How to differentiate between ADHD and autism diagnosis

I’m currently going through the diagnosis process with my daughter. Referred when she was 3/4 and now about to turn 7. Had our first appointment yesterday and the assessor says she is most likely ADHD but only has maybe a handful of autistic traits. She autism traits she was asking questions about I feel don’t really relate to girls on the spectrum.
My daughter is exactly the same as me when I was a child except my childhood was filled with a lot less understanding, especially from school. I was seen by psychiatrists since a very young age but my mum thought it was to do with her divorce rather than something else so I didn’t get an autism diagnosis until I was in my 20s. The reason I differ from my daughter at the moment is because I had all those ADHD traits hammered out of me from a young age so I spent the majority of my life in burnout and masking, which I’m trying to undo now.

What I’m struggling with at the moment is how is ADHD and autism differentiated in girls? She has traits where she never uses body language, doesn’t understand social cues, has no idea what other people are feeling or thinking, sensory issues, and thrives on routine. The assessor says even though these traits are there the fact that she’s sociable and wants to play means she doesn’t think she’s autistic, but my understanding is most females with autism are sociable and happy to talk about topics that interest them, and love to go out and do things with others, the problem is it’s just too difficult because of not understanding social cues or getting bored easily due to no interest or difficulty with things like small talk. Also harder to concentrate and need time to recharge social batteries because the constant bombardment of sensory information we need a break from.

So, how do I make sure my daughter gets the correct diagnosis? I might need to write things down for the assessor while I think of them, like the fact she is asking me if my daughters facial expresJoyons match how she’s feeling or if my daughter gets social cues when I have problems with that myself. I have no idea if she’s getting social cues or not Joy but she does talk over people and doesn’t know when she’s supposed to say certain things so that’s why the assessor has gone with her not being able to understand social cues. She also asked if my daughters facial expressions shows concern to people and I said yes, but I understand it from my point of view where showing concern to me is us saying ‘what is wrong with that person’ and then working out how we might be able to help, or to learn from the situation. But, that has come across as not an autistic trait to the assessor because she thinks my daughter is able to show concern but maybe in the way she interprets in, where in a real life situation people would say that isn’t the correct way to show concern.

Sorry for long post. I’m not sure who to discuss this with and I have the habit of over communicating to try and make sure I get my point across correctly. 

Parents
  • It sounds like your assessor is very outdated with their understanding of autism. There are plenty of autistic kids, boys and girls, that want to play, they just don't always know how to go about it or miss social cues etc. Some autistic kids are overly social and have no boundaries which causes problems because they don't know when to stop. But yes girls often mask and are more likely to be social than boys. Their special interests are also often more "socially acceptable" than boys (for example animals) and therefore don't stand out as much with the rigidity and repetitiveness etc.

    Autism and ADHD together is also further complicated because they mask each other. When I am at work I manage my ADHD very well but my autistic traits really come out because it's peopley and there's sensory things to deal with and change etc. At home my autism settles because I'm in control of my environment and there aren't any people but my ADHD is ridiculous. 

    Again not showing concern is so outdated as an autistic trait. It's long been debunked that autistic people can have empathy. Some people struggle with it yes, others might struggle with how to show it. We might be blunt about it or we might relate it back to ourselves because that's the only way we know how. Some autistic people, particularly girls, actually have hyper empathy and really feel others pain and can get really worried about other people.

    I hate that at this point in life people are still dealing with outdated assessments. I wonder whether you can ask for a second opinion? Or see if you can find information online to really make your point to the assessor.

    https://www.autism.org.uk/advice-and-guidance/topics/identity/autistic-women-and-girls

    https://www.autism.org.uk/advice-and-guidance/professional-practice/autism-and-empathy

    These links might give you a starting point. They are from the NAS themselves and explain a bit about differences in girls and the debunking of the empathy issue. You may be able to find more to back you up online but I know NAS is reputable. 

    My advice with assessments is go through the criteria for each condition (you can find this online) and write down the traits your daughter has for each. Use the information about the differences in girls to help you. This can make it easier to make your point that she does in fact meet the criteria.

    I've already written a lot so I'll leave it there for now but if you'd like me to go into the differences in ADHD and autism traits more particularly from a female perspective then I'm to share my own experiences with you.

Reply
  • It sounds like your assessor is very outdated with their understanding of autism. There are plenty of autistic kids, boys and girls, that want to play, they just don't always know how to go about it or miss social cues etc. Some autistic kids are overly social and have no boundaries which causes problems because they don't know when to stop. But yes girls often mask and are more likely to be social than boys. Their special interests are also often more "socially acceptable" than boys (for example animals) and therefore don't stand out as much with the rigidity and repetitiveness etc.

    Autism and ADHD together is also further complicated because they mask each other. When I am at work I manage my ADHD very well but my autistic traits really come out because it's peopley and there's sensory things to deal with and change etc. At home my autism settles because I'm in control of my environment and there aren't any people but my ADHD is ridiculous. 

    Again not showing concern is so outdated as an autistic trait. It's long been debunked that autistic people can have empathy. Some people struggle with it yes, others might struggle with how to show it. We might be blunt about it or we might relate it back to ourselves because that's the only way we know how. Some autistic people, particularly girls, actually have hyper empathy and really feel others pain and can get really worried about other people.

    I hate that at this point in life people are still dealing with outdated assessments. I wonder whether you can ask for a second opinion? Or see if you can find information online to really make your point to the assessor.

    https://www.autism.org.uk/advice-and-guidance/topics/identity/autistic-women-and-girls

    https://www.autism.org.uk/advice-and-guidance/professional-practice/autism-and-empathy

    These links might give you a starting point. They are from the NAS themselves and explain a bit about differences in girls and the debunking of the empathy issue. You may be able to find more to back you up online but I know NAS is reputable. 

    My advice with assessments is go through the criteria for each condition (you can find this online) and write down the traits your daughter has for each. Use the information about the differences in girls to help you. This can make it easier to make your point that she does in fact meet the criteria.

    I've already written a lot so I'll leave it there for now but if you'd like me to go into the differences in ADHD and autism traits more particularly from a female perspective then I'm to share my own experiences with you.

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