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The only way I know to speed things up is to go privately. You get a really thorough and detailed assessment this way and the timescale is good but of course it costs a lot of money. You could try getting letters to support your referral from school etc but school referrals themselves follow a different route - and they are looking specifically at learning needs and what support needs to be given for these. The ASF as I understand it won’t pay for assessments that can be done through normal channels but will pay for specific adoption related ones (eg attachment related, family therapy) They may be able to provide support for you which would be helpful. You need to contact SS and they will put you through to PASW unless you already have someone in which case contact them directly. It would be good to look at what they can provide anyway. There are specific places that do thorough assessments in this field but I can’t remember the names (possibly Beacon House is one?) Others will know. You may need multiple referrals in different areas anyway. Also do as much research as you can early on so you’ve an idea of what you need to push for. Also you may then get more of an idea what you are dealing with and how to approach it. Good luck with it all!

It sounds complex, but many of her behaviours could be related to ADHD (rages, impulsivity, little focus, no sense of time, immature), which could be controlled with medication. ADHD often cooccurs with autism and ODD. You could look at some of the literature (eg. Russell Barkley) while you are waiting for an assessment.

Have you sent an email to your post-adoption support listing all the behaviours with frequencies? Make sure to emphase the strain on your family and that the situation is quickly deteriorating. In case she is violent towards her siblings, mention that because it could be a safeguarding issue.

You could ask for an urgent assessement eg. of trauma and attachment at Beacon House, the Tavistock, Family Futures, the Maudsley or other providers. They should then be able to further assess for eg. ADHD, autism or anything else that might be in the mix or can refer her further.

I would also ask her school to make an urgent referral. In my experience, the more people saying you need urgent help, the better.

Thank you both. Chestnuttree I will look at those places you mentioned. We are nervous about saying that AD hurts her siblings in case they take her siblings away. Maybe this doesn't happen but we are scared of how this is developing. AD5 is extremely controlling and violent when she doesn't get her way. She has started to punch my husband. After an outburst sometimes it's like a switch has flipped and she acts so calm and normal as if nothing has happened.

I must admit I hadn't considered ADHD as I thought it was mainly boys and caused hyperactivity. Once asleep she sleeps through the night. She has little mental focus but is not energetic at all. She was exposed to drugs in utero and we were told no drinking.

Also who should we ask school to refer to?

I was thinking ADHD too with co-morbidities possibly. There’s lots of information on ADHD (including a really helpful book by Dr Christopher Green) so it’s worth researching and can give you lots of ideas of how to work with her in the meantime. Also from the violence point of view NVR is something a lot of people speak highly of and something the ASF do support. The trouble is there is a limit on what they pay for so you’d need to discuss priorities with your PASW

There is a type of ADHD that does not include hyperactivity. It is called ADD. It is more common in girls than boys I think.

There is a very good free short course you could take on ADHD: https://www.futurelearn.com/courses/understanding-adhd . A podcast by the Anna Freud Centre: https://soundcloud.com/anna-freud-centre/child-in-mind-adhd

I would mention the violence because it will spead things up. Ss will only take children away in the most extreme cases, so I would not worry about that.

If there is a safeguarding referral, you need to show that you are aware of possible dangers and emphasise the measures you are taking to keep your other children safe (monitoring of your AD, you are trying to give her her own room, you should do 1 to 1 with the others etc). Basically you want to show that you are taking her behaviours seriously, but that you need more support.

I think if there was drug abuse during pregnancy there’s a strong possibility that there would be alcohol as well. It’s rare that there’s only one substance involved so I’d consider FASD as well.

And also consider why bm was self medicating? Were there any underlying issues - diagnosed or not.

I’d think about ADHD, ASD/PDA as well.

There’s an article I re-found recently about the differences between ODD and PDA .

https://tomlinwilding.com/the-difference-between-odd-and-pda/?fbclid=IwAR2QtuKYJ_s-d-TBsUclNu6HPA1Ulf2ryOvDzvvmNlG5rfw967E9fBDRh2Q&fs=e&s=cl

I have two who are autistic and both present very differently. My son is more Aspie type and my daughter definitely PDA so lowering demands has worked well for her.

There’s a PDA web site and Stephs2girls is another one to follow.,

There’s also something called confabulation which is often present in FASD. We used to have this with my daughter - not so much now because I can read her well (she’s 16) but often there was a grain of something true in her tales but mightily embroidered on. And she lied. Deliberately at times to get others into trouble but also to dig herself out of a hole - the whole shame thing kicked in.

Trying to unpick what’s what is difficult. We had an early private Slt assessment which was really helpful in identifying her issues. And latterly a private EP assessment.

Whats she like in school? Does she save it up for home? Does she mask in school?