And Now There’s Two

We met with the psychologist on Friday to discuss the results of LM’s evaluation. He said that he thinks the boy is also on the spectrum, but very high functioning. The doctor said it was tricky with LM because it was hard to tell how much of his social difficulties are tied to how smart he is, but he thinks the pieces fit. He spent a lot more time with LM than the person who evaluated him when he was seven, and his testing covered more, so it was good that he had so much to pull from.

Despite the reason we tested LM — his sister’s diagnosis combined with him telling me about how he feels like he fakes it socially and stuff — I really didn’t expect that diagnosis after filling out the parent surveys. I didn’t think the surveys had as many 2s and 3s or Almost Always or Always marks (for the symptoms) as Baby Girl’s. I figured the doctor would come back with “ADHD, but has autistic-like traits” like the one who evaluated him before. (And possibly Tourette’s because of his tics.)

It was interesting to see one of the tests that shows how at-risk LM is for certain autism traits, because he had our feedback, LM’s fifth grade teacher’s feedback, and LM’s self-test. Part of the teacher’s test fell into the at-risk category, ours was a bit above hers, and LM’s was all in the probable category.

(Baby Girls’ assessment was mostly in the section where the green line is.)

I thought it was interesting how much the traits we all picked up on were lined up, just different in the severity. I was surprised with LM’s self-assessment, because while I knew that he had some difficulties, I wasn’t aware that he felt like things were so difficult to the point that most of his whole self-test fell into the probable category.

I know the psychologist had a lot of info to pull from, but I wonder if LM’s report hadn’t been so high if he would have been diagnosed with ASD, or if he would’ve also come to the “ADHD with autistic-like traits” conclusion. I don’t suppose it matters, since it doesn’t really change anything on our end. We told LM after he got home, and he said he was relieved to know “why I am the way that I am.” So, while the label ADHD vs. ASD may not matter too much from a parenting perspective at his age (we’ve been working on social skills and coping with sensory stuff for years and would continue to do so regardless), it apparently means a lot to him as far as his self-identity goes.

Now for the concerning part — the doctor said that LM’s self-report shows depression and anxiety. Additionally, the parent report and the teacher report picked up on that (although to a milder degree). That was very upsetting to learn. The doctor said that between LM going through puberty and people on the spectrum being prone to those issues (plus people with ADHD are, too), that it’s not that surprising. And, of course, there’s the biological factor.

Still, I had no idea that LM felt like that. Between not being aware of his social difficulties (fifth grade went well for him and the bullying stopped, so he seemed to improve so much there, just not internally I guess) and depressive traits, I must not be in tune with him nearly as much as I thought I was. Anxiety wasn’t that surprising, but the severity that LM reported was. I asked LM about depression, and he said that he feels down and sad and worried a lot. I know that things can look fine on the outside and the inside be a different story, but things have been going so well for him that depression wasn’t a blip on my radar.

At least we know.

The doctor is going to try to find a therapist that he thinks will work well with LM. He said he wishes his workload were lighter now, otherwise he would love to work with LM himself. He said if he couldn’t find anyone, he would figure out how to make it work, though. So that’s good. We have an appointment with the provider who manages LM’s ADHD meds this week, so we’ll run this by her. The psychologist said we may want to ask about an antidepressant, but he would recommend trying therapy for three months and go from there. I agree, because I don’t want to put LM on an antidepressant if it’s not absolutely necessary. I know from experience that the side effects can be rough, but if that’s what he needs in a few months, then that’s what we’ll do. Since it seemed to make LM feel better to know about his diagnosis, maybe that’ll help with depression, too.

Kids shouldn’t have to deal with fucking depression and anxiety. Well, no one should, but especially not kids.