do think age is a huge factor

I also think that kids need more sleep than you realise. They are exhausted by 6pm.

@2kidsnewstart as far as I understand it kids with asd (my son included) can cope with things to a certain level then when another thing is added they just can't cope if that makes sense.

So they may have been bowling before and been fine but then this time (totally guessing here), stress about being with a different person, various stresses at school, hungry, louder environment, flashing lights, more people there, tired=today can't cope.

I can't answer your original question about whether massive meltdowns are always a sign or asd/adhd as I'm no professional but I thought my son made great eye contact, turns out he does..with people he feels comfortable with. Not with others. He is exceptionally emotionally literate and sensitive. He does however have fixed interests and always has done. They are all so different.

That's so helpful, thanks so much. Sounds like you're in a much better place.

Oh that sounds incredibly tough. Do you think a bit of R&R will help get her back on track? Sending lots of good wishes your way. Thanks for the comment.

Sounds pretty similar to my child who was diagnosed with autism shortly before their 7th birthday.

Have you spoken to the school SENCO about your concerns? You could ask them to observe her in school. Ask for screening questionnaires.

It sounds as if she has quite a few sensory issues so I would recommend a private Occupational Therapist assessment if you can afford it; they are much more affordable than a full neurological assessment and will give you useful information and recommendations for things that will help her at home and in school. It can also be evidence to support a referral for assessment, too.

My child's assessment was NHS funded but it wasn't the standard route, we used Right to Choose (asked GP to refer to a private assessment provider that accepts NHS RTC funding). If you're interested in that option there is info online and a helpful Facebook group too.

If you can get it from the library I recommend 'How to raise a happy autistic child' as it has helpful info and advice about the pre-diagnosis phase and it might help to give you an idea of whether you should pursue it.

Lastly here are some links you might find interesting:
https://help4psychology.co.uk/blog/children-who-mask-or-camouflage-their-autism/
and
https://www.pdasociety.org.uk/what-is-pda-menu/

That's a good point. She's v tall and strong and eats well (enough). She used to be a terrible sleeper but much better now.

No. Ds could rage for hours , no special needs just very, very strong willed. No sign of a temper now as an adult.

I recognise a lot of ND traits in your description tbh. Don't forget female presentation is often very, very different.

No trauma, and by my measure has a lovely life. Kind, loving grandparents, me and their dad are affectionate and do loads with them etc.

She doesn't often get anxious in the way I understand the term (she doesn't obviously worry about things).

And you know immediately when she is bothered by something.

How does she cope with transitions, new things, change?

Is she sometimes controlling, wanting things her way or "just so"?

There can be subtle signs of anxiety - I didn't realise my child's behaviour was a sign of anxiety until I googled "demand avoidance" and had a lightbulb moment. Anxiety was driving a lot of the behaviours.

Once a week after school by another mum. And then occasionally has a sleep over at grandparents.

Terrible with transitions in particular leaving somewhere. Yes quite controlling and wants things her own way. Will Google demand avoidance, thanks.

This is the main screening questionnaire, OP:
https://www.clinical-partners.co.uk/images/forms/AQ-10_for_children_aged_4-11.pdf

And this is a longer questionnaire which we completed for DC's assessment.
https://psychology-tools.com/test/cast

You sound like me four years ago, OP. Down to reading The Explosive Child. We are currently going through the assessment process with my now 10 year old, after she reached crisis point late last year. I wish we had pursued it earlier and avoided that.

Like your daughter, and by the sound of it like many autistic girls my daughter is very academically able. She was also hiding or masking quite a lot of sensory overwhelm around noise, light and texture. Sitting next to a boy with mouth noise was what pushed her over the edge, and led to school refusal in the end but it was just the straw the broke the camel’s back- if she’d had ways of managing the overwhelm, we might have avoided it.

It may or may not be ASD with your dd, but if I were in your shoes I’d get it checked out now as early intervention can really help.

Thanks. I think these comments have given me the push I needed.

The explosive child book is amazing it's changed my life with my autistic son.

I would say read up on autism in girls. I'm autistic as is my daughter. We make eye contact read emotions and appear sociable. Autism is different in girls. I'd also say read up on the window of tolerance and sensory processing difficulties. Bowling is sensory overload which can lead to meltdowns. Also the coke bottle effect and masking.

No one on the internet can tell you for sure if your child is autistic. The waiting lists are years long for assessment so get her on the list. Many autistic girls fall apart in secondary school as they can't keep up the masking and social interactions become more complex

You say she doesn't seem anxious, bur anxiety often presents as anger in children. They have the meltdown because something has triggered their trauma response. In a child who has not experienced trauma, this usually is due to neurodivergence. Autism often presents as you've described in girls. I don't see much ADHD in how you've described her. Does she have problems with her attention span?