Gifted Issues Discussion homepage Forums Twice Exceptional Tell me about your child with anxiety

We found that it was helpful to ask our pediatrician for recommendations when our children were struggling - that's how we found our neuropsychologist. If you're in a much larger area than we are, you might also be able to find advice online or by networking among other parents (we have limited choices here, so networking was helpful but we don't have a lot of folks to choose from!).

I wouldn't worry about whether or not she's "diagnosable" - she seems to be struggling and you want to help by having more information about what's driving her behaviors - that's what's important. You might go through an eval and find out there is nothing to diagnose - that's a-ok! Or you might find out that there really is something up and that will be a point to start from and move forward from. In either case, you'll most likely learn a lot about your dd which will help, whether or not there is anything to diagnose. And, fwiw, we've had two or our children go through neuropscyh evals and in both cases, what we learned was entirely different from what we'd suspected, so we are very VERY glad we went through the eval process.

Best wishes,

polarbear

Her pediatrician is not a great resource, perhaps, because she thinks DD is just bright and delightful and no problem at all. (She's never seen the behavior we see.) But I guess I can ask.

I do have a friend who is a child psych, but when I had a long conversation with her about DD, her opinion was that it was giftedness and nothing else. She also does not really believe in therapy for children under 10. (Interesting position for a child psych, but she is also a professor.)

Does she do talk therapy? If so, then I'd agree. ("Tell me about your childhood." "Uh, this is my childhood.") Seriously, we found talk therapy to not be at all useful for DS.

However, there are lots of kinds of therapy that can be highly useful, and the elementary years kids are still laying down a lot of basic thinking processes--IMO it's the time to nip issues like anxiety in the bud, before kids get to be teenagers and everything is blown further out of proportion. Cognitive-behavior therapy is very good for this, and I'd say even a bright 6-year-old could use basic CBT strategies.

Our DS has also benefited from Applied Behavior Analysis, therapy targeted to giving him the skills he was missing due to his autism. Very beneficial, especially when done early in life.

DeeDee

I think that many of the problems that child psychiatrists see involve dysfunction the entire family (poor coping skills) and are not just a child problem.

Our pediatrician had also never seen the behaviors we were concerned about with our ds - in fact, the first time around in 2nd grade when we called for a referral he didn't require that we make an office visit to get the referral. What we did was to call (or fax) in a request explaining the behaviors we were concerned about, when/where they were happening, the causes that we could see of stress in ds' life (school issues), and how they were significantly impacting his life. We asked the dr for the type of professional he recommended we see and for names of the professionals he would suggest.

So it's worth a try at least even though the ped hasn't seen the behaviors.

polarbear

DD has a ped visit scheduled and I'm going to ask for a referral. The hard part is that I don't really want DD to listen to this conversation.

I've taken some notes on DD to help me clarify my concerns. I'm just going to post them in here in case anyone has thoughts. The three things I consider possibilities are ADHD, ASD, or anxiety (or more than one), but nothing ever seems quite right from my layman's perspective.

Concersn:

very defensive, victim mentality
argumentative, reflexively negative
rude in tone
obsessed with accuracy; corrects others
high anxiety�upset by things like smoke alarms, unexplained sounds, others� injuries, mentions of bad topics; worries about death, war, disease, natural disasters
some immature social behavior; seems to act more like a boy in the grade below her; occasional failure to read social cues
very literal, does not like to be teased even when it�s friendly, dislikes exaggeration
nonsense talk and inappropriate laughter when excited
highly emotional, cries easily, highly sensitive to sad stories or themes
easily overstimulated
has nervous habits such as nose picking, throat clearing
loves spinning, swinging, scary rides
mild motor clumsiness
becomes enraged easily and is unable to respond rationally or think clearly in that state�escalates small things into huge ones. When angry seems very unaware of what others are thinking or feeling, though when calm shows excellent comprehension of this.

Things that point against a diagnosis in my mind:

no obsessions
no issues with pretend play
holds a conversation very well
highly imaginative and artistic, excellent fine motor skills
does very well in school�no behavior problems
no issues with attention to work�very long attention span
not physically hyperactive
has many friends
interests (chess, birding, drawing, books) are mature and change often
able to understand what friends may be thinking or feeling
mature reading comprehension
even skill profile, processes fast

Other:
says she dislikes being a child
highly independent
high degree of internal motivation
says she is bad and that she doesn�t like herself
says it is hard to behave well even though she really wants to

Except for the high anxiety and even skill profile, you've described my DD8 almost perfectly. She was diagnosed with SPD, which explains most of her behavior. We're in the process of trying to figure out if the rest of her behavior and uneven test scores (from below to way above grade level) are just part of her quirks, or if they're something else.

Except for 'does very well in school - no behavior problems' (DS has lots of behavior problems) and 'has many friends', your list sounds exactly like my son. He was originally diagnosed with ADHD, but DH and I are skeptical of that now and are planning on having a neuropsych eval done.

You can offer the ped. the list you've given here, in writing-- so your DD is not overhearing a list of faults. I'd even expand on them, giving examples. This is a very good sort of thing to keep in writing, so that when you get the referral and the eval is long and complicated you don't lose track of any information.

I have over time gotten less cautious about talking about these issues in front of my DS. I am careful about how I say them-- choosing "DS worries a lot about small things, and that concerns me" rather than "DS is too anxious," where the latter wording might imply "something wrong with him."

I think it is actually helpful for DS to hear me say to a doc, "I think this is a problem for him, and I'd like your help in solving it"-- it gives him the perspective that what's going on now is not forever, and that problems can be solved with the right help, and it's OK to ask a professional for help. I want him to know these things, so I model it.


Many items on your list, taken together, do raise the possibility of ASD/Asperger's. Keep in mind that a person doesn't have to have every symptom on the list to be diagnosable, just a cluster of them. Gifted kids usually compensate like crazy, girls especially often try to sleuth out social cues so they'll fit in, so they are harder to diagnose. I think you're right to ask for a referral-- let the best neuropsych you can find sort it out.

Kudos to you for pursuing answers. No matter what, I think having answers is better than not, because I trust informed decisions.

DeeDee