Symptoms of HFA in a 7-9 year old girl

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Forum -> Parenting our children -> School age children

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amother

Wed, Jun 14 2023, 6:57 am

Hi my daughter has absence seizure, adhd and some learning difficulties. She has always been temperamental but her behavior has gotten significantly worse over the last maybe year. She can be so good and sweet one minute and then something triggers her, although most of the time I don’t know what, and she flips out. She yells, throws things, has major tantrums, physically hurts the other kids, often “mistakenly” hurts the other kids by knocking her hand into their head for example but saying it was a mistake. She is very often very angry. BH we have a relatively calm household besides for her. My other kids aren’t like this. My husband and I are not screamers and stay calm with her like 85-90% of the time even when I get a slipper thrown at my head or a chair sent flying in my direction.
Thing is, at school she’s pretty good. Definitely doesn’t show explosive behaviors that we have at home. They start literally the second she walks in the door. Teachers notice that she does have some anxiety in school about doing work correctly, visits the nurse regularly for a variety of complaints etc, uses the bathroom frequently (not a uti, been checked)
We tried a variety of adhd meds which weren’t helpful at all. I recently started thinking that maybe she’s on the spectrum but very high functioning.
Based on what I’ve described, could that be it? Or could it be anxiety?
We have an appointment with a psychologist but I’d like to know what you all think

imasinger

Wed, Jun 14 2023, 7:09 am

Rule out anxiety first.

Possible indicators for ASD:

How does she do at making and maintaining friendships?

How is her executive functioning?

Does she have "areas of expertise" that she focuses on, sometimes not knowing when to stop talking about it?

Does she have any unusual behaviors around sensory issues? Unusual communication (or lack thereof) strategies?

Does she know when to stop (or not start) challenging a teacher or authority figure?

Does educational testing reveal a pattern of spikes and valleys, with 25-50% difference in percentile points?

amother

Wed, Jun 14 2023, 7:51 am

imasinger wrote:

Rule out anxiety first.

Possible indicators for ASD:

How does she do at making and maintaining friendships?
She tends to come on a big strong, she does have one neighbor that she’s not in school with that plays with her frequently. But they frequently fight. Regarding classmates, she isn’t often invited to their house but seems to play okay when they come to us.
How is her executive functioning?

Does she have "areas of expertise" that she focuses on, sometimes not knowing when to stop talking about it?
No

Does she have any unusual behaviors around sensory issues? Unusual communication (or lack thereof) strategies?
What would be examples regarding communication?

Does she know when to stop (or not start) challenging a teacher or authority figure?
She’s pretty well behaved at school. At home this is 100% a problem. She doesn’t know when to stop.

Does educational testing reveal a pattern of spikes and valleys, with 25-50% difference in percentile points?

Do you mean in the same area or does very well in one subject but very poor in another?

Thank you for taking the time to write this out!

imasinger

Wed, Jun 14 2023, 8:13 am

Not always even subjects. Sometimes, it's things like fabulous memory, poor at language. Or, in math, great at concepts, not always at mechanics.

And large difference, it looks like a mountain range on intelligence testing graph, not a wave.

allgood

Wed, Jun 14 2023, 8:55 am

You mentioned that your daughter has seizures. A lot of children with Autism will have seizures though not everyone with seizures has autism. Since you sad the changes are recent are the seizures under control? For absentia seizures I have heard people complain they have a huge headache afterwards which I assume can lead to frustration and lower tolerance. If they arent under c9ntrol is it possible thatany of her behaviors that dont seem like mistakes to you ca actually be done while he is having a seizure. Has she changed medication for this which can be making her angrier as a side effect?

I have found that some children with autism may have anxiety, but that doesn't mean it's not autism. The anxiety can be about feeling the need to get everything correct, but the autism can be leading to that due to black and white thinking.

At her age it is sometimes hard to see whether or not her social skills are lacking, but you may be able to catch on to somethings. If you tell her about something that happened to you does she show interest by making a comment back? For example you tell her about the new shoes tht you just got while showing them to her, will she look and say "nice" or anything else appropriate. Is she playing with friends or on her own?

One moe thing, I always say it's a great sign when children act out at home and not in school. It means they understand the boundaries in school and know that you love them a lot and let them have their needed space at home. Way healthier than the other way around. It does though seem as though she is struggling in school but just expressing it differently.

amother

DarkViolet

Wed, Jun 14 2023, 8:58 am

OP, tou mentioned the behavior worsens when she gets home. Perhaps there is something in the area triggering her, mold or the like?

amother

Wed, Jun 14 2023, 9:00 am

allgood wrote:

They are absence seizures and bH have been under control for the last few years. No change in medication. Interestingly her behavior improved a lot after she started on the seizure medication. It hadn’t gone back to being as bad as it was prior to starting seizure meds but it’s still bad.

allgood

Wed, Jun 14 2023, 9:56 am

amother OP wrote:

Based on the fact that previously you saw changes when the medication was introduced an seizures were under control, is there any chance that her seizures did increase recently without you being aware of it? Is your daughter aware of what she feels like when she has those seizures? They may be even smaller seizures than you havenoticed previously since you say its been a few years that the seizures are under control with her change in age that would change as well. Is this something you can have a conversation with her about to see if further testing is needed again?

When speaking to the psychiatrist to get a better idea of what this is do mention any rigidities, black and white thinking, difficulties socially, difficulties with communication, etc that you may be seeing. Even if it seems trivial to you let the professional have all the needed information to help you and your child.

amother

Lavender

Wed, Jun 14 2023, 10:01 am

My son has very similar symptoms, also very obedient and quiet in school, shows anxiety, frequent bathroom and nurse visits... at home is a tornado, terrible temper, physical buy can also be gentle and helpful. We took him for evaluation thinking he may be on spectrum (its really a struggle to connect with him, and I dont see him interacting easily with other children like my others do) but all that came out was anxiety and language struggle. He still struggles, we tried therapy on their recommendation but didn't see any change. He started music lessons which has been much more helpful in calming him. Anyone with other tips would be greatly appreciated as it is really challenging.

amother

Bluebell

Wed, Jun 14 2023, 10:03 am

Instead of or in addition to pursuing psych diagnoses, which will always be somewhat subjective and arbitrary, would you be interested in looking at a root causes approach? Seizures, adhd and anxiety/asd sounds a lot like AE.

amother

Wed, Jun 14 2023, 10:55 am

amother Bluebell wrote:

What’s AE

amother

Bluebell

Wed, Jun 14 2023, 10:56 am

amother OP wrote:

What’s AE

Autoimmune encephalitis aka brain inflammation. Which has many different causes.

amother

Wed, Jun 14 2023, 11:01 am

allgood wrote:

Thank you so much for the tips to include when speaking to the psychologist.

I don’t think her seizures are back bec we do testing often and just had an extended eeg a few months ago and bH there weren’t even spikes.

amother

Wed, Jun 14 2023, 11:02 am

amother Bluebell wrote:

Autoimmune encephalitis aka brain inflammation. Which has many different causes.

She sees a neurologist pretty regularly and the dr knows abt these behaviors. But it’s a good thought. I’ll mention it at her next appointment. Ty

amother

Bluebell

Wed, Jun 14 2023, 11:03 am

amother OP wrote:

She sees a neurologist pretty regularly and the dr knows abt these behaviors. But it’s a good thought. I’ll mention it at her next appointment. Ty

Most drs unfortunately aren't trained to look for root causes. You can bring it up but don't be surprised if they don't take you seriously.

amother

Oatmeal

Wed, Jun 14 2023, 11:20 am

I was also going to suggest encephalitis testing. a Blood test and brain scan showed that a family member with seizures had inflammation, believed to be from a tick bite.

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