Adhd / asd / dyslexia in a 6 year old

[squashedtomatoandstew]

I’m a bit lost with all this and would appreciate some advice. DS is only just 6 & in year 1. School have referred him for assessment for ADHD and ASD. It’s a 2 year wait so I said yes even though I am not sure about it, because 2 years is a long time and I can then decide if I do think it’s the right thing. The issues school have raised are: not holding eye contact and trouble maintaining attention. I wonder if it’s more likely to be dyslexia. He sometimes reads words backwards. The optician said he may have an eye issue (she didn’t give me a name for this) & asked me to get him to move a pencil towards his eyes and away again every day and to go again in six months. His teacher moved him nearer to the front of the class after I told him and since then he’s made big improvements. But it could also be because I’ve been doing more work with him at home or some other reason.
He does seem to look away a lot and often day dreams but he can make eye contact. He also focuses very well sometimes. He has a very vivid imagination. His behaviour at home is not always great but at school it is apparently perfect. He seems maybe less emotionally mature than his friends and will get upset or offended quickly. He can get quite angry and can be rude to adults which is hard for me to navigate if he’s being rude to another grown up. He has lots of friends. He’s ok with change. I just wonder if I could be supporting him more with attention and even eye contact? I know I can’t pursue a dyslexia assessment for a year (or is it longer?) but is there anything else I can do.
i also wonder if the school has been too quick to assume a diagnosis is in the offing. His reception teacher had no issues and just thought he needed support with emotional regulation & that his learning would catch up. He has some speech therapy in reception because he had some minor speech issues but they are all sorted. His therapist did a language assessment and found him well within the normal range. She wondered about dyslexia too. But his year one teacher has been very fixed on the idea of adhd from the start and is now saying asd might be a possibility too. I have asked if they can support him with phonics in the meantime so he doesn’t fall far behind.
He is reading phonics band 4 books now and his maths isn’t too bad. So maybe they are over worrying it?
thank you for reading this far and if you have any advice.

The school won't be making a referral for the fun of it.

It could be nothing and the team will bounce it straight back as not meeting the threshold if that's the case.

But it could be something, and I personally would be grateful for the school acting on concerns early - especially due to the amount of time it takes to get anywhere with a referral!

School staff are experienced in spotting these things. It certainly doesn’t sound like it’s just dyslexia. Why not go through the diagnostic process and see what comes out of it.

I have said yes to the referral but it’s two years away and in the meantime I want to help my son if I can. And I also wonder if I should ask for a dyslexia referral as well.
I should also have said that the Senco doesn’t think he has either adhd or asd. Nor did his reception teacher or speech therapist. But his year one teacher does. So the advice I’ve had has been conflicting.

The SENCo would have to be involved in the referral, so must think it's a possibility (it's a fair chunk of paperwork and their time is pressured).

As for dyslexia, there isn't a referral that can be made in the same way. In most areas, the only way to get a dyslexia diagnosis is privately. It's not an NHS thing.

Don't try to teach your child eye contact! Do support them with their learning and social skills.

Thanks @solidaritea. I didn’t realise that about dyslexia. That’s very helpful to know. I am supporting with learning and with friendships but I guess maybe I wondered if I should say things like “look at people when you talk to them” or if that would just feel like a horrible pressure for him. Other members of the family have started saying that to him and it is stressing me out as it doesn’t feel the right way to go so I was wondering if there was another approach or better to leave it and tell them to leave it as well.

The eye contact is tricky because people with ASD can find it very uncomfortable and so insisting would be unreasonable. However, some children don’t find it uncomfortable, they’ve just not realised its importance in social interactions and they can learn to improve their eye contact.
Have you had his hearing tested?
You can absolutely teach attention and listening skills, just like any other skill that a child needs to learn successfully.
One other thought, ASD/ADHD/Dyslexia are not mutually exclusive. He could have them all. Or not and just be developing in his own little way. It’s hard to tell when they’re little sometimes. What I mean is that a diagnosis of ASD wouldn’t then rule out Dyslexia or vice versa.

A child could have all of those things. Your child has to have met a pretty high threshold for a referral to go through. You don't get on the waiting list just for wanting to be on it. Many referrals get rejected. If the referral gets accepted it's likely there's enough evidence there to warrant it.

Thanks @Dodgeitornot. I do understand he could have all those things. Sorry if my post was poorly expressed. I am mainly trying to support him over the next two years before he is assessed. When you say referrals get rejected, do you mean the school puts them forward and the council or NHS rejects them?

@squashedtomatoandstew yh school of GP and than they get rejected.

School or GP*

Oh OK. So will wait to see if it is accepted or not.

@Elisheva thanks too. This is what I’m wondering: if as you suggest, he just doesn’t realise eye contact is important, then how can I help? But obviously if it is actively horrible for him I don’t want to push it.
his hearing was tested at school but could maybe do a more thorough test via the GP.

In my experience schools often identify that there is ‘something’, but then don’t know quite where to go next. They tend to suggest adhd/ASD/dyslexia as these are the diagnoses that they are familiar with. But there are many other things that can cause children to struggle in school. However schools are very experienced with the range of development that children present, and as they have said that there is ‘something’, it would suggest that there might be an issue outside of the normal developmental range. It sounds like your school are doing everything they can to identify and support his needs, which is great. Go with what they suggest, as pp said an unnecessary referral will be bounced back anyway.
I also find that as children get older their specific needs become clearer and easier to identify.
Did the Speech Therapist suggest social communication difficulties at all? You could request a re referral to them and ask for an assessment of social communication.
Is your son an only child?
For now I think what you are doing is right. Identify the areas that he is having specific difficulties with at the moment and support him with them.
Working on Attention and Listening skills is never going to hurt, and can be quite easy and fun. There are lots of resources online e.g. https://ncse.ie/wp-content/uploads/2020/07/Attention-and-Listening-Skills.pdf

The fact that you are aware of his needs and motivated to support him will help your son just as much as a diagnosis.

Thanks so much @Elisheva. The speech therapist assessed his social communication and it was good. He is an only child, had v tough times during lockdowns & was premature so there are other factors to consider. School is quite on it. But they seem to be referring a lot of children (or at least this particular teacher is) which is what made me wonder if it was the right thing or not. But the referral is happening so I will see what happens and will look at that link in the meantime and keep supporting his learning and social skills.

I have a child awaiting ADHD assessment around the same age. He can read and socialise well but has a tough time with inattentiveness.

The best things I have done to support him is to parent him with interventions for children with ADHD even though he may not reach criteria when he does see an Ed pshycologist. So I don't shout at him anymore really at all because he doesn't register it and it just makes me angry and him sad. I go to him and use touch to refocus him. I give him short to do lists to try that he can tick off to manage day to day tasks that don't seem to come naturally to him like they do his brother who is a few years younger. If I want him to do a task that lasts a while (eg tidying room) we set a timer on alexa and I work along side him to keep him focused with regular breaks. Exercise is super important to him so I need to make sure he gets enough outdoor time.

I've seen so much improvement with these interventions at home but he keeps getting in to trouble at school for looking out a window, or taking too long to get gym clothes on or talking too much and as a result doesn't really like being at school anymore so I think it's a super positive thing that your DS'a teacher is engaged at supporting him.

The school won’t refer unless they think there is an issue, try not to diagnose yrself as u rnt an expert.
A lot can change in 2 years, and best to be on the list and get help as soon as possible rather than burying yr head in the sand.

Thanks @Beseen22 thats really good advice and I will give it a try.
@Skybluepinky Im not burying my head in the sand. I am trying to help my child in the two years I have to wait until he can be assessed. As I’ve said up thread I have said yes to the referral.

My child is year 2, but he was referred for adhd and asd in year 1 (still awaiting assessment). The last 12 months have been interesting as he has changed so much.

He started year 2 and has been so much more focused. His new teacher is amazing and sends him for movement breaks when he needs it, and runs a very structured classroom.

It’s also become clear that he’s gifted. He didn’t do any work in year 1 (teacher wasn’t sure what to do with him) , so we didn’t realise (though he had a good reception year). There is no talk of asd any more and I very much doubt he has it. Adhd is pretty much a given though. For my son, the teacher makes a huge difference.

Sounds like the eye thing is convergence insufficiency which can cause dyslexia type symptoms. As well as the pencil trick, you can put several beads on a string. He holds the end of the string on the tip of his nose so the beads are horizontally in line with nose. Ask him to focus both eyes on the bead furthest away. Then try the next closest bead.
Also, if he has any tracking issues then ask him to quickly read the first and and last word of each line working his way down a page.
The problem with dyslexia is that they don't assess until quite late. I wouldn't worry about diagnosis, the main thing is to give him the extra support at home so he can keep up with his peers. I found the dyslexia gold resources really helpful although they have gone up in price since we used them.

Good ted talk if you are interested.

Thanks @newmum1976 and @Gloschick. Really interesting to hear your experience and advice.

I have 2 children with dyslexia and not much in what you said suggests dyslexia to me. At 6 it’s still very common to get letters and numbers and words backwards. I would hold off a couple of years to pursue any dyslexia diagnosis.
Schools won’t do referrals for ADHD or ASD unless they are pretty sure about it - it costs them a lot to do this and they wouldn’t waste money unless they were thinking they will likely get a positive result. A diagnosis of ADHD or ASD will help your child get the support they need. I would go along with the school and see what the results are. At least you will know and if it comes back negative you will be offered techniques to help with managing behaviour. This should result in a better outcome for your child.

Thanks @TulipsAndDaisiesAndBlossom.

Just to reiterate: I have said yes to the referral and am following all advice from school. However as there is disagreement between the teacher, Senco and speech therapist, I am also trying to understand what is happening. (I have tried to get a meeting with teacher and Senco but they haven’t been very helpful with that. So it’s been left to me to navigate through the conflicting advice). And given there is a 2 year wait, I am keen to help my son in the meantime.

But I am not not going along with school advice.