SALT report in. Any views?

[lougle]

Ok, The SALT report is in.

Summary is:

Attention and listening - fine
Understanding of language -fine
Spoken language - fine
Social interaction - fine

School reports anxiety about new tasks in the classroom, which has now reduced. DD2 can be observed playing alone in the playground at times. She's been attending nurture groups and her co-operative play skills have seen some 'recent progress.'
DD2 seems to be at an early stage of friendship development because she defines friends as 'people who go to the same activity' rather than 'people who share likes/dislikes'.

So there we go.

Interestingly, she wouldn't get dressed today, citing a sore tummy. I couldn't get to the bottom of whether it was 'tummy ache' or a 'pulled muscle' - she couldn't describe it. DH came home and said 'did DD2 go in ok today? She was worried about the activities they're doing today for Euro Week.'

[StarlightMcKingsThree]

Sorry Lougle.

My version:

Attention and listening - not fine
Understanding of language - not fine
Spoken language - not fine
Social interaction - not fine

What's yours?

[StarlightMcKingsThree]

Has the CCC2 been done yet?

[StarlightMcKingsThree]

And the Test of Abstract Language Comprehension (TALC) (note: you don't have to be 'qualified' to deliver this one, you could do it yourself and ask the SALT to confirm there are no concerns based on your answers).

[Handywoman]

OK I'd like a stab:

Attention and listening - difficulty sustaining attention beyond own interests, sometimes 'zones out' potentially due to issues with ?social communication ?pragmatics ?higher level language problems ?anxiety re performance
Understanding of language - concrete, literal, difficulties with higher level language and with generalising
Spoken language - advanced vocab, expressive language difficulties ?disordered language
Social interaction - rigid, issues with non verbal communication e.g. facial recognition

How's this?

[lougle]

My version is sobbing into the report!

There are elements that I can see her reasoning for, but have alternative explanations:

'independently maintained her attention to all of the activities' - she was in a room with the SALT on a 1:1 basis. This is not the same as a classroom situation, with all the distractions that brings.

'not obviously anxious about working with an unfamiliar adult...' - the adult told her that she works with her sister every single week. The adult was kind to her. She goes to school and her 'job' there is to do as she's told.

'...and transitioned easily from her classroom to the assessment room.' Well, I'm not Sherlock, but a) she was going to her beloved dragonflies room and b) she was getting to escape the source of her stress - the classroom.

'She also started and finished the tasks appropriately' - she probably didn't give a flying fart about the tasks, so she just did as she was told. If she'd been given a task she adored, I'd put more weight on an assessment of her ability to 'finish'.

'Informally, DD2 demonstrated awareness that words can have more than one meaning.' Well done, you've stumbled across DD2's obsession: Homonyms and Homophones.

'She also demonstrated enjoyment of simple jokes based on word play' She does like jokes, but she rarely understands them. She understands that they are meant to be funny, so laughs.

'DD2 spoke in long and sometimes complex spoken sentences' Yes, completely true. Often incomprehensible.

'She can be observed playing by herself at times on the playground.' Yet, when I asked about this before, I was told it was untrue.

'She tends to interact with boys, but has started to develop an early friendship with a girl in another class group.' She's been at this school for a whole year. Would you not expect the average child to develop more friendships than this? Would it not strike you as odd that she's interacting with boys when this is the classic age for the 'girl/boy divide', where they actively point out that they won't play with the other sex...

'DD2's understanding of friendships appears to be at an early stage. Her reason for peers being friends are based on specific children going to the same school activities as her, rather than on sharing similar likes and dislikes (which would be expected for her age).' No mention of my observations about inappropriate interaction, etc.

[Handywoman]

Lougle all that being happy to go with a strange adult, sit and do as she is asked then go back to class: my dd2 would have done all these too. In the context of school day which is defined by cooperating with adult-led activities it is quite unremarkable and means zilch in terms of excluding/suspecting ASD.

[StarlightMcKingsThree]

Can you send them Handywomans' version and ask the SALT to refute it as a possibility?

[lougle]

I don't think that will get me anywhere, Star. The reason being that all the SALT could say is 'it's possible, from your written submission, but I haven't seen any evidence of this'. I don't think it's wise to push in that direction right now. I'll wait to see what OT report says, if I ever get one and go from there.

I don't for one minute think that the teacher thinks DD2 is 'fine'. I just think their bar is so high that as long as someone isn't hitting the other kids, they give it little thought.

DD1 had her statement review today. She's going to be set goals to get rid of the articulation issues, then she'll be discharged from SALT, so that she only gets the class therapy. I wasn't even naive enough to be surprised. SALT is a chocolate teapot in most circumstances, IME. Too much effort expended on getting a child to co-operate with an adult in a 'shared activity' before working on their speech/language difficulties. Dressed up as 'foundational skill sets'. Never occurring to them that if the child was more able in speech/language then they may get the motivation to share the task...

[Ineedmorepatience]

My Dd3 would also go with any adult, infact when she was younger she had zero stranger awareness so any adult at school would have been considered "safe"

I think we have been lucky with SALT's because the one that originally saw Dd3 in the complex communication clinic was able to see the subtleties in her difficulties despite her obvious high intelligence and ability to perform in tests. She still discharged her after the appointment though and it wasnt until I requested a re assessment due to Dd'3s theory of mind issues that she was seen again and put on the school based SALT list.

I think you should collect more video evidence lougle and when you have lots ask for another appointment.

[youarewinning]

Oh FFS Lougle. It really is becoming a battle isn't it.

FWIW DS attention and listening came up as "attended activity for 30 minutes without prompting or support" failed to mention he didn't sit still the whole time!

I still think if they'd have observed DS or used an ASD SALT there would be far more picked up and feel they'd pick up many things with your DD2 too.

[Handywoman]

Agree with Ineedmorepatience I think video evidence is your best/only option now. When you've got enough insist on seeing the Paed again.

[lougle]

Thanks guys.

youarewinning this SALT works in SS and has many ASD children on her caseload.

I genuinely believe that there is a 'lifelong neurological difference' between DD2 and 'NT' peers. I genuinely believe that AS is a very good candidate. I acknowledge I'm not qualified to diagnose, but I think if she was a boy she'd be dx by now.

[Handywoman]

I would want to know how many intelligent ASD girls are on that caseload, Lougle

[StarlightMcKingsThree]

I think you should continue to collect evidence too. And make notes, and where possible raise issues in writing to create a document trail of genuine concerns, especially those that allude to a likely diagnosis of something.

At some point the sheer weight of evidence will start to make people uncomfortable for denying.

And I think after the shortest time possible, you need to go back to the paed and request a referral to someone experienced in girl or complex ASD.

[StarlightMcKingsThree]

I also think you're right about 'fine' being a comparator.

Compared to the children with the most severe difficulties she really IS fine, and possibly compared to most children who receive services, but that is the wrong comparison to make.

Have you had any of the hard data from the tests the SALT has done? Do you know which test and what the scores were?

[lougle]

Our homestart lady said that DD2 is 'too intelligent for her own good' today.

Is that the sort of comment you'd expect for a child who can't do basic maths at 6.6 without major support, can't explain how they got the answer they did, etc?

Is that the sort of comment you'd expect for a child who (if allowed to write independently) doesn't put a space between words, doesn't use capital letters, doesn't use full stops, doesn't write in sentences, etc?

Why doesn't she have friends? I mean friends, not people who share the same breathing space.

Why does she stick out in a group of girls?

Why hasn't she grasped that she mustn't interrupt her teacher when she's talking to another adult? Why doesn't she give eye contact in casual encounters? Why does she get so anxious?

WHYYYYY?

[lougle]

Star
-Canterbury and Thanet verbal reasoning skills assessment. 'Passed tasks expected for her age level'
-ERRNI (Expression, Reception and Recall of Narrative Instrument) 'obtained an age appropriate score.'

No scores given.

[Ineedmorepatience]

You need someone to do the DISCO assessment on her Lougle it was designed to weed out those hard to diagnose people including high functioning girls!!

We have found a local paed who has a specific interest in HFA/AS girls [she has one herself] she is doing great work supporting parents and the girls themselves but there are still not enough proffs like her out there.

There is quite alot of stuff online though now I found quite a few articles about girls with ASD, stuff about them being underdiaganosed, misdiagnosed and masking their issues at school.

I am sure with your video evidence, diary evidence and a few articles about girls with ASD you will be able to convince your paed to refer your Dd2 to someone with the necessary experience.

Dont despair

[Ineedmorepatience]

The thing about being too clever for her own good!! goes back to that gap between ability and functional skills doesnt it.

She is clearly intelligent but isnt learning in the same way as other children of her age. She needs to be taught in a different way.

Dd3 is the same, she is really really clever but cant do simple maths or write in sentences!! And yet she has been in school for 7 yrs!!

You are going to have to keep on top of it lougle but you will because you are a great mum. Sorry I wish I could tell you this will all go away but I dont think it will

[StarlightMcKingsThree]

Lougle, I think we all know why.

The true WHY is why didn't the SALT spot this? Why aren't professionals spotting this?

Are teachers too ignorant and professionals only used to seeing severe cases that peek earlier?

Is there another agenda that you don't know about?

Do they recognise difficulties but have no clue how to address them so would rather save face by minimising them?

Were the tests appropriate for her difficulties?

Have you a copy of the national autism plan? If not, google it and look at the tests recommended there and their explanations of what they look for.

[lougle]

I think that some people are noticing some things, but she's not a 'classic autism' box ticker. She does respond and adapt to situations, albeit slower than other children. She has learned, sadly, that if she doesn't like something or feel comfortable, she just has to swallow it down, because when she has been brave enough to tell a teacher how she feels, they've dismissed it or told her she's making a fuss because she misses mummy.

[lougle]

I've just been reading the NPA, Star.

The trouble is that for me she ticks so many boxes. But I'm paralysed by the fact that the SALT has said she's 'fine'.

She deserves more than I can do. She deserves the best assessments by the best people. I can't give her it. I don't know how I'm going to progress this when people are saying 'off the record' one thing then saying another thing 'on the record.'

[sazale]

Lougle, my dd is 15 and was diagnosed AS at 13. Primary school never had any concerns and I knew nothing about autism. She always achieved high end of average and was labelled "lazy" by many teachers due to her reluctance to write. She is very eloquent and an amazing actress and has a lovely singing voice. She had 1 friend in primary who has also been dx AS as a teen.

Secondary school caused a raft of issues. It turned out she has AS (PDA traits) ADHD traits, significant sensory modulation disorder, auditory processing difficulties and a very spikey academic profile that is so spikey she cannot be given an overall iq score.

Her speech is so beautiful and complex she never got access to a salt. We got Margo Sharp independent SALT and specialises in girls to assess dd recently. Dd has some big language difficulties with verbal comprehension being on the 1st centile! She said that dd's AS is difficult to pick up unless you know what you're doing and you spend more time with her than 45 mins as she is a mimic (why she's so talented in the performing arts)!