DD12 - could this be ASD, ADHD or anxiety

[Roseyposeypie]

Our DD12 (yr8) has been questioning whether she has autism since at least year 6. Recently she’s started saying maybe it could be ADHD. We’ve tended to focus on addressing things she finds difficult but are starting to wonder whether we should look into any kind of diagnosis so that we can better support her.

Things she says are difficult:

• a constant negative voice in her head telling her she’s not good enough
• struggling with noise (noisy places like the canteen but also little noises like pens on paper in an exam)
• feeling like she constantly has multiple thoughts going through her head

Things we’ve noticed:

• over reacts significantly to even the slightest hint of criticism
• doesn’t always quite read people/the room which can sometimes make her seem very confident or sometimes slightly rude
• has always struggled slightly with friendships though currently it’s the best it’s been. Has one close friend and a small wider circle
• likes to have routines to some extent and to know plans in advance
• has some specific interests that are unusual for her age (e.g. medicine)
• things get worse through the school term and generally better in the holidays

What school say:

• Has the most ‘positives’ (like merit marks) of anyone in her year
• seems happy and confident and does well at everything
• unlikely to be ND

I would welcome thoughts from people with similar aged girls. And if you do think it’s worth looking into a diagnosis, how do I start the process especially when school thinks there isn’t an issue.

I think it is worth pursuing an assessment. It could be ASD, ADHD or anxiety. Or a mixture of 2 or 3 of them. Just because the school doesn’t see it, doesn’t mean there aren’t signs there. Some schools are rubbish at noticing certain presentations. I would speak to the school again and speak to your GP.

I have boys - one with ADHD and one diagnosed with ASD in y8 - I think that his presentation is a lot like that of girls diagnosed in secondary school. Sounds to me like your daughter might have both. The ASD screening (done privately) included a screen for ADHD, just a checklist, because they so often go together.

My ASD child is exceptionally well behaved and high achieving at school. His teachers were surprised when I went in to discuss my concerns. They were very helpful in terms of filling in the forms for the assessment.

An ADHD diagnosis has clear benefit - access to medication. Otherwise, for ADHD and for ASD it is possible to put help in place without having a diagnosis. My experience was that the SENCOs will think in terms of ASD traits for children without a diagnosis and are willing to help these children. I found that outlining a specific problem, e.g. noise sensitivity, elicited solutions - e.g. noise blocking headphones or loop ear plugs.

I think you can go via the GP for a diagnosis. My understanding is that there are long delays in most areas.

Doesn’t sound like adhd but that is just me. Schools are rubbish so don’t listen to anything they say. You should be able to get a pre screening test / talk through if you go private before you decide to pay to check if they think it is worth going for diagnosis.

Thanks to those who’ve responded.

School have allowed things that DD has told them help her (eg loop ear plugs in the canteen, small fidget toys in her pocket). I think I’ll pick it up again with school in the new term.

@Roseyposeypie

I don't have girls, but it is quite well documented that many girls (and some boys) "mask" in school to try and fit in, which works to a degree through primary school, but the wheels eventually come off in secondary school as everything is so different and expectations are so much higher.

I certainly think it is worth pursuing further investigation/diagnosis. I know of a girl who struggled with secondary school but was not diagnosed with autism until she was 15, and then only after having a complete nervous breakdown. As a result, it was several years before she was able to go back into education full time.

Whatever it is, given that she has articulated to you numerous things she finds hard, and that she is only a couple of years away from GCSEs, I think you should get her into the system and refer to CAMHS. As she edges into the teen years, the demands of school may become more difficult for her to manage. A strong internal monologue like she has indicates that she is highly goal oriented, which can be a precedent for future mental health problems if she is neurodivergent. Even 'just' anxiety alone needs to be dealt with.