Dd's report from the comunity Paediatric Doctor

[Marne]

Hi, as some of you may have seen in my last tread dd2 was seen by the paed last week and we were told she may have Autism. This morning i recieved a letter/report from last weeks apointment.

Feeling a bit as some parts are not quite true, anyway the letter says;

I saw *** in the presense of her mother at my community clinic, she is 2 years and 4 months of age and was refered by her health visiter.

Her mum is concered about her lack of speech. She can sometimes say 'mamma'. She is only doing noises like children of 1 years of age. She is copying noises she hears from others. She was refered to SALT and she is awaiting an appointment. She is also not responding to commands and she is not interested in listning to peoples conversations.

She is usually flapping her hands. She likes to line things up all the time, especialy toys rather than playing skilfully with them. She is lining the food up on her plate.

She is very obsessive with jigsaw puzzles and she could do them all day. She preferes to be in her own little world rather than communicating with others.

She is flexible with her routine and her eye contact is variable. She is sensitive to loud noise and physical touch. She has lack of imaginative play.

Otherwise she is healthy and well. She refused to be examined as she does not like physical touch.

I tried to do a developmental assesment and complete a schedule of growing skills. During this assessment she did not give any eye contact. She had difficulty to understand. I noticed she is still mouthing and her mum confirmed that she takes evrything to her mouth. She also did not engage in imaginative play. However she seems to be good in some of her visual skills, especially completing the puzzles and shape form board and the fish form board. She also matched four of the colours.

Her gross and fine motor skills are appropriate for her age.

Her hearing and language skills seem delayed. She could not point to the dolls body parts or her own body parts. She is not interested to know names for familiar objects or people.

Her self-care social skills are appropriate for her age.

Her congntive skills score at about 18 months of age.

It then goes on to say that she has been reffered etc..etc...

Anyway, i was upset as it stated that she does not like physical contact, this is not true as she loves to cuddle people. She said that she could not examine her, she did'nt realy try, dd was a bit wriggly but she could have examined her easily. She also said that i said she mouths at evrything, i told her that she does'nt do this much anymore but used to.

It all looks so much worse written down on paper and i'm realy worried about the future, i just hope SALT can help her.

[Marne]

Sorry about the long post.

[silverfrog]

I am sorry you have been upset by the report. They are a kick in the teeth each time they come. As oyu say, it is hard seeing it all written down in black and white.

If there are things you disagree with, try calling the doctor and askin gthem to change the report. I have done this before. Usually, I get sent an advance copy to "ok" before it gets sent out to all and sundry (hv, gp, etc) and so I get it changed to what is appropriate before it goes on dd1's
file.

Do try to remember that the report is a stranger's assessment of your dd - it cannot contain everyhting about her, and they always say nothing about character and personality (which is what makes your dd the loveable girl she is, not the suspected autism).

It is hard to read, but it is the beginnng of the process that will get oyur dd whatever help she needs.

[silverfrog]

sorry about bizarre spacing - dd2 was helping!

[nikos]

It's really difficult when they put things in black and white and it feels like you have no recourse to correct them. On our first appointment the paed said my ds lost eye contact when she approached him but all he did was look at her from under his eyes (a sort of princess diana look) but with a smile on his face. It was a natural toddler reaction to being approached by a lady with a stethascope!!
We had a few factual errors in our recent SALT report (who is fantastic usually) and we emailed her the correct details. Is this an option? The hospital should be able to give you an email contact (of a secretary at least). I think this is better than phoning.

[TotalChaos]

the reports are hideous, a litany of all your child can't do. one salt report was so inaccurate that most of nursery parent's evening consisted of me and the teacher going through all that was wrong on the report..... I agree with silver and nikos - if you are very upset by the inaccuracies, then phone up/e-mail and tell them and see if they will change the report. tbh though if you agree with the vast majority of the report I probably wouldn't bother getting it changed, but just mention what you don't agree with at next appointment. remember as well that these appointments are only a snapshot - you know your kid so much better than they do.

[moondog]

I hope salt can help too and Iamone, but I would also advise you to start looking into and reading about ABA, which stands for Applied Behaviour Analysis.

[moondog]

If it is any comfort to you, reports are pretty all much of a muchness and actually not that much attention is paid to them.

[nikos]

I also try to bear in mind that a lot of professionals know that they have to make things sound as bad as possible so that we can access funding and one to one support. But these reports can be so depressing. I've been generally up most of the time and got really disheartened with our last SALT report.

[moondog]

What matters most is how the child presents at the moment I am seeing him/her.

[nikos]

I didn't know that moondog. I assumed great weight was placed on them as quite a lot of the time professionals see our dc 'cold' IYSWIM.

[moondog]

Nikos, thousands of reports written to basically same format are shuffled back and forth so people do become immune. .

[moondog]

Nikos, thousands of reports written to basically same format are shuffled back and forth so people do become immune. .

[moondog]

If there are reports that you think are useful, highlight and pass on to othersyourself. Sharing info. generally hit and miss amongst profs.

[Marne]

But surely a child presentd differently infront of a stranger and in a uknown enviroment?

Dds eye contact at home with people she knows is alot better than it was with the paed last week.

We have our first SALT apointment next week and her next apointment at the hospital should be in 8 weeks (ish), it just seems a long wait, dd1 has been going for apointments for 14 months and we still do'nt know if she has AS or not. I wish i could hurry it along

I want to get dd2 a nursery place but i am unsure where to send her, dd1 went to a lovely nursery which helped her alot, but i am unsure about sending her there, we have a local special needs school which have a nursery but i can get her a place without a referal.

[Marne]

Thanks moondog, i will highlight the bits which i think are wrong and pass them on to SALT etc when i see them.

[moondog]

TrueMarne, but astandardised asessment takes this into account, although yours is of course informal. Must say,the English isn't great!

[nikos]

My paed report described ds as 'an attractive boy'. Very nice to hear but we did have smile at its irrelevance!!!

[moondog]

All reports from paeds. start like that. I have seen hundreds even when kid patently acomplete sod!! Really irritates me. Means nothing.

[jimjamshaslefttheyurt]

"But surely a child presentd differently infront of a stranger and in a uknown enviroment?"

Exactly Marne. Something I've tried to make a point about in a paper I've just written. I actually think it's a problem because children are denied services because they don't present well in standardised assessments. ("there's no point giving any therapy because he/she isn't capable of anything').

Stanley Greenspan (Floortime) makes a point of saying it's essential to score the child at their best and worse in order to understand what you should be aiming for. Generally most assessments see the child at their worse. And imo are therefore pretty much useless for lots of applications.

It would be worth looking into things like ABA and Floortime. Think of the assessment as showing there;s some sort of problem that your child needs help with. Don't think of it as describing your child or even indicating where they need help. It's rare that they do.

it's a tough time

[Marne]

The paed in Indian, her English is'nt the best which makes her hard to understand and hard for me to get my point across. She gave me alot of info about the NAS and courses i could go on, she seemed very understanding but i found some of the tasks she was asking dd to do were not realy suitable for her age group, i felt like saying 'she's only 2, so what if she cant point to her nose'.

[Marne]

nikos, yes she said dd looled pretty and normal

[Marne]

is indian, not in indian

My english is crap

[Marne]

Sorry, typing in the dark as trying to get dd to sleep.

[silverfrog]

Oh, definitely agree that these reports show our children in the worst light.

I often find the sessions turn into a very long series of "no"'s on my part

• can dd1 count
• is she potty trained
• can she dress/undress herself

etc.

The annoying bit is that evn when she improves in an area, the next report won't state that, just move on the next thing she can't do.

eg at dd1's last assessment, she could not walk up stairs with a cross tread - would walk up step-together, step-together, iykwim. Now she can, but that won't get a mention - the focus will prob be on the fact that she can't hop, or similar

The reports are just a black and white snapshot, of a particular time and place (and person - dd1 has responded better to some docs than others), but it can be very hurtful to think that that is how someone else sees your child

[cyberseraphim]

Focussing on what the child can't do is a waste of time. You need to think in terms of what she can do and build on those positives. We are thrilled with the progress DS1 has made since being dxd but as silverfrog says, the goalposts keep changing so you never really catch up. If DS1 could do and say everything an NT child could do, he wouldn't be autistic so what is the point in highlighting the deficits? Our DS is quiet and overly formal in public (we are lucky!) but the fact that he can't annoy people by chattering and playing loudly with cars is held against him not seen as a good point in itself.