Advice for non diagnosis

Hi, 

I am looking for advice. My daughter (age 8) has been going through the NHS system for autism assessments. We finally after 3 years got told she "doesnt fit the criteria for autism". 

The reasons they gave were that: 

- she doesnt line up toys 

-she doesnt stim by rocking or spinning 

- she doesnt know lots of facts about a topic 

- she can cope with routine changes 

- she hit milestones as a baby

And she has friends. 

They dismissed her sensory issues and said its most likely ADHD.

I relayed this information to her school and they have disagreed with the decision too. 

She sensory seeks to keep herself calm 

She has attachments to her fidget toys

She wont wear certain materials (ie denim or silk) 

She has had sessions with a mental health nurse due to high anxiety and low self esteem

She has had interventions at school about coping with anxiety and self image

She struggles to 'fit in' and alters her behaviour to fit who she is around 

She repeats questions or re tells the same stories frequently 

She misunderstands social situations very easily and then becomes very distressed 

She doesnt understand boundaries - she will always hug people randomly even strangers (obviously i have spoken to her about this an explained why thats not always a good idea etc) 

She worries a lot about what people think about her

She walks on her tip toes 

she has recently been diagnosed with Dyspraxia. 

She becomes easily disregulated when she cant do something 

She has had episodes where she hits, bites or scratches herself when she is upset 

My self, and school both believe there is an element of ADHD but many traits point to Autism too

So my question is this: Is it worth challenging the decison? Seeking a second opinion? 

And HOW do i even go about this? 

I am so worried for when she goes to secondary school that she wont get the right support without a diagnosis. I also want to get an EHCP in place for her but school have even said she is unlikely to get an EHCP without a diagnosis

All i want is support for my little girl Sob

Help and advice please!!! 

Parents
  • If you have any doubts, yes a second opinion is well worth while.

    There are a couple of points to bare in mind, though.  Since your daughter has a dyspraxia diagnosis it is already evident that she is neurodivergent.  It can be complicated when someone has more than one form of neurodivergence.  I am both dyslexic and Autistic, for instance.  Some features can overlap and be mistaken for another or mask the presence of another co-existing form of neurodivergence.  Throughout my life I explained away a lot of things that are there in fact because I am Autistic (which I had no clue about) as down just to my dyslexia, which I did know about.  Notoriously, ADHD (and sounds like you suspect she may be an ADHDer) and Autism get confused and one tends to hide the other by pulling in the opposite direction, whilst they do also share features.  My ADHD other half and I both have a lot of sensory stuff going on, an intolerance of pointless small talk and are excellent pattern spotters, for instance. Yet he isn't Autistic and I'm confident I'm not ADHD.  This sort of thing can make the job genuinely difficult for clinicians.

    Some individuals do have high numbers of Autistic traits without actually being Autistic.  My son for instance thinks just like me!  Soooo very logical and very blunt with his honesty, and gets socially tired.  But then, he also engaged in imaginative social play that didn't involve lining stuff up and was confident and popular in school.  A few little sensory things, but not much to speak of.  Errrrrr, I'm not a clinical psychologist and wouldn't like to say whether he is Autistic or not, but some marked traits are definitely there. Well, he is my son!

    Also, the quality of NHS assessments are known to vary.  Our knowledge about presentations in girls and women is getting better by leaps and bounds, but sometimes clinicians aren't entirely UpToDate.  It's impossible to say whether yours were skilled enough to pick their way through any masking or not etc.

    So, your little girl could well be Autistic and they missed it.  Or she could well not be Autistic but have a battery of other neurodivergences which are similar to in some respects.  It's only right and proper that you should get clarity given the complexity of her case.

    If you do decide to try for a second opinion, personally I would take on board the reasons that they did not give her a diagnosis and consider whether there was in fact evidence of those things which perhaps wasn't put before them or made clear enough and start collating that.  Observations made in school reports, family photos of her at play etc.

    But, whatever the truth of what her brain is like, what's important is that the school respond to her need.  If she's got co-ordination problems whether because of dyspraxia and/or Autism, they need to respond.  If she has organisational, sensory or social problems whether due to ADHD and /or Autism, and/ or dyspraxia, the school need to respond.  The most important thing is that they listen to her and you and respond to her need whatever the truth of its label.

Reply
  • If you have any doubts, yes a second opinion is well worth while.

    There are a couple of points to bare in mind, though.  Since your daughter has a dyspraxia diagnosis it is already evident that she is neurodivergent.  It can be complicated when someone has more than one form of neurodivergence.  I am both dyslexic and Autistic, for instance.  Some features can overlap and be mistaken for another or mask the presence of another co-existing form of neurodivergence.  Throughout my life I explained away a lot of things that are there in fact because I am Autistic (which I had no clue about) as down just to my dyslexia, which I did know about.  Notoriously, ADHD (and sounds like you suspect she may be an ADHDer) and Autism get confused and one tends to hide the other by pulling in the opposite direction, whilst they do also share features.  My ADHD other half and I both have a lot of sensory stuff going on, an intolerance of pointless small talk and are excellent pattern spotters, for instance. Yet he isn't Autistic and I'm confident I'm not ADHD.  This sort of thing can make the job genuinely difficult for clinicians.

    Some individuals do have high numbers of Autistic traits without actually being Autistic.  My son for instance thinks just like me!  Soooo very logical and very blunt with his honesty, and gets socially tired.  But then, he also engaged in imaginative social play that didn't involve lining stuff up and was confident and popular in school.  A few little sensory things, but not much to speak of.  Errrrrr, I'm not a clinical psychologist and wouldn't like to say whether he is Autistic or not, but some marked traits are definitely there. Well, he is my son!

    Also, the quality of NHS assessments are known to vary.  Our knowledge about presentations in girls and women is getting better by leaps and bounds, but sometimes clinicians aren't entirely UpToDate.  It's impossible to say whether yours were skilled enough to pick their way through any masking or not etc.

    So, your little girl could well be Autistic and they missed it.  Or she could well not be Autistic but have a battery of other neurodivergences which are similar to in some respects.  It's only right and proper that you should get clarity given the complexity of her case.

    If you do decide to try for a second opinion, personally I would take on board the reasons that they did not give her a diagnosis and consider whether there was in fact evidence of those things which perhaps wasn't put before them or made clear enough and start collating that.  Observations made in school reports, family photos of her at play etc.

    But, whatever the truth of what her brain is like, what's important is that the school respond to her need.  If she's got co-ordination problems whether because of dyspraxia and/or Autism, they need to respond.  If she has organisational, sensory or social problems whether due to ADHD and /or Autism, and/ or dyspraxia, the school need to respond.  The most important thing is that they listen to her and you and respond to her need whatever the truth of its label.

Children
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