GP appointment to request autism diagnosis process, help please.

[ItWentInMyEye]

Hi everyone, I'm taking my almost 4 year old DS to the GP today as since he joined nursery in January its become increasingly clear that he displays behaviours in line with some traits of autism. Nursery raised the concerns within his first week and it didn't come as a shock, but we're still devastated. It's not the end of the world, we totally know that, just I'm trying to get my head round everything and I'm looking for advice as to how I phrase it with the doctor? We have the full support of all nursery staff, they suggested we go to the GP as it might speed things up when they refer him at Easter. I have no experience of any of the processes, agencies involved etc so it's all just whirling round my head. Any advice would be greatly appreciated. Sorry for the long post.

[Wonderpants]

Make a list of things that cause you concern as they will ask you why you want an ASD assessment.
We just outlined our concerns and asked for a referral and it goes from there. Try not to worry too much about the process yet, nothing happens quickly. You could ask your GP if they know what happens next although your nursery (is it in school?) SENCO might be able to advise you better! Good luck!

[ItWentInMyEye]

Thanks so much for your reply. Yes it's a nursery attached to school, and they're brilliant. The teacher told me to ask anything I want, even if I think it sounds silly. Do you know who am I asking for a referral to? I want to make sure I'm saying the right things, I'm worried the doctor might just send me away!

[Sausagepickle123]

It depends on your area for process - GP should know and ours referred us to developmental paediatrician (community paediatrician) who agreed that a referral for full assessment necessary. Nursery also referred for autism assessment through the LA early help forms.
I didn't take my son to the initial GP appointment so I was free to talk without being distracted by a child. I just cried my way through it. The GP was lovely and made referrals straight away. Good luck - the recognition of issues and diagnosis has been key to us getting help and support for my son and he's doing really well now xx

[ItWentInMyEye]

I've come away from the GP a bit... Meh. At first it was like he didn't believe me that anyone has any concerns and passed it off as his age, then said he can't refer DS any quicker than nursery, laughed when I said they only make a referral once a term, mentioned ADHD, then as he watched DS a bit longer I think he started to 'get it' and noticed how active and into everything he is.
Now I have to wait till next week to speak to his teacher and ask if it can wait till Easter for their referral or if I should see another GP. I just feel like I'm even more in limbo than I was earlier.

[Hurricane74]

Hi, I am not sure what the answer is here but didn't want to read and run. Could you ask the nursery to refer now rather than waiting until Easter (why do they only refer once a term?!) and if they can't do it now then see another GP? I feel that I was fobbed off quite a bit by our health visitor and speech therapist and wish I had pushed harder sooner for a pediatrician referral as even when the referral had happened there was a long wait for an appointment and the whole process seems to take such a long time that you don't want any additional delays if you can avoid it. Good luck and let us know how you get on xx

[Allthewaves]

Our nursery had a hv come out and Wath the kids then she referred to put hv who came out to the house and spent an hour playing with ds. Could your hv come out to you?

[Allthewaves]

Wath = watch

[FrayedHem]

You should be able to self-refer to Speech and Language Therapy - some areas have drop-in clinics, mine has an online form you complete. With DS1 the HV did referrals to the paediatrician and SALT, with DS3 I self-referred to SALT and they then did a referral on the paediatrician so you may be able to bypass the GP if they aren't being particularly helpful.

[ItWentInMyEye]

I took a list of concerns with me to the doctor, which he asked to keep. Is this normal? I don't know why school only refer once a term, the teacher just said that's their practice! She did mention gathering observations until Easter, I assumed it was to help have more information about DS. I'll wait till next Monday (half term at the mo) to speak to her before I ring the health visitor, I don't know if asking too many different people to set things off will confuse things. I suppose this is the difficult start to a difficult journey. Thanks everyone for your replies, it helps to know other parents are willing to help navigate this unexpected process

[ItWentInMyEye]

@zzzzz Sorry, what's an MCHAT? I really am a newbie to all this.

[gatorgolf]

I don't think the nursery can refer themselves as such. As far as I know it would have to go through a health professional, my ds got referred through school nurse so nursery equiv would be health visitor, maybe they have a health visitor coming in once a term so that's why referrals are once a term?

[gatorgolf]

However saying that I do think schools/ nurseries get taken a lot more seriously with their concerns so going via a school nurse or equiv for nursery you would be more successful than ppl that go direct to gp

[ItWentInMyEye]

The school inclusion officer has observed him, I'm guessing she'll be the one to refer him? The doctor said he doesn't really know DS and so nursery would be better placed to set things going.

[Phoebesgift]

When my daughter was at nursery she was referred to an educational psychologist by the nursery SENCO. We also asked for our daughters hearing to be checked. Both assessments led to a paediatric community referral and a subsequent diagnosis. We never (and still haven't) used our GP for anything related to the process.
Have you asked for advice from your health visitor?

[TheNoodlesIncident]

The GP may not know your DS but you do and you want a referral to a developmental paediatrician. You are not there at the doctor's to waste their time and yours, you are there because you feel there is something to be investigated and the sooner the process is started, the better for your ds.

And stamp your foot a little...

Yes, the nursery can start asking for assessments but you are the parent and YOU can request it too, there is no reason to wait, especially if you have all your concerns collated on paper to refer to. (Videos are useful too, no harm in recording DS's behaviours if you can do it safely) Be firm with the GP, you will probably have to develop an aura of feistiness in order to ensure your DS gets what support he needs. I was kidding about the foot stamping though but only a bit

[BackforGood]

In our area, the Nursery can refer whenever they choose - can't believe there is some kind of "once a term" rule anywhere ?

I agree with the GP that the referral is FAR better coming from the Nursery though, as they know the dc far better than the GP. They will have developmental profiles they can fill in, and other evidence from observations. The GP will have seen the dc once for 7.5mins in an unfamiliar office.

Where they get referred to is different in different parts of the Country. Here, it would be to see a paediatrician at the Child Development Centre, but I've read on MN that CAMHS are involved in some areas, so the actual process seems different in different LAs and HAs.