adhd/asd combined

[chelseamarie1995]

my daughter has been showing symptoms of adhd for a good whole, the school she is at is keeping track and using strategies to help her at school, obviously as we all know the waiting lists are very long! now she got referred back in November but I have just found out yesterday that the doctors actually referred her to a over 14 place (she's 7!) so I had to go through the whole process again, I'm now starting to question if she has traits of autism (food problems, clothing, loud noises) so the doctor asked me a million questions (over the phone because it's impossible to get an appointment!) and asked if I had any behaviour concerns, to which I answered no not really, he then proceeded to tell me that if I have no concerns about her behaviour then there is nothing wrong with her? he said some kids are just naughty and parents push for a diagnosis?!?!? I haven't spent the last few years fighting to get her help for the fun of it!!! so I answered him with she's not a naughty kid, she struggles with alot of things but being naughty isn't one of them, I can deal with whatever she throws at me, she's my daughter fgs! but being naughty isn't the issue here, she's falling behind at school, she's struggling to concentrate, she's non stop in the sense of she doesn't sit still, talking, singing etc... she hardly eats anything good for her, specific beige foods from specific shops! and wet food (beans, gravy) has to be in a separate bowl, she can't wear tights, knitted jumpers anything by her neck, she goes into a state if she hears any sort of alarm. my question is could she have either of these without being naughty?

Yes, I'm not sure the concept of naughty is very helpful here. It implies a child is exercising a conscious choice to misbehave. It is quite possible for children to behave in inappropriate and problematic ways, and not to meet expectations that their peers are able to meet, because of differences in their development capacity. This could be not yet having developed cognitive skills associated with executive functions (self-monitoring, impulse control etc), or because their social understanding and ability to read implicit expectations, or communicate, is different from other children at that age etc etc.

I think you perhaps need to separate out whether you are seeing behavioural challenges, from whether or not you think your child is to 'blame' for them, and how far you are having to modify their environment in order for these not to be so problematic?

Standard definitions of autism and ADHD (DSM or ICD) require not just evidence of 'traits', but evidence that these result in impaired functioning in daily life.

One of the things people often mention here is how soul destroying it can be to have conversations with professionals which focus on the things a child finds most difficult, when as a parent we always want to nurture our children's strengths and enable their achievements. However, the nature of the beast is that we have to talk about the bad bits too, and the lengths we go to avoid them. As you are describing, it is possible to describe these things without a child-blaming narrative.

If you feel the Doctor has not heard you I would request a second appointment or second opinion. And during that, be sure to share any observations school have offered too.

The understanding of neurodiversity in primary care is patchy. I once took a letter from school to a GP which suggested that a referral for assessment was needed (written by a SENDCO with a doctorate in the field of child neurodevelopment). I was told by the Doctor this was just school's way of saying my child was naughty (it really wasn't). And that the GP could always spot the children with ADHD as they wriggled, and as my child had not wriggled, they clearly were not neurodivergent. Suffice to say diagnoses eventually followed.

yes so the school are trying to do everything they can but the providers they use have shut refferals! I mean she has like impulses where I can physically see she's trying so hard to control herself but can't, but other then that I wouldn't say her behaviour is any different to any other 7 year old, she's a back chatting, sassy 7 year old girl🤣 I don't agree that he's basically told me because she isn't naughty there can't be anything wrong, I'm mainly worried for her academically, maybe as her mum I'm making excuses for some of her behaviour but I certainly don't see it as a major problem that needs help, she doesn't sleep well, eat well, or handle certain situations well, I only want whats best for her so when it comes to SATS/GCSE she can have extra help/support, its such a overwhelming and painful process but I just wasn't sure if we were going to be shut out as her behaviour isn't 'naughty'

Sounds frustrating. Have you spoken to your GP? If not, take evidence from school and see if they can refer directly onto an assessment pathway? Girls can present very differently to the way that both autism and ADHD have been thought about historically. Ultimately, diagnoses will not be made without evidence of functional impairments in daily life but that does not necessarily mean challenging behaviour.

If the GP used the word naughty I would complain. It demonstrates a lack of understanding of the violent and challenging behaviour that can sometimes be associated with ADHD and ASD. Having said that behavioural concerns has a wider meaning than the VCB behaviour typically described by some as ‘naughty’. For example, it could include sensory related behaviour, impulsivity, sleep difficulties that you describe.

Support in school is based on needs. What support are they providing? Has an EHCNA been requested? When you say the providers they use have shut referrals who have they referred to?

In some areas the school can referral for ASD assessments. Have you checked if they can in your area?

yes it was the gp that said that! I've spoken to her teacher this morning and he is appalled at the gp and is going to write a letter complaining. sorry but what is VCB?
the school have put in place strategies to help her that's all they have said, the schools sen team are monitoring her and are going to keep a record for me to give to the doctors.

I'm not sure what EHCNA is?

my daughter was referred to mindworks who have said they aren't taking any more refferals, I have asked to be reffered under the right to chose act but was told this was just a long a wait as nhs!

the school are saying there is nothing they can do as the referrals are closed so I'm stuck on what to do!

VCB is violent and challenging behaviour.

An EHCNA is an Education, Health and Care Needs Assessment. It is the assessment you first request as part of the EHCP process. You should request an EHCNA. On their website, IPSEA (a charity) has a model letter you can use.

Relook at RTC if your area has closed referrals for now. Even if it is a wait it is better than no referral at all.

Depending on your income/savings you could look at a charity ASD assessment via Caudwell Children (another charity).

thankyou! I will request that ASAP! and I'm going to get a second opinion tomorrow from a different doctor!