Does anyone else ever have skepticism over too many dx?

Anonymous
Or am I a bad person?
It's not that I don't believe parents so much (although maybe sometimes a little bit that) but mostly that I just think how crppy the dsm is that you need to say 'my kid has asd, adhd, pda, anxiety and sensory issues'. Like - really? I could say my kid has all of those but just seems like overkill.
Really wish the DSM would come up with some more profiles for us so that we had better categorization. I see so many on here who have oppositional, inflexible kids who display few of the traditional symptoms of asd but nonetheless get that label for lack of a better option.
Anonymous
YES

Labels, labels, labels....
Anonymous
My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.
Anonymous

BECAUSE THERE ARE CLUSTERS OF COMORBIDITIES.

You can have ADHD as a standalone.

But if you have ASD, it usually comes with anxiety, ADHD symptoms, sensory and coordination issues, OCD, etc. It's part of the autism profile.

Having said that, a lot of kids have ADHD and anxiety. A lot of kids have ADHD and dyslexia.

This is because there must be a number of genes that commonly induce those disorders, so if you inherit a particular common combo, you get a multi-whammy.

I have one child with ASD, ADHD, anxiety, OCD, sensory issues, and accompanying medical issues that frequently appear with autism (constipation, sleep problems, etc).
Anonymous
Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.


I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.
Anonymous
Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.


I do not think you are lousy, but I would think about how to modify your parenting TBH. Can you provide more “action” / activities ? I wouldn’t assume it’s “masking” — that seems more intentional than what is happening — as much as that certain environments and situations suit him.
Anonymous
Anonymous wrote:
Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.


I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.


If he'd been born earlier, I think it would have been harder for the school to ignore him and deny our request for a 504/IEP. Post-pandemic, the fact that he goes to the clinic frequently, uses the restroom multiple times a day, and is visited by the school counselor are just lost in the noise of out of control kids and tired teachers. ADHD meds really help. And he does better in a group where he can follow along and do the same thing that everyone else is doing. He no longer hides under tables so it's fine.
Anonymous
Anonymous wrote:
BECAUSE THERE ARE CLUSTERS OF COMORBIDITIES.

You can have ADHD as a standalone.

But if you have ASD, it usually comes with anxiety, ADHD symptoms, sensory and coordination issues, OCD, etc. It's part of the autism profile.

Having said that, a lot of kids have ADHD and anxiety. A lot of kids have ADHD and dyslexia.

This is because there must be a number of genes that commonly induce those disorders, so if you inherit a particular common combo, you get a multi-whammy.

I have one child with ASD, ADHD, anxiety, OCD, sensory issues, and accompanying medical issues that frequently appear with autism (constipation, sleep problems, etc).


eh. just a few years ago the DSM said you can’t be diagnosed with ADHD and ASD. the DSM is not a manual of genetics or even underlying disease states. It’s a taxonomy of symptoms getting ever broader so more kids have more dx’s. It’s also more common now for kids to get “neuropsychs” that provide multiple diagnoses.

My kid has ASD dx and also recently got a dyspraxia diagnosis. The dyspraxia diagnosis actually is pretty helpful because he has pretty meaningful fine motor & coordination challenges. I’m sure we could probably also get anxiety, ADHD and maybe something like DMDD or ODD dx’s. But I don’t think there’s really any point to that. I will say that people tend to see autism as more totalizing and explanatory, even though he doesn’t really fit any sort of classical presentation and his main challenges are not core autism symptoms (unless you just call it all “rigidity.”)
Anonymous
Anonymous wrote:
Anonymous wrote:
BECAUSE THERE ARE CLUSTERS OF COMORBIDITIES.

You can have ADHD as a standalone.

But if you have ASD, it usually comes with anxiety, ADHD symptoms, sensory and coordination issues, OCD, etc. It's part of the autism profile.

Having said that, a lot of kids have ADHD and anxiety. A lot of kids have ADHD and dyslexia.

This is because there must be a number of genes that commonly induce those disorders, so if you inherit a particular common combo, you get a multi-whammy.

I have one child with ASD, ADHD, anxiety, OCD, sensory issues, and accompanying medical issues that frequently appear with autism (constipation, sleep problems, etc).


eh. just a few years ago the DSM said you can’t be diagnosed with ADHD and ASD. the DSM is not a manual of genetics or even underlying disease states. It’s a taxonomy of symptoms getting ever broader so more kids have more dx’s. It’s also more common now for kids to get “neuropsychs” that provide multiple diagnoses.

My kid has ASD dx and also recently got a dyspraxia diagnosis. The dyspraxia diagnosis actually is pretty helpful because he has pretty meaningful fine motor & coordination challenges. I’m sure we could probably also get anxiety, ADHD and maybe something like DMDD or ODD dx’s. But I don’t think there’s really any point to that. I will say that people tend to see autism as more totalizing and explanatory, even though he doesn’t really fit any sort of classical presentation and his main challenges are not core autism symptoms (unless you just call it all “rigidity.”)


yes, same (I am op).
i guess what i mean is because there is no 'aqua' in the dsm, we are forced to say that our child has blue, green and yellow.
would be better if there was aqua. because my child may have elements of blue or green, but is not blue or green.
Anonymous
I guess the question is are the multiple DXs helpful? Do they help the child get the supports they need? Testing is as much an art as it is a science.
Anonymous
Anonymous wrote:I guess the question is are the multiple DXs helpful? Do they help the child get the supports they need? Testing is as much an art as it is a science.


I very rarely honestly hear anyone on this forum say that any supports have been super useful, with the possible exception of medication for adhd and family therapy/ the very occasional good individual therapist.
For us, because dcs are in private, it doesnt matter what the dx is, you all just decide what adjustments would be helpful in school depending on the unique challenges of the kid. realize with public is a different kettle o fish.
Anonymous
Anonymous wrote:
Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.


I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.


Eyeroll. You think wrong.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:My DC has those diagnoses, asd, adhd, pda, anxiety and sensory issues. He masks at school and craves novelty so loves visiting his cousins and behaves (somewhat) unproblematically there. So no one sees it but us at home. Or maybe we're just lousy parents.


I mean … I don’t think you are lousy parents but I also don’t think a child can “mask” to that extent.


Eyeroll. You think wrong.


would you like to support that with evidence? behavior does change with environment but the “masking” discourse suggests that kids are deliberately hiding their condition at school. that’s not really believable. of course kids behave differently at school v home, but the stressors are different. my kid is generally much better at home than school but he’s not “masking” at home - he has many fewer stressors at home that trigger him.

most of the DSM diagnoses require the symptoms to be apparent across multiple domains. if your kid is only having behavioral issues at home - yes that it due to something happening at home, likely including parenting style - not because your kid is somehow fooling everyone else.
Anonymous
There are also evaluators who insist on certain dx’s despite some of the criteria not being met. It drives me crazy. They are too quick to jump to ASD when a kid seems quirky.
Anonymous
Anonymous wrote:There are also evaluators who insist on certain dx’s despite some of the criteria not being met. It drives me crazy. They are too quick to jump to ASD when a kid seems quirky.


It's in vogue right now to identify "subtle" cases of ASD, based on the notion that these kids bear a significant mental health burden due to masking. And I am sure many kids do benefit from getting supports identified but I wonder if for others it becomes a needless source of stress and confusion.
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