Finally had some feedback from camhs play-based obs.

[sagandswing]

Hello Dh and attended the development meeting with camhs this morning and we finally got a little bit of feedback from Ds's (7) play-based obs.

He didn't want to engage at all with any of the imaginative play (when Psychologist pretended to be something else etc) she said he just was not having any of it, didn't want to know. Really struggled to stay still in his seat, constantly fidgeting. She had no eye contact at all until the last 5 minutes. When various toys were placed on the table in front of him he again did not want to know he was more interested in the wheel of a small car, even told the psychologist what type of car it was (which he could see across the room in a train box through a little celophane window??) apparently afterwards the psychologist and her collegue (who was taking notes) had a debate about wether this was a skill or just an interest but TBH I just thought it was a diversion technique because Ds wasn't interested in what was on the table . He also only pointed at a picture which he was given and asked to describe what was going on (he was really detailed with this) but didn't point at anything else in the room IYSWIM, and he also did well with story telling. And volunteered information about a birthday party when he was 7 (it was actually his 5th birthday party which didn't go too well ).

Please could someone tell me why these things were pointed out to us? would these things be seen as evidence for an ASD dx, sorry if I sound really stoopid but I just want to know of anyone elses experiences and outcomes.

TIA

[sagandswing]

oops Dh and I [embarrassed]

[EllenJaneisstillnotmyname]

Lack of eye contact and lack of pointing can be flags for ASD, but on their own wouldn't lead to a DX. The 'skill' or 'interest' in car type could be an ASD type 'special interest, but there needs to be a pattern of behaviours across the triad, really. I suspect they mentioned these things because they may point towards ASD. Difficulty concentrating and fidgeting could be signs of ASD or ADHD, but again, not enough on their own. My DS2 who has ASD, is constantly seeking sensory feedback from movement, which looks like ADHD, but isn't.

Do you have more observations planned?

[WeWilsonAMerryChristmas]

It can be so confusing when they point out 'meaningful' things that don't mean anything to you, can't it? I recently read through all DS dx notes and there were loads of things that I'd thought 'so?' about, which I now know to be flags.

As Ellen says, lack of eye contact and pointing can be flags for spectrum-type dxs. The skill/interest thing I would agree with you and think that's to do with distraction, which is control - my ds is big on using verbal techniques to control situations. Lots of detail in the picture can also be a flag for spectrum-type stuff if the DC can't give a broad answer (so, 'I see a wheel, look at that wheel, I like wheels' as opposed to 'that's a picture of a car').

But again as Ellen says, these are pointers - not enough in themselves to lead to a dx I would have thought?

[sagandswing]

Thanks Ellen and Wewil, camhs are due to go into school to observe in the new year (we had been told that they had already been in but when I asked questions about how it went the same psychologist who originally told us checked his file for the info then realised they hadn't been in , and to think I get embarrassed if I forget something ). We only did half of the development history this morning so again it will be the new year before we do the second part. Then as far as I know that's it no other observations were mentioned, its been a long weary road and I feel a little relief that the end is in sight just hope it doesn't drag on another 12 months.

[sagandswing]

oh dear I didn't mean to strike out your names [embarrassed] I really am not good at this typing lark .

[dairylea4brains]

Hi sag, can I be really cheeky and ask you what kind of questions they asked for the developmental history? I have a 2 hour appointment in the new year and worried I won't be able to remember stuff!

[sagandswing]

Hello dairylea I think the paper the psychologist used was the ADI-R but can't really remember (I had spent all week stressing and was really surprised how relaxed I was during the meeting!) It felt nice to be able to talk about our Ds the way we saw him and as we were the psychologist was explaining why Ds was doing the things he was e.g repeating things he had heard during his school day over and over....he was doing this to process what he had seen or heard, most children would just say "oh my friend in class was crying because Mr x shouted at him" and that would be it but not in my Ds's case.

The interview is divided into five sections: opening questions, communication questions, social development and play questions, repetitive and restricted behavior questions, and questions about general behavior problems. We got as far as the play questions, so had already covered any delays in development eg talking,walking etc did he ever stop talking?, did he ever lose any skills he had already learnt? When did you first have concerns about Dc? (which in our case was after we had been told about Ds's difficulties!). We were asked to describe Ds between the age of 4-5 and now. Does he point, nod, shake his head, which TBH we hadn't actually noticed .

We were asked about play with others does he share his own toys?
Does he play with his siblings toys? how does he play with them?
Did he ever pretend to be a super hero?
Does he ever describe something with a lot more detail eg. Rather than "its raining" does he say something like "the cold water is falling down all over the ground and trees".
Does he ever ask why? eg when you have to go shopping does he ask why? (not sure what this would be for).
Does he make eye contact? in Ds's case we don't tend to have any a) when he doesn't want to talk about something. b)when he is busy concentrating on something.
When you walk into a room and start speaking does he look up and answer you or do you have to use his name to get his attention?

Really can't remember anymore, sorry. But what I will say is don't worry if you can't remember or have never noticed anything. you are not expected to Ds's psychologist just gave us a little list of things to observe and jot down until our next appointment. Which so far we have noted that he only points to something if you ask him where it is, or if he has made something he will point to the parts when explaining what it is for but never really to show you something at a distance. He does nod and shake his head but his whole body moves with it eg when he is shaking his head it is slow and his whole body turns side to side too.

Hope this helps.