Autism or attachment?

My son is 3 and a half. He came here at a year old, and until now we’ve had a reasonably comfortable time. Don’t get me wrong it’s not all been easy, but the tough times were relatively expected given the moves that this child has had in his short life.

Now though…
He doesn’t want to play, he wants to help with the housework.
He likes to line up his cars and animals, rather than play with them, and gets really cross if they get knocked out of line.
He isn’t very affectionate.
He repeats noises over and over.
He won’t make eye contact with either me or my husband.
He gets really upset if we have even the slightest change in routine.
He hates us saying ‘No’. It’s not just a toddler tantrum that ensues, but instead a full blown meltdown.

Naturally, I started thinking about Autism. These all seem likes traits to me but my health visitor thinks I’m wrong. She’s observed him at his nursery and said he has great social skills with the other children so can’t possibly be autistic. But equally, she won’t say that these symptoms are ‘normal’ or could be of something else.

I started looking online, and now I see that some of these quirks can also be signs of an attachment difficulty. They’re very similar to autism and it’s hard to make the differentiation. So what now?
The health visitor doesn’t know much about attachment disorders, but is quick to rule out autism. My GP won’t do anything as she says the health visitor knows us best, and he’s so young to diagnose with anything.

Have you experienced similar? How did you get a diagnosis of autism or attachment? If you can suggest anything for this mum to try, please leave a comment below.

10 thoughts on “Autism or attachment?

  1. dara de burca

    Really interesting. My son is now nearly 14 and there are still question marks about autism. He attends a special needs school and at times even the teachers there think he is autistic. Sometimes I wish for a diagnosis of autism as with it comes a range of educational and other support for him immediately, but more importantly for his future. It gives him and how he is in the world a level of recognition. Whilst a diagnosis might define him as different it would give him the support he might need in the difficult journey I know is ahead into adulthood. I worry for him as a young man and adult in a world that truly doesn’t understand the severity of the impact of attachment disorder. Even in the adoption sector the impact is barely recognised. The vulnerability of children like mine is played down and viewed case by case rather than a predictable and inevitable need that can and should be predicted and planned for. As he grows older his potential to become one of the many mental health, offending or other statistics increases. There is a need for attachment disorder to receive the same recognition and acceptance that autism Is beginning to receive so that the many children experiencing this can receive the support they need now and into their adulthood.

  2. Cathy McGrath

    We had similar experiences. We adopted our daughter aged 3. She was about 6 when she started displaying concerning behaviour. Anger, lying, anxiety, we had a play therapist but it didn’t seem to shift her symptoms. We insisted on a child development paediatrician assessment. She ruled out any autism and has referred us to Camhs as as an attachment disorder or possible other mental health issue. We are still waiting. Although a lot of the symptoms do cross over and can all be on the autistic scale. We feel this is more down to her traumatic past than autism. Attachment disorder is quite scary and I think my daughter can tick at least 10 boxes on the symptoms including aggression and being superficially charming.

  3. Tonya Curtis

    I’m an adoptive mum to 2 adopted children, one who has diagnosed attachment issues, I also have 2 birth children. I am presently half way through my student health visitor training. Here are my thoughts for what they are worth. I would be interested in how the nursery staff view your sons interactions and other adults who know him well (how is he with family members and friends) it’s great that you health visitor has done a nursery visit but it will only be a snap shot. It is my understanding and limited experience that autism can often become very obvious around 3 often associated with significant deterioration in behaviour, I would also be interested in sleep, eating habits and speech as all can be effected by autism. In our area we use a screening tool to identify children who would benefit from a referral for formal assessment for autism it is the ‘Ages and stages, emotional and social development tool’ it might be worth investigating if anything similar is done in your area.
    I’m short it sounds as if there needs to be more assessment, I would probably tip a little more towards suspecting autism at the moment, although a tendency to contain behaviour and ‘appear’ to function better outside of the home is generally indicative of attachment issues. Of course our children are rarely totally straightforward and the key thing is to access support in the short term, attachment or autism: traditional parenting strategies that might be recommended are not going to be particularly helpful! Could you also ask for some input from you post adoption support team.
    Hope you get some help to move things forward. Xxx

  4. Catherine

    Our daughter came to us at the age of six with an ‘avoidant attachment’ style. At the age of nine we referred her into CAMHS for help with trauma related behaviour…..two years later after eleven months of therapy from Camhs she has a high functioning autism diagnosis.
    there are many similarities between autism and attachment. A group from a university have attempted to show the similarities and differences between the two using ‘the Coventry grid’- it’s a useful comparison and easy to find via Google. In my experience autistic behaviour has a root cause in anxiety caused by social and sensory worries. My son, (adopted at the age of four) has also had a Camhs assessment and they have not diagnosed him with ASD but with anxiety caused by attachment. I live with the subtle differences of the two. My son worries about what is going to happen next, my daughter worries about social interactions, social situations, food that has certain textures, sensory overload. How we parent both is slightly different but both benefit from a therapeutic approach, clear routines, words and pictures to plan by, clear, reassuring instructions. It is subtle, but there is a difference.
    I would suggest a referral into CaMHS for an assessment. Also check out the Coventry grid.
    Good luck

  5. Michelle

    Have you heard of the Coventry grid research by John Whitwell? Looks at overlaps, similarities and differences. Might be helpful…

  6. Suddenly Mummy

    Wow – a big thank you to everybody who signposted the Coventry Grid, which I had never heard of before. Very helpful. My son (age 4) also goes in for a lot of repetitive noises (it’s worst of all in the supermarket for some reason and gets us a lot of stares!) – the grid makes it clear to me which side his behaviours are on. In fact I’m a bit shocked by how many of the attachment things do apply to him.

    Lining up toys on its own would not concern me any more, despite it being rather a red flag for ASD, as I have known so many children who do that for a phase and yet display no other ASD traits. However, it seems as though you have a number of concerns which are building towards a picture. Your HV says he is fine at nursery. Have you been able to speak to nursery staff and share your concerns? Do they have an opinion on his social interaction? Surely they would see more of him in that setting than your HV has.

    1. Nic

      Your son might be making lots of noise in a supermarket to block out other noises. Some children with ASD have hypersenisive hearing and talk about hearing the noise the fridges and lights make. Sometimes ear defenders or wearing headphones may help.

  7. SafeMum

    I absolutely agree with other comments and particularly seeking specific adoption support (since HV doesn’t know) and looking at the Coventry Grid. To my knowledge autism often won’t get looked at until 4 at least.

    Can I just add something into the mix here to think about? Although please read all this with caution, I mean to be helpful. When did this behaviour start? Could it be linked with starting / being at nursery? My questions are based on you saying nursery don’t see what you see, so I wonder if you are getting the ‘true’ picture of feelings and nursery just getting a coping child. Here are some thoughts:

    1. He wants to help with housework – so he wants to be near you / with you doing anything you do.
    2. Lining up cars and things is about creating a sense or order & so links in the same with the upset at routine.
    3. Not being affectionate – could be him protecting himself or shutting down his feelings. In his little mind perhaps you gave him affection and then “send him away” to nursery and he doesn’t understand / isn’t ready.
    4. Repeating noises – could be similar to talking all the time, often means, life feels safer when I make noise, I make sure you know I’m here.
    5. Won’t make eye contact – could be avoiding intimacy – similar to no 3, or feels shame / not sure what he will see.
    6. Really upset with slightest change in routine – feeling out of control, highly anxious, trying to make things predictable.
    7. Saying ‘No’ & full blown meltdown – No means rejection of him not the action or activity & so the fight flight response is always close to surface.

    These are just ideas of interpreting from a more distant perspective.

    Go with your gut, I did when mine were little (still do) and it does pay off. That said, my 13 yo had autistic assessment last year and even with use of coventry grid was not diagnosed. Whatever happens, remember that most things that help autistic also help adoptive children, so you can put things in place without diagnosis. xx

  8. Nina

    I have had a very similar experience. I brought my daughter home at 10 months and things were pretty good. However I did notice she didn’t like to be snuggled and held as most babies do. We were taking a parent/child music class together in hopes it would help bond us. At the end of each class your supposed to cuddle with your baby. My daughter crawled away from me every single time. Ironically she would go and cuddle with a complete stranger but never with me. She was able to focus on books for more than an hour at a time as young as 18 months old. She is now 10 years old about to be 11 and our relationship is very strained. She seems to not want to learn anything from me including important life skills that I’m supposed to be teaching her. I’m afraid things are only getting worse as she grows up. I’m wondering now if all this time she has had this”high functioning” autism in combination with an attachment disorder. The hardest part is she has continued to listen and learn from my friends but seems to refuse my direction, parenting and love. At this point I feel so rejected I don’t know what to do with myself. I don’t know anyone else who is experiencing this situation.


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