Receiving a dual diagnosis is common in children with autism. Research shows that mental illness presents itself at a higher rate in children with Autism Spectrum Disorder (ADS) than in neuro-typical children. From my personal experience with my son, getting a diagnosis of autism was difficult. Be persistent if a diagnosis doesn’t feel right. No one knows your child like you do. Before we received the ASD diagnosis I was told that he had oppositional defiance disorder. This didn’t seem to fit for me and my child. My child wanted to please me, he was a loving boy. He was upset that he was melting down and would cry because he wanted to not feel the way he felt. Currently his diagnosis consists of high functioning autism, ADHD and anxiety disorder.
So why is it so hard to properly diagnose these kiddos?
Autism Symptoms Overlap with Other Mental Illnesses
The difficulty in diagnosing a child with Autism Spectrum Disorder (ASD) is due to the facts that the symptoms of ASD overlap with the symptoms of other mental disorders. According to Autism Speaks, (www.autismspeaks.org) just over two-thirds of children diagnosed with ASD have also been diagnosed with one or more mental illness diagnosis. The most common secondary diagnosis are anxiety, ADHD, and depression.
The symptoms of Autism such as social inappropriate behaviors, meltdowns, stemming (repetitive movements or sounds) and extreme sensitivity can be misdiagnosed since these behaviors alone can be any of the above mental illnesses. The key is to find a doctor willing to look at the entire picture, one that is capable of performing all the necessary diagnostic testing and one that also will take your observations, as a mother, into account. Children who have be diagnosed with Autism usually experience extreme anxiety and even depression depending on where they fall on the spectrum.
Anxiety and Autism
Research shows that roughly 30 percent of children with ASD also suffer from Anxiety. My son’s anxiety was overwhelming to himself as well as all adults that spent any length of time with him. Anxiety over sensory overload or not knowing how to react in a certain social situation would overtake his body and create a fight or flight response. It is common for children with high functioning autism to suffer from anxiety because they are keenly aware that they are not like the other children around them.
Social anxiety is particularly common among children and adults with autism. Meeting new people or experiencing new social situations can bring on a slew of emotions for our children. When my son experiences new situations, his reactions can vary greatly. Sometimes he will flat out refuse and won’t even discuss the possibility of participating, other times he will beam with excitement only to have an epic melt down on the way to the event or shortly after we arrive.
The most common reason for his anxiety is the fear of not knowing what to expect from the new adventure. I have learned that explaining the order of events, the sights, sounds and smells that he may experience in as much detail as possible can greatly increase his willingness to try something new. Another factor that can help decrease his anxiety is bring a friend or family member along to help increase his comfort level.
There are several behavioral therapies for children experiencing anxiety
There are several different behavioral therapies for children that are experiencing Anxiety. Techniques include, role playing, challenging negative thoughts with more logic-based information and modeling the social expected behaviors that appropriate for the new setting.
For instance, the first time I took my son to a hockey game we went over all the things that are socially acceptable for people to do while at the game. I explained the loud buzzers that would go off when someone get a goal. We role played how people will stand up and cheer for their team.
I also gave him suggesting on how he could properly deal with the overwhelming sounds. Then I showed him how he could either wear his noise protection head phones or how he could plug his ears if it got to be too much. Offering options tends to help children with autism feel more in control. He chose to just plug his ears. We entered the game with lots of excitement, but I must admit I was ready for a melt down at any time. The first few goals he covered his ears and buried his head into my body, but by the end of the game he was covering his ears but jumping and screaming with everyone else.
Total success!
Depression and Autism
Research provided by Autism Speaks suggest that individuals with autism are particularly prone to depression as they enter adolescence and adulthood. They also suggest that it is more difficult to diagnose depression in an individual with autism than other depressed individuals. This is believed to be because individuals with autism do not express the feelings typically used to diagnose depression. Such as an individual saying that they feel worthless, unable to concentrate or feel depressed.
Since communication deficits prove the traditional method of diagnosing depression it is up to us as the parents to be cautious and look for any signs that we may feel are concerning. Has your child suddenly lost interest in activates that he or she once loved. Maybe they have picked up a new hobby, that’s great! But what if they are seemingly not interesting in anything anymore. Are they sleeping and eating like they usually do? Keep all of these things in mind and let your doctor know of anything that is cause for concern.
Attention Deficit and Hyper Activity Disorder (ADHD) and Autism
The most common symptoms or ADHD are impulsivity, the inability to focus on a single task and hyperactivity. Unfortunately, these are also symptoms very similar to someone with autism. It is imperative that you locate a doctor that is experienced with both ADHD and autism as well as one that understands the necessary evaluations needed to diagnose ADHD in an individual with autism.
Medication does help relive symptoms of ADHD, however it is best if the child also receives a combination of medicine and therapy. For my family we have gone the route of using medication in conjunction with therapy to help increase focus.
Choosing medication was not an easy decision for me. I agonized and tried everything I could get my hands on to help him with his focus. These includes diet changes, natural remedies, fidget toys, a more relaxed classroom environment. Nothing helped. I finally succumbed to the fact that all these ideas couldn’t work for him until I allowed something to help him focus on the tools we were giving him. It took a long time to find the right combination, and I questioned myself every step of the way. But I can say with certainty that for my son, medication and therapy was the answer.
Reach Out
Sometimes, parents just need to know that they are not alone. Reach out to other moms that are going through the similar challenges as you. Let’s face it, we all have the “I have no idea what I am doing” meltdown. Use your resources, pick those other mom’s brains and ask them what they would do or what they have done. They may not have the solution, but they may have a connection. They may know someone else that has struggled through the same challenge. Unfortunately, we were not handed a book when our children where born. We must learn to reach out to others for advice and help.
Hang in there Momma…You got this!
