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ADOS

(63 Posts)
dingledangles Fri 11-Jan-19 14:22:07

Hi everyone, my daughter got a recommendation for a dyspraxia diagnosis from an OT privately last month, we have now been given an appointment for an ADOS on the NHS, can anyone explain more about what this is please and what this will entail? Thank you.

DobbinsVeil Sun 13-Jan-19 22:19:12

2 of my sons had the ASD. They were preschoolers (there's different modules of the ADOS depending on age/ability to engage). Their ADOS was done by a Specialist SALT and OT. It was mostly the SALT engaging my child, with the OT observing and scoring as they went through the various games and task. It was things like puzzles, balloon games, pretend play with characters, a birthday party. Some questions as well. They both had an absolute hoot and seemed to be engaging really well. But they both also scored in the ASD range.

dingledangles Mon 14-Jan-19 06:22:58

@DobbinsVeil

That's such a helpful response, thank you! Were you in the room and watching it all? I've received a letter to say there will be a paediatrician, a SALT and an OT. Did your children engage with the staff quite happily? How long did it take for you to receive the scores/report/diagnosis?

I am guessing that there is a scale and there's a certain score that would mean a diagnosis and then varying degrees of it?

Following the diagnosis did you get further appointments/referrals? Did the diagnosis open any doors for your children at school?

So sorry for all the questions!

Claw001 Mon 14-Jan-19 08:15:46

Is assessment being done through CDC or CAMHS?

Our assessment involved Specialist Paed who took history of development etc.

Specialist SALT, who did assessments, for example trying to engage my son in play, observing his play (ie disengaged, lining toys up) more formal assessments, such as reading a story, showing visuals and asking my son questions etc.

We watched through a 2 way mirror, with CAMHS, EP and school SENCO.

At the end of the assessment I was asked to join my son and play for a few mins (probably due to school implying I was the cause of his difficulties hmm)

After we all had a short meeting, where I was told my son would receive a fix of ASD.

Prior to this my son was assessed by same SALT in Feb. In June we received DX report.

DobbinsVeil Mon 14-Jan-19 09:17:50

For both children I was in the room for the assessment. The paediatrician was taking a full history from me, so I wasn't observing directly what was happening, but could hear. I was sent off for about 20 minutes after it was completed and then given the dx. I think some areas call you back for a further appointment to do history and give the diagnosis (or not). And some areas have the parents waiting outside, though I think can be flexible if the child is too anxious to go in alone.

For DS1, it did open up a few things. He was just 3, he was referred to the Ed Psych who assessed him at preschool and he got extra funding. He was then referred to the Specialist Teaching Team, which was a brilliant support. He was also referred for a sensory assessment by the OT. And something called Early Support which was basically a contact point rather than any kind of intervention. I should add this was in 2008. He started school with a statement (now an EHCP) and a lot of that was down to having the Ed Psych assessment and Specialist Teacher.

DS3 had his assessment last year, he was just over 4. There were no further referrals and we were discharged. But a diagnosis has been useful for school, they are getting the Specialist Teaching Team involved. I have just been turned down for an EHC needs assessment and I'm currently appealing.

Both of them engaged really well. DS1 was normally quite resistant to assessment, but he had an absolute blast and was laughing his head off! DS3 still asks when we are going back to see the "talking ladies" and asks to go as a treat(!)

I was really shocked DS1 was diagnosed tbh. It's a clever assessment, it teased out the subtle difficulties they have. From memory, there's 3 or 4 categories based around the ASD criteria (social interaction etc), and scores for each, then an overall score. There's a band for Autism, a band for ASD, and then scores outside of those would be not in the diagnosis range. But it's a tool for assessing and doesn't mean they won't diagnose overall, as history and previous assessments are taken into account to.

Like anything though, it's not perfect, some of it will depend on the skill of the clinicians carrying it out. it should give you some insight into difficulties present, even if there's no diagnosis to be made.

Good luck, I hope it goes well.

dingledangles Mon 14-Jan-19 15:36:36

@Claw001 I've got no idea, I don't think it's either, the letter says 'specialist children's health service' at our local hospital and says it will be with a paed, SALT and OT. Helpful that the school thought you were to blame 🙄 how old was your son? Was this last year? Has it changed anything with the school?

@DobbinsVeil very informative, thank you. Do you feel ds3 would have benefited from referrals or do you feel the diagnosis is enough and the school support will be enough? I don't think it will change much at all at school!

DobbinsVeil Mon 14-Jan-19 16:33:52

Yes, I think an Ed Psych assessment would have been hugely helpful as well as having a Specialist Teacher from the start. I've just paid out for a private EP assessment. The dx alone has served a purpose with the school. They aren't the greatest with SEN <understatement> and having a formal diagnosis means I am not subjected to the usual runaround of getting them accept he has SEN. It also means he has the added protection of the Equality Act - reasonable adjustments etc.

Punxsutawney Mon 14-Jan-19 17:11:01

Is the ADOS used at a speech and language assessment for an older child/teenager? My 14 year old Ds has been referred by the community paediatrician for an ASD assessment with speech therapy but she didn't actually say what they would do. He has a separate appointment with occupational therapy for fine motor issues. He is not due to see the consultant again until all assessments are done.

Claw001 Mon 14-Jan-19 17:29:20

Dingle sounds like CDC (child development centre) far better than CAMHS IMO.

CAMHS attended, as my son was already under CAMHS, for other non related diagnosis issues (anxiety). (CAMHS had previously told me they saw no signs of ASD either) thank god they were not responsible for diagnosis!

My son was 5. He is 14 now! My how time flies!! It changed lots, thankfully! School were saying they saw no signs of ASD 🙄 and I was responsible for his anxiety! We changed schools pretty sharp!

I applied for a then called Statement, prior to diagnosis hence the EP being too.

dingledangles Mon 14-Jan-19 19:11:15

@DobbinsVeil I might be asking a really obvious question (and I should know this because I work in schools) but what does an Ed psych actually do? I've had them come in and observe children and say xyz but not sure what it actually achieves for the child 🙄

@Claw001 can CAMHS actually diagnose then? I've heard CAMHS thrown around a lot at school but again, not really sure what they actually do 🙄 school have said they see nothing as well 🤔

The senco actually said even if there was a diagnosis they wouldn't change anything because they 'do everything already' with all the children 🤔

dingledangles Mon 14-Jan-19 19:12:54

@DobbinsVeil did anything come out of the private EP assessment? Any suggestions for school etc?

@Claw001 I've heard of CAMHS a lot but not sure what they actually do, can they diagnose then? School see nothing with my child apparently 🙄

dingledangles Mon 14-Jan-19 19:13:38

My post wouldn't send and kept deleting and I rewrote it 3 times I got bored by the 4th hence the 2 versions of my comments 😂

DobbinsVeil Mon 14-Jan-19 19:41:50

I got the private EP because I need evidence for my EHC assessment appeal. Ed Psych has lots of suggestions for the school - getting them to implement them is another story though! For me, having his cognitive abilities assessed was something I really wanted as the school have a habit of declaring everything fine/age expected when the reality is different. A fresh pair of eyes in the classroom is helpful if the child is struggling and the school believe they are doing everything possible.

Claw001 Mon 14-Jan-19 19:43:17

CAMHS is mental health, anxiety etc. Either a Paed or psychiatric (CAMHS) can diagnosis. As ASD is a social/communication disorder IMO a specialist SALT is far more apt, working alongside a Paed. Although CAMHS should take a multi team approach, we probably would not even got assessment, as they didn’t see any ‘signs’!

During the SALT assessment for ASD, it was so glaringly obvious that my son had Autism. To be honest, even I had not seen his autism to this extent! The assessment is designed to ask the right questions and highlight things someone with ASD would find difficult.

dingledangles Mon 14-Jan-19 20:00:23

@DobbinsVeil what kind of things did they suggest if you don't mind me asking?

@Claw001 can you remember any of the types of questions? My child appears quite neuro-typical to most people, however in conversation I do notice things that she just cannot grasp and answers in very odd ways. I'll be very interested to see this part of the assessment. I still would be shocked if a diagnosis of autism is given, but I am still interested to see how the assessment goes!

dingledangles Mon 14-Jan-19 20:02:34

@Claw001 strange that CAMHS can assess for ASD. Do they do the ADOS? Is that the only way to diagnose ASD? I am trying hard to find all this info by googling but I am just going round in circles!

DobbinsVeil Mon 14-Jan-19 20:19:40

I've not had the report yet, but a couple of specific programs (one for writing one for something I can't remember), she will also recommend an OT assessment for sensory stuff, advice on using now/next boards to help with his problems with transitions, advice on how to introduce a change to the now/next activity. He has difficulties with working memory and segmenting words, which school weren't aware of and which will impact on his learning. Also advice to the school on better demonstrating to the LA what they are doing to support DS3 (they aren't great record keepers).

The LA Ed Psych for DS1 made a lot of suggestions for his EHCP transfer - so for him it was breaking down his work in advance and giving him his own copy at the start of each topic, some kind of lego program for social skills, communication cards etc.

How old is your daughter? I remember a poster on here years ago said that her child was asked if he would like to get married. Her child thought the assessor was proposing! I do remember the SALT trying to engage DS3 in a conversation about cats. the SALT was saying her cat was very naughty. DS3 just kept smiling in response to her, he didn't ask why the cat was naughty etc.

DobbinsVeil Mon 14-Jan-19 20:22:24

Both mine were assessed and diagnosed by the child development centre. The equivalent to CAHMS in my area doesn't diagnose ASD. An ADOS isn't a requirement for a diagnosis but a lot of areas use it as it's consider one of the better assessment tools.

dingledangles Mon 14-Jan-19 20:31:47

@DobbinsVeil all of that sounds like things my child could benefit from, especially with writing. She's 5, there's so much she struggles with at school that they're refusing to admit and probably won't until she gets to year 5 and hasn't achieved. I don't want to let it get to that point as her self esteem is already so low, I am looking forward to getting the reports so I can work out what to pay privately for. We don't have a lot of money to do so but will put things aside for things if they are going to help that much! Even if it's a bit of 1 to 1 tuition to help with writing etc.

Claw001 Mon 14-Jan-19 21:06:42

I remember one question, SALT was looking at a picture (ds couldn’t see) he was giving him verbal descriptive clues. He was describing a balloon. They are round, you blow them up, tie string around them, play with them at parties, they can go up in the air.

Ds said ‘bird’. When he was told it was a balloon, he argued, the string could have been tied around the birds leg! Told SALT if it was a balloon, he should have described like x,y,z!

Ds then took a turn at describing various pictures to SALT. He simply gave the exact description.

The questions were mainly SALT describing situations or show ds picture situations etc and expecting ds to infer from them. Which he really struggled with.

Claw001 Mon 14-Jan-19 21:10:11

For example describing a balloon. Ds would have said, it’s red, it’s round, the background is blue.

dingledangles Tue 15-Jan-19 06:44:19

This does resonate with me, especially with understanding/describing pictures in books!

DobbinsVeil Tue 15-Jan-19 11:51:40

The only thing with the Ed Psych is they can make all the recommendations in the world, but getting an obstructive school to implement them is nigh-on impossible, even if they have an EHCP (BTDT DS1). But I still think there's value there - it should give me ideas of how to support DS3's learning at home, as well as evidence for the EHC needs appeal. And I can point at it every time I have a meeting with the SENCo!

dingledangles Tue 15-Jan-19 12:33:37

Oh yes I totally agree with you.. schools won't always implement things or even be able to, but it gives parents a good idea of what will help at home and even if one thing from the report is implemented it's better than nothing. Is your sons school very unhelpful?

BlackeyedGruesome Tue 15-Jan-19 12:49:46

The school can not see a problem at all. We are waiting until Thursday to say I told you so ( or not) a friend's child did not get a diagnosis but gets help as the appear to be struggling, DD masks and hides her struggles, and does not get help and the school are saying it is a parenting issue.

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