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

No offence but are you qualified to say whether you think it's OCD or ADHD or similar? Go along with all the referrals and see what the professionals say. You can't possibly know enough about ADHD to say 'you don't think it's Adhd'

Thank you for all the replies

@tellmesomethingtrue you're right I don't know anything about them really to say whether it's one or the other. I think my worry was seeking a diagnosis in one condition would mean potentially others are overlooked.

Im considering going private too. I'm not sure whether I challenge his behaviours or answer all the questions to ease his anxiety

My daughter is older at 13 but she is having a joint referral for adhd / asd

I am planning on going private due to her age but it is pricey. I am not sure I would do that if she was a lot younger.

There are some Facebook support groups for right to choose which can speed up the NHS process.

Thank you @Fluffycloudsfloatinginthesky
Yeh ive heard its quite pricey. Ill no doubt stick to the nhs route for now.
I might contact my doctor to see if he would consider doing a joint referral.
Im speaking to the head of the sen team at his school tomorrow so I'm hoping that will shed more light on the situation. As far as I know though he's different at school from what they've said.
It took me 20 minutes just to get him out the door this morning because of the questions. I feel so sorry for him.

@Jentwin2mom I have been quoted £3k by a couple of providers. I'm Greater London.

@Fluffycloudsfloatinginthesky
Yes I had a feeling it would be around the 2-3k mark from what I've seen when I've researched.
Im going to hold on with the nhs for now. I just hope I don't make him worse whilst I'm waiting for help!

Have you considered trying makaton and asking simpler questions? It will take the pressure off him a bit and give him a way to communicate without verbalising. So "are you hungry? " With simple yes or no signs which are easy to learn. Makaton is what they use on something special on cebeebies.

You could also encourage pointing to make choices so put drinks in front of him and ask him to chose which one he would like.

Might also be useful to know that asd and ADHD are often comorbid, i.e. kids have both, and that they are both extremely hereditary, so if he has one or both then it is likely you and/or his dad do.

Also, you can ask for help, and put in all the support needed without a diagnosis (with the exception of ahdh meds). You just need to ask for specific things. So at the moment I would be asking for the GP to do a referral to CAMHS for anxiety and a referral to speech therapy for the language issues.

He's been discharged from speech and language but I could get another referral. That was before all of these questions manifested.
Apperently the doc said the best course of action is to seek an adhd diagnosis first but will prob ask for an asd one too

I know this sounds patronising but I did find musical /creative/ humorous distraction the best way of dealing with obsessive repetition. Son loved singing songs, nursery rhymes, or listening to formal story telling with regular refrain, rhymes and it was also good for his language, especially if a song has several verses!. Calmed him and stopped the hyperfocus. Reframed repetition as something you did on special occasions not part of normal speech
My son has autism (diagnosed at 7)and inattentive ADHD (never diagnosed but I know it is there too)Just left uni. Good at drama and v articulate.
A twin.
I think with verbal tics (ds stimmed with his hands, so a physical tic I suppose) it is very comforting for them so you have to not stop it but let something else take its place to provide the calming effects. Ds grew out of stimming at 9.

Also, does he like school...what is happening there? His anxiety might be related to something he cannot cope with at school which OTHER children can cope with...meals, teacher, friendship group, toileting...children that age arent particularly good at explaining what is exactly making them anxious. At that age I was practically mute and never told anyone what bothered me or that I hated certain things.

Mine was discharged from speech and language aged 3!!! He subsequently had an EHCP in his teens with a speech and language component so really being discharged means nothing in the scheme of things. All sorts of things get overlooked

The diagnoses won't get you anything that you can't get without it except access to medication. Ask for the other referrals. He has problems that he needs support with and an ADHD or asd diagnosis won't directly help with that. Also the ADHD diagnostic waiting times are 8 years where I am so you may be waiting a very long time.

I'm encouraging certain behaviours.

What certain behaviours do you think you'd be encouraging? Do you think it means you're 'spoiling him' or enabling a certain 'entitlement behaviour'?

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.

Yes to the first. Not really to the second. It would be best to try and reduce anything that causes anxiety or distress. So even though it can be exhausting for you, try and find ways to 'pacify' him/his tendency to being distressed or significantly anxious.

I see visable relief when he asks and gets it answered 'correctly'
I just want to be doing the right thing

You seem to be doing the right thing. This tells you when you are too.

Educational psychologist here. I would actually be most concerned that:

A) at 5 years old he realises he is irritating and has to apologise for himself constantly - who in his life is down on him?
And
B) I would be hypothesising about his language processing. DLD (developmental language disorder) is very common, very under diagnosed, and can have huge impacts on self esteem and academic progress.

I don't particularly pick up autism, autism isn't reframing language to buy processing time, that's much more DLD like. Autism is a core sensory and social difference. And he's too young for ADHD diagnosis in most areas.

I would be wanting an ed psych or speech therapy assessment to rule out a specific language processing problem. You might find it quicker to invest in a private assessment if that is doable for you financially.

Editing to add : seen he has been discharged from speech therapy. I would still want his processing checked.

The difference is that he isn't generating repeated questions (asking the same questions over and over) in your description, he is repeating what you say to him. That suggests processing rather than anxious repeated questioning per se.

I agree. Sorry edited to say I agree with @Whatthefuck3456 My quote disappeared.

...

People pleasing to the point of ignoring your own needs, and fear of rejection/needing reassurance are key features of ADHD.

Key features of an Anxiety Disorder, not ADHD. It can co-occur with ADHD or Autism but it's a separate diagnosis.

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.

People pleasing is definitely psrt of RSD, which is a type of anxiety disorder, but isn't part and parcel of impulsivity unless one also has ADHD alongside.

@Whatthefuck3456 Really surprised you haven’t come across this if you are specialised in ADHD. It’s very common.

It's only common because a lot of people with ADHD or Autism also have an anxiety disorder. It's not common as a feature of ADHD so that poster (Whatthefuck) is correct.

I agree with posters who say it could be an anxiety disorder or language processing or echolalia (if repeating not rephrasing) or OCD, etc. It could be RSD too. So far I haven't seen ADHD or even Autism with what OP has said. Not every issue begins and ends with Autism/ADHD. There are several diagnosis and interventions that are not Autism/ADHD but can co-occur with them if he happens to have them too.

I'm also actually concerned about him apologising for what he said. OP, I'd assure him that he doesn't need to apologise and he isn't being annoying.

Also agree with @DrRuthGalloway

Im considering going private too. I'm not sure whether I challenge his behaviours or answer all the questions to ease his anxiety

@Jentwin2mom When you say "challenge his behaviours", do you mean ask out of curiosity to find out what is happening behind the behaviour or challenge him to get him to stop and change his ways? I'd not encourage the latter but the former might help you understand how best to support him and help ease his anxiety. He isn't intentionally trying to annoy you and "challenging" his behaviour isn't how I'd phrase trying to help him manage his emotions.

I'd also try and find multidepartmental assessments to rule out or diagnose anything he may be struggling with. It doesn't have to be one or the other.

@Geneticsbunny
Oh really, I was hoping that it would help me with strategies once we knew what we were facing. At this point I'm just guessing at how best to help him.

@ReelMeOut
By saying encouraging certain behaviours i don't mean spoiling him no, just answering his questions to alleviate his anxiety.
Thank you for the advice. My instincts told me to carry on as I am doing and answer his questions as I dont want him to feel distressed.

@DrRuthGalloway
Thank you for your reply, it's good to here from a professional point of view.
In terms of 'realising he's irritating' me and his dad do not let him think its irritating at all. We answer his questions. Out of the blew he will often just say sorry. I will aw you dont have to say sorry. He'll say no mom just say its ok.

I will look into DLD i hadn't even heard of this before and it would make sense that's its to do with language processing. As a youngster he was very violent but then after help from speech and language this improved. Then for the last couple of years it's been anger and frustration (lots of long meltdowns) and no violence. Then this questioning materialised all of a sudden.

I will ask the doc for a speech assessment again or perhaps go private.

Yes he does repeat what I say as you said but adds on the same qiestions every time
'Did you hear me' etc

@ReelMeOut
Yes he apologies all the time. When I gently talk to him and tell him he doesn't need to apologise he gets angry. Very angry. He wants me to say 'it's ok'

When i say challenge behaviours I simply mean to talk to him. Not tell him he's got to change into any way. Simply a wrong choice of words. I just invite him to talk to me and open up about anything.
I couldnt agree more. The doc jumped straight to adhd and I didn't even think of that. Ill perhaps speak to the doctor again to consider different assessments being done.

Ultimately I just want to help him. Im not interested in a label i just want to have some idea what it could be so I can read up on it amd find strategies to help him and alleviate his anxiety

You're doing well OP and seem to have the right ideas. I hope you get some solid solutions. His anger and just wanting you to say it's okay sounds like all he needs is reassurance and not correction of whatever he's said. Sounds like an OCD- type behaviour where he simply needs things to be the way he needs them to be - whether they're right or wrong to someone else. If it's not, it can be very distressing. Must be really hard for him to deal with (and I'm sure you too because you never really know what he needs until his distress shows it. Just follow his cue when he gives/says it). You're doing well.

@ReelMeOut thank you I appreciate that. Yes i couldn't agree more. He needs things said and to be done a specific way no matter whether they make sense or not. Thank you for all the input