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WHY isn't the CHAT test used routinely?

48 replies

Jimjams · 27/07/2005 09:07

IS there a reason? Does anyone know?

I found this in a report to paliament by the All Party Parliamentary Group for Autism - made in 2001- ie the year ds1 was busing failing all relevant areas of the CHAT test (which wasn't done) whilst I was being told he definitely wasn't autistic:

"early intervention can only be achieved by early identification ? the need for the national adoptionof the CHAT "

So WHY are they not doing that then????????????????

Now I would be on for everyone writing to thier local PCT/MP and asking why the CHAT isn't being used. Unless anyone knows a reason why it isn't.

Apolgies for kind of x posting as well.

I do see this as something that is a) worth campaigning for (especially having read the thread on B and D last week) and b) probably achievable. I do suspect that if they introduce the CHAT then they may be forced into providing early intervention.

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Fio2 · 27/07/2005 09:10

I had never even heard of it before mumsnet and looking how useless and uninformed some professionals are on autism and developmental problems, i think it is ridiculous it isnt being implemented

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Jimjams · 27/07/2005 09:13

MOst HV for example are completely useless at spotting autism ("no dear we don't worry about not talking until they're 3" "but he's not pointing" "well that doesn't matter" aaaaggghhhhh).

With the CHAT at their disposal they would be able to spot it (and may begin to understand the important signs).

I won't get started in SALTs as I'll be accused of SALT bashing, but I do think it should be part of standard SALT testing and part of their training. It's so simple it would only take 10 minutes to teach- so at least they would then know when to refer on.

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Bethron · 27/07/2005 09:17

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Jimjams · 27/07/2005 09:21

An ed psych????? They shoouldn't be diagnosing! The CHAT isn't really a diagnostic tool - but its a good screening tool- so the best people to use it would be HV and SALTs who would then refer onto a developmental paed/ clinical psych for diagnosis.

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maddiemo · 27/07/2005 09:21

My Health Visitor was very excited at being trained to do CHAT. However, it has never been implemented here and personally I think it is to do with not wanting to refer children on when there is little provison available.
HV's here are not allowed to refer for SALT before 2.6, any earlier referral has to be made by paed.

DS4 failed CHAT (that I did myself) at 18 months, I told staff at CDC where ds3 was being seen. They said "Don't worry, he seems fine". Over two years later the same person is asking me if I am sure that ds4 does not have other problems (asd) in addition to his complex langauage problems which could also have been picked up at eighteen months!

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expatinscotland · 27/07/2005 09:23

I agree 100%, jimjams! Early intervention will also save the education and medical systems money in the long run.

Our DD is currently being evaluated for GDD. The only reason she was given CHAT was b/c the GP lived in the States for 10 years and heard of it there.

I still find it very frustrating that it's been 3 months since a sample was sent to the lab to check for chromosomal abnormalities and we STILL have no results.

Or that she had 6 sessions of physio and then sent on her way.

She hasn't been referred for SALT at all even tho her speech is obviously delayed - just like everything else - and won't be till she sees the community paed again. In December. When she's 2.5 years old.

The prevailing attitude seems to be 'wait till they're 3' or go to school and then try to cobble together the diagnosis that requires the cheapest treatment.

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Jimjams · 27/07/2005 09:24

oh FFS maddiemo- that is appalling (and of course is the same CDC that proclaimed ds as definitely not autistic). I always suspected that my HV there thoguht he might be- so referred him onto the specialist SALT and then couldn't do anythng when he was proclaimed OK by then. I wonder if she was CHAT trained.

I feel strongly about it because children are missing out on years of early intervention.

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tortoiseshell · 27/07/2005 09:24

In our area they've got rid of the 2 year check altogether - it's up to the parent to ask if they're concerned. Which I think is mad - a friend of mine has a son with autism, and he passed his 2 year check fine, one or two comments about not doing imaginary play, not playing with cuddly toys, then when diagnosed at nearly 4, HV says 'Yes I wondered about that at his 2 year check, because of the imaginary play etc.' Interesting that she didn't see fit to mention it, or to keep an eye on him! There doesn't seem to be a system of following through - the CHAT test done as a routine check might provide that.

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Jimjams · 27/07/2005 09:25

expat- the GP had lived in the States- the CHAT was designed by a British team!!!!! It's ridiculous isn't it!

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Bethron · 27/07/2005 09:28

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expatinscotland · 27/07/2005 09:28

Tell me about it, Jimjams! This GP also managed to get mercury-free jabs and Thin Prep smear tests in before everyone else did - things that have been standard in the US for years.

She uses CHAT on all infants at the 18 month check. Until I started using mumsnet, I had no idea this wasn't standard procedure.

If it hadn't been for her, we probably would have just been told, 'Oh, your DD is fine. Don't worry till she goes to school' (and has a horrid time b/c no one could be arsed to figure out that she's about 9months-1year delayed for some reason).

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maddiemo · 27/07/2005 09:29

Also wanted to say that my HV tried to refer ds4 at two for portage but despite being seen he was referred on to one to one pre school support for which we have been waiting over a year.

My SALT can't believe he does not receive portage !!

It all comes down to money and what the LEA can get away with.

The further into the system I have gone the more disgusted I am.

We are undergoing massive changes to our SEN provision and none of it is based on anything other than finances.

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Davros · 27/07/2005 10:31

I would be more inclined to get involved in a campaign on this as it is specific and very important.

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Jimjams · 27/07/2005 10:34

ageed davros- and i think achievable. and if they are identifying at risk 18 month olds they'll HAVE to then think about early intervention. I'm game.....

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bundle · 27/07/2005 10:36

jimjams, do you have a link for CHAT? I'd love to find out more about it

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expatinscotland · 27/07/2005 10:36

Count me in, I'm game, too. This is Britain's future we're talking about here!

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Jimjams · 27/07/2005 10:36

do you think the nas would get involved davros. I supose a start would be to see if it is used anywhere routinely in the uk (outside expats gp's )

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Jimjams · 27/07/2005 10:38

\link[http://www.nas.org.uk/nas/jsp/polopoly.jsp?d=128&a=2226\here}

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expatinscotland · 27/07/2005 10:38

And I think she only did ours b/c DD was so late to sit up on her own, crawl, etc.

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Jimjams · 27/07/2005 10:38

and again...

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coppertop · 27/07/2005 10:40

Count me in for the letter-writing etc. Ds1 would've got into the system so much earlier if the HV/GP had used CHAT.

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bundle · 27/07/2005 10:43

thanks jimjams, looks pretty straightforward, is it just a lack of knowledge that prevents it from being used across the board (ie looks like a good test for HVs to be aware of for all children, never mind just SN)

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Jimjams · 27/07/2005 10:54

it's meant to be used on all children bundle- routinely at 18 months- to flag up those with communication difficulties....

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bundle · 27/07/2005 10:55

I see, that would make sense then, so not just if the parents/hv think there's a problem. makes perfect sense.

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expatinscotland · 27/07/2005 11:00

But oh no! Then they'd have to pay for those who failed to be evaluated by a specialist. Wouldn't want to spend precious pounds on children now, would we?

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