The world would be boring if we were all cut from the same cloth. Raising unique little humans who will one day take on the world makes us feel incredibly lucky, but as parents, we often find ourselves questioning their abilities as they grow and getting caught up in the comparison game.
Have you ever been in a mother’s group? Putting a group of babies of the same age in one room, will naturally lead to conversations relating to their development and milestones. Anything from sleep to crawling, walking and talking will tend to dominate conversation – besides the poo explosions of course.
Don’t get me wrong, milestones are great because they help both you and medical professionals know how your baby is progressing and in some cases, lead to further investigation and a diagnosis.
In some cases your little one may have been tracking well and the more subtle differences only start showing as they grow out of the toddler stage. Things like social interactions, school readiness or just different ‘quirks’, might lead you to believe that there is something different with your child.
Now, it can be easy to question yourself and whether or not you are ‘overreacting’, especially if it’s your first child. But as the saying goes, it is important to trust your gut and I always encourage anyone who might be unsure to ask questions and seek further support.
If I’ve learnt anything through my own journey with kids who have ASD and ADHD, it is that early diagnosis and intervention can make a huge difference.
Clinical Psychologist Jaimie Bloch explained the signs to look out for and how to get screened if you suspect your child has ASD, ADHD or both.
It is important to know that Autism signs fluctuate throughout an individual’s lifetime and are dependent on their everyday stressors and environment. Autism relates to different interpretations and responses to social interactions, experiences with sensory input, strong and restricted interests and repetitive behaviours.
Early signs of Austism Spectrum Disorder:
Some early signs of ASD to look for in young children include but are not limited to:
– Walking on their toes after the age of 2
– Rigid and literal thinking
– Poor eye contact
– Delayed speech and language development
– Sensitivity to sounds or textures
– Sensory interests such as staring at lights
– Repetitive behaviours such as flapping hands, twisting their fingers and/or rocking their body (otherwise known as stimming)
– Restricted interests which interfere with their ability to carry out everyday activities
– Difficulty following instructions
– Difficulty with toilet training
– Emotional sensitivity to trivial changes in daily routines
– Not responding to their name
– Minimal interest in interacting with other children with a preference to play alone
– Minimal pretend play
– Minimal shared enjoyment and joint attention
– Playing with parts of toys rather than the whole toy and not playing with toys as they are intended to
– Not understanding emotions in themselves or others
– Limited facial expressions or inappropriate facial expressions in certain situations
– Echoing what you say to them
– Repeating the same phrases
Children with ADHD may exhibit constant agitation, act impulsively, and struggle with attention. However, certain children with ADHD exhibit different symptoms, such as concentrating all of their attention on a single toy and refusing to play with any other toys.
It is important to know that ADHD has 3 subtypes: hyperactivity/Impulsive, Inattentive and Combined. The symptoms will look different between the 3 types. It can also look different between the sexes.
Early signs of ADHD
Some main signs to look for but not limited to (does not need to meet all criteria but a certain amount):
– Difficulty listening and paying attention across home and school
– Disruptive and struggles to wait their turn and may often blurt out answers
– Issues with memory: forgetful, losing items and misplacing things
– Careless mistakes
– Difficulty sustaining attention during play or in tasks they don’t enjoy
– Struggles to follow through on instructions or complete homework/tasks
– Has difficulty in organising tasks (sequencing, chunking, poor time management
– Avoids tasks that require sustained mental effort
– Fidgets, squirms, taps their leg constantly
– Restless (could look like not being able to stay seated or climbing when an inappropriate time)
– Finds it hard to sit still
– Interrupts and intrudes on others’ space and conversations
How do I get an autism or ADHD assessment for my child?
The purpose of assessments is to identify how your child’s brain is functioning. It can help identify and define their cognitive strengths and weaknesses and give you as a parent, the school as well as your child more insight into their symptoms and why they are manifesting. and It will also help a clinician begin to develop and outline a plan to not only support your child but help them remove the barriers that stop them from unlocking their emotional and cognitive potential.
An assessment is useful to help identify the ‘why’ behind your child’s challenges and symptoms. It can also support a diagnosis which can be useful in better understanding your child and finding the right support services and treatment options. For a child, assessments can be very beneficial in creating support at school and at home, applying for special provisions through the school and also if needed applying for NDIS.
Once you have identified, or a teacher has begun to notice that your child meets the symptoms checklist, or you meet some but are unsure the next step is to go and see your GP or paediatrician if you have a regular person you have seen for your child since they were born. A GP would be providing you with a referral to explore diagnosis, they are unable to assess and diagnose. If you are hesitant and unsure about testing you can book in to see your paediatrician. A paediatrician can do an in-depth developmental milestone assessment and help identify if there is a need for further testing.
When you get tested for ADHD do you also get tested for autism?
A psychiatrist, psychologist and paediatrician can assess and diagnose both ADHD and ASD. However, a psychologist will not only diagnose but provide you with a detailed recommendation plan for support, and the next steps for home, school and other potential services to help with intervention. A psychologist can also support a school in developing any learning plans that will be utilised and developed as part of the support for the child once they have been assessed.
What is involved in ADHD screening?
ADHD is diagnosed through a mix of semi-structured interviews with a clinician, a questionnaire and an objective measure of attention (typically will involve IQ testing) that is administered by a psychologist. All these diagnostic tools are utilised by the clinician who then will analyse the results and assess them against the DSM-5 criteria. The DSM 5 is a diagnostic manual of mental disorders that is the gold standard for clinical diagnosis.
1. The caregivers involved with the child will meet with the psychologist alone for an initial assessment where they will gather important background information, goals/priorities and the purpose of the assessment. This generally takes 1 hour.
2. Your child will come to the clinic for their assessment part. In this appointment they will undertake a Cognitive assessment, a semi-structured interview and a computerised test of attention. The clinician advertising the testing will also be gathering important observations about your child as they undertake the testing. This can take between 1.5-2 hours.
3. A clinician will score, analyse and assess all the results and collate this information together with the information gathered in the initial interview and write the findings of the report. They will put a profile of your child together, explore whether they meet the criteria from the Diagnostic and Statistical Manual 5th Edition (DSM) for ADHD and develop important recommendations.
4. Feedback session with the caregivers to go through the results, recommendations and next steps.
What is involved in ASD screening?
One health professional (Psychologist, Psychiatrist, or Pediatrician) or a multidisciplinary team can conduct and diagnose ASD assessments. They typically conduct assessment processes after a thorough medical evaluation to explore other causes of the child’s behavior and identify any developmental delays.
An ASD assessment involves a structured interview with parents as well as a structured play and observation session with the child. The parent interview assesses developmental history, current social, communication, and play behaviors through questions and discussions with the parents.
When there is possible funding involved and school planning, a psychologist will also incorporate a cognitive assessment (if over the age of 6 years old). All these diagnostic tools are utilised by the clinician who then will analyse the results and assess them against the DSM-5 criteria. The DSM 5 is a diagnostic manual of mental disorders that is the gold standard for clinical diagnosis.
Autism awareness – the ASD assessment process
1. The caregivers involved with the child will meet with the psychologist alone for an initial assessment where they will gather important background information, goals/priorities and the purpose of the assessment.
2. Parents/Caregivers come in on another day for a formal Autism interview called the Autism Diagnostic Interview-Revised (ADI-R).
3. Child comes into the clinic to meet with a clinician who will administer the Autism Diagnostic Observation Schedule (ADOS-2). This generally involves scenarios administered through pictures, play and structured questions depending on the child’s age and presentation.
4. Child comes in for a cognitive assessment (unless the child is under the age of 6)
5. A clinician will score, analyse and assess all the results and collate this information together with the information gathered in the initial interview and write the findings of the report. They will put a profile of your child together, explore whether they meet the criteria from the Diagnostic and Statistical Manual 5th Edition (DSM) for ASD and develop important recommendations.
6. Feedback session with the caregivers to go through the results, recommendations and next steps.
If a parent wants to explore both ASD and ADHD, the tests combine the assessments.
Receiving a diagnosis can bring a mix of emotions including concern, confusion and uncertainty about the future. However, it is important to remember that your child’s diagnosis does not define them or determine their potential. Your love, support, and understanding will play a crucial role in helping them thrive.
Your assessing clinician can create a treatment plan to help them move through life as easily as possible. This should also help you feel guided in understanding how your child’s brain works.
School-based support can involve developing individual education plans and parenting guidance to equip children for a healthy, independent adulthood.
While it will be undoubtedly challenging at times, have faith in your child’s ability to grow, learn, and overcome obstacles. With your unwavering support and belief in their potential, they will continue to surprise you with their resilience and progress.
I will leave you with something that has always resonated with me:
“When a flower doesn’t bloom, you fix the environment in which it grows, not the flower.”
And that is exactly why understanding and accommodating our child’s needs will ensure they can grow into their own unique beautiful selves.
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