Help with Anxiety

[Iamsodone]

Hello
I have a 7Y old daughter diagnosed with severe ADHD. she is generally very happy but has always had some anxiety in different areas form.
We are lucky that separation anxiety and anxiety about going to school have very largely disappeared since starting ADHD meds. her relationship with peers have also improved which, I think, has contributed to lower anxiety.
What remains is :
-the phobia (fight/freeze) when presented with medical events (she won't even have her height/weight/BP taken), dentist or eye checks are out of questions...
-some social anxiety around specific social events (a certain type of birthday parties, certain people gatherings, with a degree of unpredictability)

can anyone shed some light on this to understand it and provide some pointers to what support may work and is available ? or just some strategies please?

At the moment, we are going with gradual and supported exposure, reducing uncertainty by going through what will happen, with whom, where etc ? I am also thinking that if we help building the communication skills, by giving her tools it may help with the social communication anxiety side of things.

Does CBT work with that age group ? how can we access it through CAMHS?

We may put her forward for an ASD assessment in the spring (currently on WL) but I am fully aware it will not give us access to any significant service or support that we aren't getting already for the ADHD support apart from probably a group parental training !

thanks so much !

Has she got a diagnosis of anxiety? It is often co-morbid with ASD and also with ADHD, but it is a seperate condition.

CBT can work for DC. If DD does have ASD it will probably need adapting and even then some autistic people find it doesn’t work for them. Play therapy can help too. It can be accessed via CAMHS, but there will be a long wait and that is if DD is even accepted at all. If DD has an EHCP it can be included in there.

For the dentist, is DD under the special care community dental service? If not, request a referral. They do this day in, day out.

The social anxiety may be in part because of sensory needs. OT can support that. Things like ear defenders/noise cancelling headphones, sunglasses, big hoody can help. SALT may also help with social interaction.

@Traverseedubosphore no she hasn't, please tell me who can diagnose anxiety ?
Her NHS pediatrician consultant will only consider the ASD side of things. No one is given any consideration to her anxiety, except the private psychiatrist who diagnosed the ADHD.
I emailed a week ago to ask for support with anxiety and the ADHD nhs Dr got back to me going on and on about support we would get once she has received her ASD diagnosis (as if it is a done thing!), which is in 7 months from now !!! which, I know already, won't open up any significant new support, DR has not even suggested anything we could do now apart from applying for DSA which we are getting already. I don't know if she hasn't read the question or there is no available support anxiety so she is just shoving me off :(

@OvertakenByLego thank you we will be trialing Music therapy privately and are having an SaLT assessment as well, as I think it might give her some skills that will be useful to build confidence
she has had play therapy in school, but outside of having a good time there, I can't see that helped, it was before receiving the ADHD diagnosis and starting medication, do you think it's worth trying again ?
for dentist, she isn't
how do I get that referral to special care?
thank you

NHS Paed in our case. Referred to Neurodisability Service Psychs for help with health/medical aspect of anxiety. EP also administered a screening assessment: The Screen for Child Anxiety Related Emotional Disorders (SCARED).

In some areas you can self refer to the special care community dental service. If you can’t, the dentist should be able to. In some areas the GP, school nurse, paed would be able to. If you google, you should be able to find your local service and the referral process or a phone number to call to ask.

It is worth trying play therapy again. Now DD is medicated she may be able to engage better. It is something that has to be persevered with, it isn’t a quick fix.

I also think you should consider requesting an EHCNA if there isn’t already an EHCP in place. And if there is, you need an early review.

Scope offer mentoring to parents on the assessment pathway and recently diagnosed.

thank you @OvertakenByLego will follow those leads
school is not concerned as now that she is medicated she has no behaviour issues and she gets to school happily :(

Some things you can drop…. Can she see? Then you don’t need an eye apt. As long as she doesn’t get headaches. My boy has never had one and he is 10 😬

blood pressure - can she play on your iPhone games whilst the dr does the blood pressure

blood pressure - you can buy a monitor to have at home too - dr are happy to take mums night before reading

weight - I weigh my boy before a bath on scales - we both do it - I make a joke about my weight - both happy to do it. It used to be a flat out no for many years including not being able to stand on scales for water park rides. So I do feel your pain on this

height - you can get a wall chart for home off Amazon. He will stand happy at home to do it - each height has an animal and make a joke of now your a lion etc do it every couple of months. If there is any incentives of oh once your 140cm you will able to go on x ride

dentist - now that’s an issue only as the last dentist wasn’t caring. Dentist wouldn’t refer him to a specialist but then the dr did (phew) we are working on that one ….. he has seen her twice

try and make the environment work for the child at socials and realise that some people hate gatherings - they just don’t find it fun.

Therefore does your child really have to go to the party? It might just be too much for her. Or pop in for a bit but always know that there is a quick exist if it’s too much.

You can medicate for anxiety - you will have to decide whether it’s worth it. Keep the people / environment safe and then that will lower the anxiety plus lots of notice of what’s happening / times / who will be going etc

good luck

Parents can’t always tell if their DC have sight problems or other eye problems. Children should still have eye tests which is why they are free for DC, and if OP’s DD is autistic she is statistically more likely to have sight problems.