Mind is a blur. New shock diagnosis + National Offer Day yesterday

[NewtoAuDhd]

This was not on the cards AT all, just didn’t see it coming. I must have been so blind - how could primary school have not said anything??

Very long story short…National Offers Day yesterday and we got our first and only choice, the local comp. DD passed the 11+ but due to significant trauma at a previous primary school, we wanted her to be with friends that support her and have her back & is closer to home.

24 hrs later: a Prescibing Practitioner & ‘family’ specialist from the council recommended by school have both today come to the same conclusion that DD has Autism and Adhd.

She’s going to be assessed by CAHMS imminently.

I have no issue with this at all but am now massively concerned that she is about to start Year 7 in a school that is so wrong for her. ☹️

Where do I even start with all of this please?
I’m the worst mum. How could I not see it?

Paperwork? Assessments? Meetings - with who? Choose a more suitable school?

Nothing. Honestly. We had a GP appointment at Christmas because of her biting, the GP did an urgent referral to CAHMS. The GP said the biting isn’t self-harming, that it’s emotional disregulation due to previous trauma.

She’s on her 4th primary school due to significant safeguarding issues at the others.

I didn’t come here for any kind of sick game. MN will confirm I’m an old-timer. I came for advice.

Do you think the school will be so wrong for her? There are children with autism and ADHD who function and thrive in mainstream secondary school. Not all, of course, but I’ve taught them and they’ve been successful. A discussion with the SENCo at the school would be useful.

You say the primary school have not said anything, but they must have asked someone to see her in school if a family specialist has visited.

A Prescribing Practitioner and family specialist from the council can’t diagnosis. They can recommend an assessment but they can’t diagnose.

If DD has only just been referred for assessment, it is highly unlikely she is going to be diagnosed imminently. There are long waiting lists. The diagnostic assessment will involve paperwork and assessments.

Speak to the SENCO at the current school and offered school.

A diagnosis doesn’t change DD’s needs and it won’t automatically result in more support. Support in schools is based on needs, not diagnosis. If you thought the offered school could meet DD’s needs before this week, that doesn’t automatically change now.

Ok, so, timeline, have gone through diary, emails and docs. V sleep deprived. Other stuff going on as well.

Started biting herself when she was 6, in lockdown. No punctures. Superficial is what the GP said.

4 schools & a housemove later, (to escape family trauma) DD asked to see a therapist or to speak to someone, to get some help. This school has been amazing. The Lead Nurse in Feb told me to contact CAHMS which I did. Speaking with them formally in a few wks; in the meantime they also have said the biting - in their opinion - in emotional deregulation.
I really do not have any issue with my beautiful dd having SEN, I believe in her being an individual and being her best self, she is loved for being her.

I asked the teacher and Head (she’s been at this school for two terms) for their thoughts on ASD and ADHD. They both said it’s hard to gauge.

The school asked me to see the Prescibing Practicioner at the GP. She diagnosed AuDhd on the basis DD’s leg was shaking and minimal eye contact.

I’m absolutely fine with a diagnosis, this doesn’t bother me, I’m just overwhelmed with the next steps as the Prescibing Practitioner has said I need to get a list from school staff of any signs they see in my child.

The Prescribing Practitioner at the GP cannot diagnose ASD &/or ADHD. That is beyond their remit. They may suspect and refer onwards, but they cannot diagnose.

It sounds like you have seen signs earlier but you are attributed them to other factors.

The school also contcted CAHMS off the back of DD showing staff a bite mark, to get them to prioritise us and deem it to be more urgent.
School asked me to get back in touch with CAHMS to highlight that the biting was becoming more frequent and the need to see us was more urgent.

I understand your reason for leaving. I myself am struggling. Thankyou anyway x

Yes I believe now thinking about it that this is the case. I am such a failure. Did the exact thing my ‘mother’ did to me that I promised DD I would never do. I have let her down in the biggest way possible.

Fuck.

Trauma and ASD can be confused by those who are not trauma aware.

So I wouldn't assume that any diagnosis is correct.

You are not a failure. At first glance ASD and trauma can look similar. There are differences too, of course, but there are similarities.

I pointed that out to the Prescribing Practitioner, as I have Complex-PTSD myself and she said I was in denial, so thankyou for confirming this x

I really have no issue with DD having any kind of diagnosis, of any kind, I am just so overwhelmed and emotional with how to move forward.

I’m also concerned about this diagnostic process. It’s not necessarily a wrong conclusion, but to meet the diagnostic criteria there should have been a more complex assessment that involved evidence from yourselves and her school. A prescribing practitioner usually refers to a nurse, pharmacist or paramedic who has done additional training. Although some mental health nurses will be able to diagnose adhd and autism and prescribe if appropriate, it would be fairly unusual for someone with sufficient experience to be based in a GP surgery and rare for a diagnosis to be given.

That said, it isn’t impossible. There are initiatives for mental health practitioners to work in primary care and so it is certainly possible that they have someone with the appropriate skills and experience. In your shoes though, I would want to check that the diagnosis is valid and has been made by someone with the right qualifications.

In terms of school, a formal diagnosis doesn’t actually change anything about your DD. She is still the same child with the same needs but it may now be easier to obtain an EHCP to meet those needs. That doesn’t inherently change the best school for her and your reasons for not selecting a grammar remain valid.

The way forward is to focus on her needs and ways to manage her dysregulation. The ADHD and Autism charities have a range of resources that you may find helpful.

As PP have said, trauma is a differential diagnosis when traits of ADHD and Autism are present and so additional care is needed when giving a diagnostic outcome. Even if she does have ADHD and or Autism, it sounds like her trauma is still unresolved and she needs support for it. Is she still on a waiting list for CAMHS? From what you have said, she needs intervention from a more experienced team.

Even if the prescribing practitioner has the qualifications and training to be part of an MDT assessing for and diagnosing ASD, it is highly unlikely they have diagnosed. If they have, they haven’t followed NICE guidelines.

You are not a failure. You have been taken aback by things that have been said to you recently, by your own history and by a diagnosis that seems to have been offered out of the blue and by someone who may not be qualified to do so.

Speak to the secondary school, outline DDs needs and tell them what support she needs. There may be some adjustments that are straightforward to arrange and there may be others that need more support. You don’t need a diagnosis to get support. There is evidence of need and that’s what’s required.

The school won’t know unless you tell them and work out together how your daughter can be supported in school to make a positive start.

I feel for you but I think you are over-reacting. A label, especially one given by a practitioner possibly not suitably qualified to make diagnoses, does not change your daughter's needs. Go ahead with her place at the school where she has friends to support her, but ask for a meeting with the SENDCO before she starts, and explain matters fully (don’t just present them with the label). Any further needs she may have can be addressed further down the line, as and when / if they emerge.

Something I would add is that friendship groups change a lot in year 7. Although she may be feeling glad right now that her friends are going to her next school with her, they will likely be in different forms and classes and will make new friends. As part of your planning for her transition, I would make sure that she isn't too dependent upon her primary school friends. The SENDCo may be helpful as they will have seen it all before and may be able to help.

Great post - thankyou for all of this. I will look into as much as I can relating to what you have said.

Couldn’t agree more. She absolutely needs help and this is why we initially went to the GP, we thought the biting was self-harming. We can’t afford a more specialist team other than anything that’s offered at no fee. Private therapy was suggested but at £90 p/h, it’s simply not an option so that’s why she started talking with the school nurse.

Had to google ‘MDT’ ☺️ She definitely said to all of us (Me, DH & DD) that both are present. She asked us if we had any questions, to which I replied about my concerns that I feel there may be an overlap of trauma personality, to which she told me in front of DH and DD that I was in denial.

Ok, noted, thankyou. There has been so much in the last 24 hours about EHCP’s and plans and schools and notes and calls that I lost the plot and everything.

So it sounds that as long as I communicate fully with her new school about what DD needs, she will be more comfortable. Eg, the chewy toy.