An adhd diagnosis in my 5 year old. Im not sure if the doctor is correct

[Jentwin2mom]

Hi. I was hoping somebody else has discovered similar behaviours in their child
I have a 5 year old boy who has a twin sister. He hasn't had any diagnosis and is physically healthy.
He is a very easily frustrated child and my doctor is seeking an ADHD referral. However over the last 2 months I've noticed certain behaviour patterns that concern me.
It seems as though he has a compulsion to continually repeat what someone says by way of a question. For example.
I will say zack did you see that bird? He'll say did i see that bird? Am I looking at that bird? Sorry I said that.
Ill say zack are you hungry? He'll say am i hungry? Sorry I said that.
This is in pretty much 80% of my interaction with him. If i don't answer he gets extremely frustrated and upset (for instance if I didn't hear him)
I ask him why he asks and he says he's worried but can't tell me why.
If anybody asks him a question he will say I don't know and say he's scared to answer.
Im so worried for him.
He constantly seeks reassurance and is constantly saying Sorry. We show both my children lots of love and never raise our voices. I just want to help him.
He just seems constantly anxious. I'm so worried about him. Any comments or advice welcome
Sorry about the long message

Hopefully someone more qualified and with more experience will be along shortly to help

To me, the way he talks sounds OCD like?

Thank you so much for replying. I'm at my wits end in terms of helping him. I thought the same.

He's clearly very anxious and it's entirely possible he is neurodivergent - from the limited info you've given here, I would suggest autism rather than ADHD (or both). Does he have sensory issues? E.g. Can't bear certain noises or textures, or seems to seek sensory input?

Is it "am I hungry?" or does he repeat "are you hungry?"

I ask because the second kind - repeating the exact words - is echolalia. This is a normal part of development, but can continue much longer in people with autism.

Rephrasing is more unusual.

Thanks for your replies

MoMandaS.
Yes agreed he's super anxious and it's a lot of the time which is heartbreaking.
Yes I said to the doctor I'm not sure i agree thst it's adhd. I also said I'm not seeking a label I just want to know how I can support him. Quite rightly the doc advised they can do that when they can understand if he's neurodivergent.
Nope no sensory issues.

ThesebeautifulthingsthatIvegot
No he doesn't repeat exactly what i say but he has a list of questions he asks.
It will be am I hungry?
Did you hear me?
Did I talk over you?
Sorry I said that.
He will either say all of these questions and one or two after everytjing that's asked of him. If I don't answer correctly it causes extreme distress.

@Jentwin2mom Sounds like asd to me

https://www.speechandlanguagekids.com/echolalia-when-children-repeat-what-you-say/

This sounds like echolalia which can fall under the autistic spectrum condition but not always. Ask the doctors for a speech and language referral as well as autism and adhd testing.

I would say it sounds more Autism...people pleasing behaviours, repeating phrases of speech etc.

The GP can’t diagnose; they can only refer you to a psychologist so hopefully you will get the right diagnosis and the right support to help you with your son

It sounds like your Dr hasn't diagnosed anything but has referred your son for an assessment?

Agree with PP that an autism assessment would also be beneficial.

Sounds like Gestalt language processing.

Can occur independently but can be a feature of autism. As can extreme frustration. And high anxiety.

Is it that he’s learning sentences rather than learning individual words and learning how to create sentences with them? I’m not an expert but I think that’s gestalt language processing and so a speech therapist may be able to help.

Sorry no the doctor is just in the process of sending a referral. He jjst advised it be an adhd referral whereas I thought more ocd or autism.
He has been discharged from speech and language now as his speech is perfect and doesn't struggle to hold conversations the same as his twin.
He does have people pleasing behaviours. Massively so. Constantly needs reassurance too and get extremely jealous of his sister over very small things

your doctor hasn’t diagnosed your child - they have referred them for specialist assessment which is appropriate, and this will screen and assess for neuro developmental issues like adhd, ASD, ID etc.
keep a list of your concerns and questions and bring them written down to the paediatrician or psychologist you attend. Early intervention is really important so getting the ball rolling is a positive. (I’ve been a lead for assessment team and they should talk you through it in detail at initial apt) best of luck.

Could it be tourettes? The repeating questions could be a vocal tick - Echolalia and Palialia are both symptoms, as is OCD type behaviours

Thank you
@Psychologymam
That's true he's just sent off a referral. I was just worried that seeking an adhd referral would rule out other neurodivergent conditions.
This is all totally new to me so I'm just so unsure of everything going on. I'm just waiting for a school report now so I can get the ball rolling. I don't think his behaviours are as severe at school so not sure how serious I'll be taken

@BloominNora
Yes it's definitely a possibility. I'm not ruling anything out at this point. Thank you for the imput. I'm grateful for all opinions and advice

There's a lot of overlap between ASD and ADHD. Also with other conditions like sensory processing disorder, dyslexia and Tourettes.

One of my friends children has a combination of these and one of their Tourettes symptoms is repeatedly asking the same questions and needing the correct answer (sometimes multiple times a minute). My friend found it exhausting before they got support for it.

Not really - GPs aren’t experts in this (some will have extra knowledge of course) but the specialist team will know this and look at it more globally. Share your concerns with the person you meet - you’re the expert in your child and make sure you ask if you don’t understand aspects of the ax but don’t worry - a cornerstone of both ax is parental interview and getting your perspective on what’s going on.

Repeating what you say could be potentially delayed processing or echolalia. They are common comorbidities with ADHD/Autism but technically are separate diagnosis.
ADHD and Autism are much more commonly diagnosed together now than previously thought so it could be that he may have both if you see some autistic behaviours also.

Thank you so much for the responses.
These repetitive questions are so exhausting. I always try and answer correctly I'm just worried I'm encouraging certain behaviours.
In my position would you continue to answer him as it causes anxiety if not answered. Would you question him...again this causes him anxiety. I see visable relief when he asks and gets it answered 'correctly'
I just want to be doing the right thing

@User0ne
Can I ask what sort of support your friend received?

OP, I would check whether or not the assessment will also consider other neurodivergences. Some can assess for multiple neurodivergences, but my experience was of solely an ADHD assessment being carried out, and then years later an autism one.

Hi, I am specialised in ADHD and I haven't came across this before in adults or children. I would lean more towards anxiety.

People pleasing to the point of ignoring your own needs, and fear of rejection/needing reassurance are key features of ADHD. The fear of rejection is called Rejection Sensitive Dysphoria (RSD). People pleasing is often linked to the RSD but is just as often part and parcel of impulsivity. @Whatthefuck3456 Really surprised you haven’t come across this if you are specialised in ADHD. It’s very common.

OP ADHD isn’t just about being disorganised, struggling with linking tasks, ‘getting going’, managing emotions and emotional regulation is a big part of ADHD. ASD and ADHD are also often seen in combination and there is cross over between the features of these. Reading your post I thought it ‘could’ be ADHD, it might be ASD, it might be a little boy learning how to manage big feelings but in any case it’s better to confirm early so interventions and support can be put in place in school. Good luck x

It's tragically common for "experts" and people in the field in the UK to not have come across them. They often also don't realise OCD is on the ND spectrum as well and pure-O-type OCD is probably the worst understood of all. See also: Inability to understand hyperfocus.