Do I ask for diagnosis?

[ImperfectTents]

Dd is receiving cbt with Cahms . Her counsellor has suggested asking for a asd assessment. To cut a long story short, dd is extremely anxious, prone to violent out bursts . She does have friends but is constantly anxious about them not really liking her and not being able to have anything to say in social situations. She struggles with school due to the noise and crowds. She is super well behaved at school and basically bottles everything up until she gets home.

I am really torn. I think dd will find the assessment process stressful and tbh I am hoping they will find that she does not have asd. But I recognise that if she is autistic it might help her navigate life and will open more doors for help at school.

I am not sure what I want from this thread , maybe just some helpful advice

Hi. I really understand your dilemma. Our son is 15 and has just got a diagnosis of ASD and it is borderline. We had years of anxiety and trying to get him support at school /Cahms. Also he started asking questions himself about being different from his peers. We decided on balance it was better for him to have proper support at college and when we are not around. People do respond better when you say he has ASD. Having a diagnosis does open doors once you have accepted it. Good Luck!

Thank you! It's nice to hear from someone in a v similar situation. Dd hates me discussing her with my friends so I feel very alone with this and dh refuses to admit it dd is anything other than 'shy like I was'. I feel guilty that I haven't pursued this sooner .

I am really torn. I think dd will find the assessment process stressful and tbh I am hoping they will find that she does not have asd. But I recognise that if she is autistic it might help her navigate life and will open more doors for help at school

If she's autistic, she's autistic whether there's a diagnosis or not. If she's autistic, she will have reached this age as an autistic person and will continue to be an autistic person.
People who have a diagnosis have some reference as to why they feel or appear to be different to their peers.
Without a diagnosis, schools can be resistant to providing interventions and other people can react in unhelpful ways.

There must be reasons for her counsellor's suggestion, they've noticed something about her communication or behaviour which has suggested the possibility of autism. Could you ask them to put their concerns in writing to support a request for referral?

Several people have posted on these boards about being diagnosed as an adult and retrospectively wishing they'd known as a teen as they've felt it would have made their teens and early adult lives so much easier and prevented years of misdiagnosis and treatment for MH problems which were in fact autism.

Try completing the AQ online quiz as if you were answering from her point of view and see what the score is, it's not diagnostic, just an indicator, but it may help you to see some of her strengths and weaknesses more clearly.

She comes up as not autistic on all the online quizzes. She is probably v borderline if at all. My worry is putting her through unnecessary stress. Cahms will refer her and explain why if dd wants to go for it. Currently she says she wants to know but not tell the school.

Currently she says she wants to know but not tell the school

I'd think it likely school would be asked for their observations to be included in an assessment by a team BUT I don't know the CAMHS systems for doing anything, hopefully someone else can advise?

Or ask for a private assessment, Ed Psych maybe with SLT so any difficulties would be highlighted. You could ask for an extra copy of their findings to give to school IF your dd wanted any interventions they'd recommend. Be sure of what you'd be getting for your money before you agree.

It can be expensive, and if you needed an ECHP there's no guarantee the Local Authority would accept the private dx, unless the professionals doing it also work part time for the NHS.

The Lorna Wing Centre is the gold standard and priced accordingly. However, they are used to diagnosing girls as they can present very differently to boys.

From your description, the anxiety, the masking and the social difficulties would make me want an or several assesments because her melting down and being violent after school would be something I'd want investigated so I could help her.

Maybe time to consider your options

If she is autistic then she is weather you do the assessment or not. In your original post you talk about her being well behaved at school and saving it all up till she gets home. This is common for autistic girls. You also talked about online screening questionnaires. Did you fill them out or did she? Also you talked about her worrying that her friends don't like her this could be a result of her lacking "theory of mind". This basically means that she cannot understand or relate to the feelings or motivations of other people? Lacking this ability makes social situations very upsetting. Also it means that your point of view is the only point of reference you have so if you feel like no one likes you it isn't just a feeling in your head it's a fact.

My own DD was diagnosed with Aspergers at the age of 17, after over 3 years of high levels of anxiety, depression and self harming. She too is a borderline diagnosis and most people are surprised when they are told. DD however was not surprised as she had pretty much worked it out. Everyone is of course different, but I think on balance it is helpful to have a diagnosis. They don't give it lightly so, even if it is a borderline case, if they conclude a child has ASD it is for a reason. I know that DD finds it better to have a "reason" for her Social Anxiety and persistent sense that she is different and struggles to relate to others. It is also fair to say that we all understand her, and her reactions, better now. DD will always have Anxiety, but the depression is (for now at least) gone and she has not self harmed for over 2 years. My only word of caution is that our CAMHS service washed their hands of our DD once she had the ASD diagnosis, saying that there is no treatment. This is true in relation to ASD of course, but they completely ignore the ongoing Anxiety problems, which can still be helped. However, those with ASD can often find CBT less helpful and other methods are worth exploring. We use a private counsellor. Different CAMHS may be more helpful however.