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How much faith can you put in a peadatricians "gut feeling".

(13 Posts)
pepsi Wed 16-Mar-05 13:38:11

My ds 5 has some special needs which are well documented on this site. His school are noting, poor concentration, dislike of loud noises, making noises in class (train, quiet singing), not doing what he is told ie. stopping playing cars to go and do something else, poor motor skills, poor eye contact, poor social skills. At home although we do notice these traits its not that big an issue, we can take him anywhere no problem, he is loving, cuddly and knows right from wrong, sleeps well and is generally gorgeous. The school are obviously edging towards aspergers/autistic spectrum but the paed said his gut feeling was that our ds did not have this condition, although he doesnt rule out another learning dissability or delays in development. DS was half deaf until he was 3 and he does have hypotonic muscles as well. I want to believe the paed as it is what I want to hear. Should I get my hopes up?

Lonelymum Wed 16-Mar-05 13:41:36

Why not? He/she is the expert, far more so on medical matters than the staff at the school. I don't mean to be rude about the teachers, but I am one myself and I couldn't diagnose aspergers or autism unless it was blindingly obvious. Did the paediatrician suggest anything else that would fit your son's symptoms?

pepsi Wed 16-Mar-05 13:46:25

He said its early days but couldnt rule out dyspraxia. His deafness and his muscle situation really could affect how he is. He is most compliant whenever we see the doctor and does everything he is asked. It seems something in the school environment really exagerates his symptons. I dont know what to think. The doctor said he would see us again in 6 months. He is really lovely and has been doing the job for yonks. I can see he is different from the other kids. The school are bringing in an Ed Physch to see him too which the doctor said would be good. He said that our ds is confusing as although there are negatives there are loads of positives too. Is a child with aspergers/autistic even in a mild case noticetable to someone who knows what they are doing. I just dont know,

Jimjams Wed 16-Mar-05 13:55:02

Lots of autistic behaviours stem from sensory problems (eg with processing sound etc) and a lot of deaf people can appear to behave quite autistically (to the point where I know of people who have approached otehrs and said "I couldn't help noticing that your ds/dd is autistic mine is to" only to be met with a "he/she isn't autistic they're deaf!")- and I know of that happening more than once!)

coppertop Wed 16-Mar-05 14:24:41

I think I would go with what the Paed says rather than the teachers when it comes to medical stuff.

His poor hearing up to the age of 3 might explain a few of his difficulties. I have poor hearing myself and even after I got my hearing aids I still carried on looking at people's mouths when they spoke rather than their eyes. I'd become so used to lip-reading that it was a hard habit to break. It's a completely different world when you can hear again. He may be making quiet noises because he can now hear them for himself and likes it. It may also just be an age thing. Several children in ds1's class make noises to themselves.

Obviously Paeds will vary but both of ours spotted ASD traits in ds1 and ds2 at the first meeting. Ds2 IMHO is pretty high-functioning and a milder case than ds1. His traits are not obvious to people with no real experience but it was enough for him to be given a preliminary diagnosis.

sophy Wed 16-Mar-05 15:22:58

Pepsi, when my DS saw paediatrician aged 3.5 because of my concerns about aspergers, he said he thought DS seemed fine (he had good eye contact) but referred him to autism specialist unit at GOSH "to exclude it." Well the autism specialists found that DS was borderline autistic, i.e. at the very mild end of the spectrum. The paediatrician was great though and filled me with confidence about the future -- basically saying be wary of labels, we are all different and all individuals etc. DS1 has done so well since then (he's now 6, in mainstream school,concentrates and plays happily with friends). So, in my case the paediatrician didn't get the dx quite right but was still incredibly helpful. That does not mean to say that your paediatrician's gut instincts aren't right however, but I think the more professional opinions you can get, the better.

Keane Wed 16-Mar-05 15:37:52

", poor concentration, dislike of loud noises, making noises in class (train, quiet singing), not doing what he is told ie. stopping playing cars to go and do something else, poor motor skills, poor eye contact, poor social skills."

all of this can be typical of "a" learning disability not necessarily autism. my dd is like this, she isnt autistic! she has a learning disability

dilligaf Wed 16-Mar-05 15:40:48

My ds and yours sound like twins. He has loads of problems coping in school and some days he behaves really badly - others he is fine. He is 6, we can take him anywhere he's loving, sleeps and eats well. He has seen two paeds and both say no signs of autism or aspergers. We thought maybe it was adhd but scince doing more investigation we are now leaning towards dyspraxia. We are waiting for a ot appointment. He had hearing problems as well and his speech took a while to catch up we had to pay for salt as the waiting list was so long. Its so stressful trying to help him when you dont really know what is causing the problems. How so the school help him?

dilligaf Wed 16-Mar-05 15:42:50

My ds and yours sound like twins. He has loads of problems coping in school and some days he behaves really badly - others he is fine. He is 6, we can take him anywhere he's loving, sleeps and eats well. He has seen two paeds and both say no signs of autism or aspergers. We thought maybe it was adhd but since doing more investigation we are now leaning towards dyspraxia. We are waiting for a ot appointment. He had hearing problems as well and his speech took a while to catch up we had to pay for salt as the waiting list was so long. Its so stressful trying to help him when you dont really know what is causing the problems. How do the school help him?

lars Wed 16-Mar-05 16:02:07

Hi pepsi, I understand totally how confusing this is for you. As had the same sort of thing with school and Paed and child phsy with my ds.
We finally got a diagnosis and that was O.D.D. and speech delay and development delay. All the behaviours can be rather similar with all similar traits and can be difficult to diagnoise correctly.
One thing I can say is take no notice of the school as they are really not the professionals in this case and are unable to make a diagnosis.
It does take time to get the right diagnosis.
It is important to find out want strategies help your ds in school and the way forward to help him. I also found that my ds behaviours were far worse in school then home, but then that's usually when things come to light they cannot conform to school. Ask the senco what strategies are in place at school and how are they working?
When you see the paed it is something you can comment on. Hope this helps Larsxx

Saker Wed 16-Mar-05 16:20:29

Hi Pepsi, your ds sounds a lot like mine who is 3.5y. The paed initially decided global developmental delay but referred him to the clinical pyschologist because I queried autism. The paed said at the time he didn't think that autism was a likely explanation and the first time she saw him, the clinical pyschologist said he didn't fulfil all the criteria for an ASD although he had a few traits. The clinical pyschologist reviewed him last week and now seems to think he has more ASD type traits. Having read her report the paed is going with that but along the lines of "there may be no specific pigeon hole" for him, he might have a bit of several things. He also has lowish muscle tone and motor problems and could be dyspraxic although no-one will commit to that either! He also has poor social skills with other kids, variable eye contact, but like you say we can take him most places (except e.g. the theatre or somewhere he has to sit still) and he is fairly easy to deal with most of the time.

What I am trying to say is I think the paed's gut feeling is worth something because they will have seen a lot of children on the spectrum. However it depends a bit on how much they have seen your ds (our paed doesn't take much responsibility for diagnosis but leaves it all to the clinical pysch. and has only seen ds2 for 4 20 min appts). I was a bit put out how quickly the paed changed his opinion based on the report and seemed to forget that he hadn't thought that at all before. But I think I would go with the paed's opinion rather than the school. Got ds1 hanging over my shoulder so have to go, sorry don't think this is particularly helpful.

pepsi Thu 17-Mar-05 09:36:10

Regarding global delay, i know nothing about this and wondered what the symptons are. Does a child eventual catch up or are they always behind. Just worried about the future.

binkie Thu 17-Mar-05 10:50:20

hi again pepsi!

I'd see what the ed psych says. Unless you've got a sense otherwise of how reliable your paed is, one person's "gut feel" is a bit uncertain. But if, like us, the paed, the ed psych and the SALT all have the same gut feel of not-ASD, then it is something to rely on I think. After all, those people are seeing your child in the kind of unfamiliar circumstances where ASD-type anxieties would probably be fairly stark.

However: it isn't necessarily a bad thing for the school to consider ASD, so long as they're doing that as a way of thinking up strategies to help your ds - because, as it's often said, using ASD strategies with a child who's in some borderline area (or even with children who don't have those difficulties at all!) can be of real help.

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