Child psychologist talks ADHD, autism: Is my child neurodivergent?
With a new school year around the corner, many parents have questions about whether their child is neurodivergent – which can include ADHD, autism, anxiety and other social and learning difficulties.
Dr. Emily King, a child psychologist and former school psychologist, said the term neurodivergent -- an umbrella term for people identified with a learning difference -- is becoming more recognized as awareness spreads.
"We are learning more about how kids learn and more about how anxiety, autism or ADHD impact learning, relationships and emotional functioning," King said.
Parents, trust your gut
Wondering when it's time to seek help? Parents and caregivers should trust themselves – the right time to ask for help is when you feel like help is needed.
"You are going to have a gut feeling as a parent," King said. "You're going to feel like, ‘I'm out of ideas. I don't know what to do next.'"
Talking to your child's teacher or pediatrician can also help parents get an objective opinion, gather information and explore their concerns.
"Follow that parent instinct if you're concerned your child is not enjoying life," King explained. "Are they not able to sleep well, eat well and play in a way that makes them happy?" That's when it's time to see an expert.
Is my child neurodivergent? What to look out for
Parents often wonder what behaviors could indicate their child has a learning difference.
Different learning difficulties can appear at different ages. For example, a child may not struggle with inattention and disorganization until they experience the demands that come in middle school.
Babies and toddlers
According to King, some symptoms to look for in babies and toddlers include difficulty to soothe, attachment issues and difficulties sleeping or eating.
All young children struggle from time to time, especially if they are sick or going through a growth spurt. The most important thing is to talk to your pediatrician if it becomes a bigger issue.
"Talk to your pediatrician about anything that's disrupting your child's eating or cuddle time," King said.
Most pediatricians now screen children for autism, speech development and motor skills at 18 months of age. If you aren't sure, ask your child's doctor.
Young children grow and change so quickly that sometimes the right thing to do is wait.
"I often tell parents, let's wait three months and see what's going on," King said. However, if your child is emotionally distressed more days than not or is not meeting developmental milestones, we would not want to wait.
Just because your child plays differently doesn't mean you need to act. Characteristics of autistic play, like repetition and intense focus, for example, are not cause for concern if your child is happy and can play well with their peers, King said.
As your child gets older, if they want to play with other children but their behavior isolates them, it's also time to ask a professional for help.
"If their behavior makes other kids distance themselves, that could end up being a situation where a child might not get the social exposure they need," King said.
School age children
When kids get older, parents may notice differences in how their children speak and how they communicate, both verbally and non-verbally.
King explained some autistic children may read very early but struggle with conversations. Other kids may be very interested in certain topics but struggle to chat about other ideas.
"Noticing these asynchronous skills in early childhood is something to look out for," King said. "It just means that your child may play or learn differently than you expected."
These differences are normal. It becomes time to seek professional advice if your child's day-to-day interactions with others or ability to learn becomes stressful for them.
"We want to notice anything stopping a child from accessing things that help them grow and learn, which is being out in the community, building relationships with each other, being able to go to school and learn in a group," King said.
Remember, your child's teacher is a great resource to learn more about how they're developing and learning during the school day.
"It becomes a need for support if your child is anxious, such as if your child is refusing to go to school or you feel like their school is not the best fit for them," King said. "We want to help them if there's distress or if they are feeling left out. Is your child upset or feeling sad or having a lot of behavior that you don't know how to manage?"
What causes children to struggle?
It's often anxiety and expectations that cause children to struggle.
"Usually what's happening is the expectation around them is higher than the skills they have," King said. "This is what I talk with teachers and parents about all the time: we either need to support their skills or we need to adjust the expectations to help them find a learning zone where they feel comfortable and connected to keep practicing."
Ask an expert for advice
Before seeking a specialist on your own, turn to your pediatrician to get their opinion.
"You are going to have that gut feeling if your child needs more support," King said. "Your pediatrician has seen so many children and is going to have an objective opinion about those things, and they will be able to help you decide if you need a specialist or not."
Preschool and elementary school teachers are another resource.
"Teachers have so much experience with kids and they have a good sense of what's in this expected range of development and what is a little bit outside of that range," King said.
Teachers will reach out to parents and caregivers if they're worried about your child.
"You might be worried your child is doing something different [in school] than maybe you did or than a sibling did, but if they're not upset by it, it's not really a concern," King said.
Resources to help families
In addition to working with kids, King spends much of her time training teachers and working with parents. Her website can help adults better understand what tools are available to help neurodivergent children.
There are also resources available in North Carolina public schools and through state-funded programs.
Birth to age 5
If you're worried your child is not speaking, playing or moving like other children their age, talk to your pediatrician. The state of North Carolina offers free in-home screenings if your pediatrician is worried a child is not meeting developmental milestones.
Most pediatricians already screen toddlers for autism and developmental, social and communication skills, so your doctor may approach you first if there is a concern.
Qualifying families with children approaching age three in Wake County can also access preschool services where their child is observed and evaluated.
Your child may benefit from a play therapist, an occupational therapist or a speech language pathologist. Trust your gut, and count on your pediatrician to help organize a plan for your child.
"Sometimes there's so many cooks in the kitchen, it can be hard for parents to figure out whose advice to listen to," King said. "But just remember, you are the expert on your child."
Elementary and middle school
At this age, it's a good idea to talk to your teacher about how your child is learning and behaving throughout the school day. Again, teachers will come to you if they are concerned.
"Talk to your child's teacher about how they compare to other kids in their class," King said. "Talk to other parents or teachers to get their objective opinion because it's hard to stay objective when you're worried about your kid."
As your child gets older, you may have concerns about anxiety or learning differences. Your school psychologist is someone you can partner with at school to investigate those concerns.
"Once your child is enrolled in public elementary school, your child will have a school psychologist assigned to their school," King said.
Parents can talk to school psychologists, administrators, and their child's teacher if they are concerned about a child's learning or behavior at school.
Talk to your pediatrician if you feel your child could benefit from seeing a therapist or child psychologist. There are many different types of therapists, but only psychologists can perform intellectual testing, King said.
We're in this together
In addition to trusting their own gut, parents should remember children are always changing and growing.
If you're struggling, you're not alone. Support and resources for neurodivergent children and adults have evolved in recent years.
"I think so much of the change that needs to happen is changing adult mindsets," King said. "This was not talked about when we were growing up. If it was, it was because someone had a disability."
King also encourages parents to speak openly with other parents, teachers and even their children about learning differences.
"We're all in this together, and every classroom is already a neurodiverse classroom," she said. "We just need to change our mindset and how we think about our differences and supporting each other."
