11 year old girl missed ADHD tendencies

[Sunflowers189]

Our daughter is currently 11 years old and has just begun her journey in secondary school. Before this transition, she faced several challenges related to food from a sensory perspective and exhibited tics, including eye tics and nose scrunching. She also finds it difficult to sit still, often bouncing her leg and struggling with focus, and she is uncomfortable with physical contact, such as hugs.
While our daughter has been able to meet expected academic levels, including during her SATs, I have observed that her tendencies seem to be intensifying. I am seeking guidance on how to best support her. I recently spoke with our GP, who mentioned the need for substantial evidence and referrals from the school. However, I’m concerned that the staff may not recognise her behaviors, especially since she is still new to the school environment.
Navigating the system to secure appropriate support for our daughter, who exhibits several traits associated with ADHD, has proven to be quite challenging. If anyone has experience or advice on accessing support services or strategies for advocating for her needs, I would greatly appreciate it. Thank you for your help!

Tics are far more common than most people realise and often resolve by themselves. Do they trouble her? If they have been there for a while she might fit the criteria for Tic Disorder and if painful or debilitating there are meds that can be tried. On the whole they are best ignored as focus on them can make them worse. CBT to techniques can also reduce them but again it depends how much they are really impacting her. Food sensitivity (I’m assuming you mean she avoids some foods) are inconvenient but in my experience even very severely restricted diets can be expanded over time. Is she growing and does she take supplements?

What support do you feel would really help her? Is the level of need difficult now or are you mainly concerned that it will escalate?

Even though she tends to keep her feelings to herself, I’ve observed that her tics sometimes create challenges for her. In primary school, for instance, her eye tics were frequent enough that reading became quite difficult for her, impacting her ability to concentrate on the text.

Additionally, her small stature places her at the lowest end of the growth percentile, and she has been assessed for ARFID. Eating can be quite an overwhelming sensory experience for her.

It’s evident that her behaviors may not align with neurotypical patterns, and these differences influence various aspects of her life. I believe it’s crucial to recognise that, with the right support, she can thrive. She would benefit from assistance with sensory processing and possibly support for managing her time during exams.

Unfortunately, the waitlists for these services are quite lengthy, and I want to ensure that her needs are identified and addressed early, rather than waiting until it becomes a larger issue.

So what support do you feel she needs?

if she’s been assessed for ARFID but presumably didn’t reach the criteria what did the assessor feel was causing her difficulties?

As far as extra time and those sorts of accommodations go, the school should be able to help.

What was the outcome of the ARFID assessment? Is she still under an ARFID service/dietician?

Has DD had a sensory OT assessment?

Speak to the school’s SENCO. About a referral but also about support now. Support is based on needs, not diagnosis. The school doesn’t need to wait for a referral or a diagnosis to provide support, including with exam access arrangements.

The ARFID service provided some support for our daughter, but it primarily focused on weight gain and addressing vitamin deficiencies, which didn’t fully meet her needs. We have now been discharged but the service is available to us as and when we need it.

We haven't pursued occupational therapy yet, as this hasn’t been suggested to us. Our GP mentioned that all concerns must be addressed through the school. While I understand the academic perspective, I feel it’s important for the school to consider the day-to-day experiences our daughter has, which they may not be fully aware of.

In terms of support from the school, during her time in primary school, we faced challenges in obtaining accommodations like extra time without an official diagnosis. Moving forward, I believe starting the referral process earlier would have made a significant difference in her support.

Support (academic and otherwise) in school, including exam access arrangements, isn’t based on diagnosis. It is based on needs. So speak to the SENCO at the secondary school.

Not all areas commission sensory OT on the NHS. If your ICB does, request a referral. Or in lots of areas you can self refer to OT.

If your area’s ARFID is only about weight restoration, you could ask for a referral out of area. For example, to Maudsley’s ARFID service.