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To think autistic children with needs affecting their day to day life should go to the top of the waiting lists?

369 replies

orangeleopard · 17/09/2024 07:52

As The title says, children who’s needs are severe enough to impact their every day life to an extent that they need help urgently should be put above all of the other children on the waiting list that ‘may’ or ‘may not’ be autistic. My son is in primary school and only able to do half days due to his additional needs, but is told to ‘just wait’ to have his initial appointment with a pedestrian. He hurts himself and others on a daily basis. He doesn’t sleep until midnight/1 each night as he’s so hyperactive. He has severe meltdowns that sometimes lasts hours. He cannot speak properly and has also been waiting years for speech therapy. He is a severe flight risk and runs as soon as he has the opportunity to. He also has no sense of danger and injures himself on a daily basis. His day to day life is affected so severely , as is mine as a parent and he needs severe help yet is told to just ‘wait’ for his assessment to get diagnosed and help. Yet there are children on the waiting list who yes, deserve to have an assessment but needs are not impacting their day to day life as severely- ie they can attend school ‘normally’.

am I being unreasonable to think children like my son should go to the top of the list and that the list should be based on need

OP posts:
LostTheMarble · 17/09/2024 11:40

Areolaborealis · 17/09/2024 10:48

Surely part of the criteria for getting on the autism assessment list should be there is a history of significant functioning problems and that other explanations have been investigated and discounted. So those with higher needs would already be further along in the process.

I think its reasonable that someone who has never been involved with mental health services, functions well socially and never required support in work or school but turns up at the GP asking for a diagnosis should start at the beginning of the process and therefore at the end of the queue.

Not how it works. Haven’t seen one GP about my children’s autism traits - both my older children were initially flagged as having traits by a health visitor. She made referrals to other agencies including the local children’s paediatric unit. Medication for ADHD can only be given by a consultant so a GP wouldn’t be of much use unless the child is much older or even looking for an adult diagnosis (which is referred elsewhere anyway).

My youngest was seen as ‘possibly autistic’ from his one year assessment. Obviously I had to be proactive, but with two older children diagnosed any delays in early assessments were taking more seriously. He was referred to paeds by a HV at 18 months which wouldn’t have happened with my eldest (with speech and social delays present, not as a precautionary).

And someone who ‘functions well socially’ isn’t autistic. Someone who can mask highly daily but it’s having a high impact on every other area of their life should have the same opportunity for diagnosis as anyone else. Functioning is a false term, anyone can look like they’re managing by acceptable social standards, you have no idea what chaos it’s causing behind closed doors.

BackForABit · 17/09/2024 11:39

Ohfuckwhatdoidonow · 17/09/2024 11:38

Hmm, I don't think you're unreasonable for thinking that children with the more severe behaviour issues that come with Autism should be put toward the front of the queue, like the poor lady who's child had broken her finger. Dad's needed stitches, younger sibling is covered in bruises, and she's broken her own arm.
The problem is, children like my own, also a bolting risk, a huge risk where water is concerned, completely non verbal at 2 and a half years old, not ready to potty train, but almost too big for normal nappies we can find, covered in bruises because he hurts himself, and sleeps 6 hours in a 24 hour period (broken sleep of course!) Cannot cope with being at the childminders (who he only attends for evidence) because he screams and screams, refuses food or drink during that time.... also have issues that need support, and if they keep getting pushed back, and back, and back they'll never get seen.

In our area we're already at over a 2 year wait... I know it's not longer than most other areas, but I've been begging someone to listen, and now they have its unlikely we will have a diagnosis before he starts school, and I've no idea where that leaves us with getting an EHCP

You can apply for an EHCP yourself without a diagnosis.

Ohfuckwhatdoidonow · 17/09/2024 11:38

Hmm, I don't think you're unreasonable for thinking that children with the more severe behaviour issues that come with Autism should be put toward the front of the queue, like the poor lady who's child had broken her finger. Dad's needed stitches, younger sibling is covered in bruises, and she's broken her own arm.
The problem is, children like my own, also a bolting risk, a huge risk where water is concerned, completely non verbal at 2 and a half years old, not ready to potty train, but almost too big for normal nappies we can find, covered in bruises because he hurts himself, and sleeps 6 hours in a 24 hour period (broken sleep of course!) Cannot cope with being at the childminders (who he only attends for evidence) because he screams and screams, refuses food or drink during that time.... also have issues that need support, and if they keep getting pushed back, and back, and back they'll never get seen.

In our area we're already at over a 2 year wait... I know it's not longer than most other areas, but I've been begging someone to listen, and now they have its unlikely we will have a diagnosis before he starts school, and I've no idea where that leaves us with getting an EHCP

ZombiePlanet · 17/09/2024 11:37

Possiblyfamous · 17/09/2024 11:27

It seems that many agree that the level of need and support is growing in the current cohort of children. I worry about what will happen to these children once they leave school, how will we, as a society, support these young adults ? It must be a huge concern for parents .

Needs are exacerbated by lack of early diagnosis and intervention, lack of appropriate specialist support post-diagnosis, lack of appropriate support in schools to help children achieve the best outcomes, and lack of appropriate specialist educational placements for those who require them.

Redirecting resources from endless Local Authority teams working on "strategies" or "advice to schools" or gaslighting parents through expensive tribunal processes to instead providing appropriate support and education would mean better outcomes and far more children being able to live independently and contribute to society as adults.

As with everything in the UK, short term thinking resulting in poor long-term outcomes.

nicknot · 17/09/2024 11:36

@ZombiePlanet

I'm sorry I really didn't mean that

CyanFawn · 17/09/2024 11:35

No that's ludicrous, why should one child who's been waiting be pushed to the bottom if the list over another (unless serious medical issues)

Sounds to me you just can't handle the behaviours and you need to learn how to manage ect. Diagnosis doesn't mean you get more help either btw, and school seems your biggest issue you need to apply for an ehcp parents can do it theirselves if school won't. My sons in alternative provision within school.

Before anyone jumps on me my sons nearly 14, currently on 18 month wait list for autism diagnosis, suspected pda, been passed around since 10 on whether its adhd autism or something else, sees a camhs consultant every 2 weeks, has depression, anxiety and medications plus melatonin. Hes been referred for speech and language with camhs and still waiting because although hes verbal he cant communicate feelings and emotions. Some days are horrendous for us and others not so bad, but I sit and wait because I have done for the past 5 years and I know diagnosis won't change anything.

Any child with any extra needs will experience difficulties and all we can do as parents is try to be there as much as we can.

sunseaandsoundingoff · 17/09/2024 11:35

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ZombiePlanet · 17/09/2024 11:34

nicknot · 17/09/2024 11:22

@ZombiePlanet

What? So when the NHS sends people to private providers through "right to choose" are their diagnoses invalid?

No not at all, obviously those clinical staff have already had their credentials checked.

I'm not against private assessment, I have done this myself several times, it hi k I have badly worded my comment as I didn't mean any of the stuff you said. However when people are paying for an assessment it is actual vital to query the credentials of the person conducting rhe assement.

Their "credentials" and the assessment methods used are always included in the reports. As they are for diagnoses via the NHS. There is no justification whatsoever to put any more weight on one than the other based on whether the NHS did it or not. We all know how variable NHS standards of medicine are! I have heard of great variability in diagnosis methods used by NHS staff. Surely if somebody wanted to check the "validity" of a diagnosis they would need to read the specific report to see the assessment methods used and the qualifications and experience of those who did the assessments.

My point is that these kinds of flippant comments discrediting or casting aspertions on a diagnosis based on whether it was done via the NHS are potentially very damaging. It has been known for Local Authorities to try to use the fact that diagnoses are done privately (often on the advice of the NHS neurodevelopmental paediatrician's initial assessment putting children on the autism pathway, and then advising parents to complete the diagnosis privately if possible to avoid the child having to wait several years to have it confirmed!) to deny children the support they require, so it is important not to perpetuate such attitudes.

My diagnosis was done a long time time ago by the NHS. My children saw an NHS neurodevelopmental paediatrician and then a private team to complete their diagnosis in a timely manner, advised by the NHS neurodevelopmental paediatrician per the above so that the chance for early intervention would not be wasted. I can tell you for a fact that their diagnoses were carried out by far more highly qualified and experienced professionals and far more thorough than my own NHS diagnosis.

Casting aspertions on private diagnoses in this manner also discourages those who can afford to do it from doing so, thus lengthening the NHS waiting list for everyone else.

Ellie56 · 17/09/2024 11:34

This.

@orangeleopard

As your child is only in school part time, the school is clearly not meeting his needs regardless of whether or not he is diagnosed with autism.

You should ask for an EHC Needs Assessment. Information here:
https://www.ipsea.org.uk/ehc-needs-assessments

Model letter here:

https://www.ipsea.org.uk/making-a-request-for-an-ehc-needs-assessment

Include everything you have said on here including not being able to attend school full time.

Template letter 1: making a request for an EHC needs assessment

CLICK TO DOWNLOAD: Asking for an Education, Health and Care needs assessment (template letter 1) You can use this letter to request an education, health and care (EHC) needs assessment. Our page about asking for an EHC needs assessment contains informa...

https://www.ipsea.org.uk/making-a-request-for-an-ehc-needs-assessment

CautiousLurker · 17/09/2024 11:29

No, I think each case needs to be made individually and if there are cases of extreme concern, you’d hope that it would be ranked as a priority. However, as far as I can tell, to even get a GP referral means that each child has already been considered to have an extreme/urgent care need from the get-go. How do you chose between a teen with gender dysphoria who is self-harming every limb/stomach and has taken overdoses etc vis a vis a 6year old autistic boy with SEN needs not being met by his school because they have no funding/too few staff/not enough expertise? Both are extreme and distressing.

The issue is that there is not enough money, not enough trained staff, not enough being being trained and too many severe referrals.

Possiblyfamous · 17/09/2024 11:27

It seems that many agree that the level of need and support is growing in the current cohort of children. I worry about what will happen to these children once they leave school, how will we, as a society, support these young adults ? It must be a huge concern for parents .

Ozanj · 17/09/2024 11:26

ZanyPombear · 17/09/2024 11:18

The children attending school normally are then having meltdowns, suicidal thoughts and self harming at home. they just mask at school. This is why you can’t say that another potentially autistic child has less needs than yours.
there is actually a lot you can do at home to help yourselves until you can get help professionally. Assuming you don’t work? There are a lot of books and online resources. A routine, knowing what’s happening next, giving 20, 15, 10, then 5 mins warning before activity is over so they are prepared. Using a harness and lead, using sensory toys, trying very hard not to overwhelm them day to day. Using a sound machine. Not forcing them to do things they aren’t emotionally capable of. Etc etc

Yet there are also kids who are non-verbal at 5, need toilet training assistance, school’s a dream, and modern research shows they benefit the most from early intervention which we’re so crap at in the UK because every part of the assessment process is on the NHS so it makes it prohibitively expensive to go private and it’s swamped by parents whose kids are not as severely impacted. That is the truth and it is why the parents of children with severe autism are calling for the thresholds for treatment on the NHS to be increased.

glittereyelash · 17/09/2024 11:26

The sad truth is if you have a child with a disability you need to go private for everything. I was asking for an assessment from 11 months old, they finally put us on the list when he was 20 months old. I went private when he was 2.5. I only got offered a public assessment in the past month. He's nearly 6.

MovingTooFast121 · 17/09/2024 11:25

Everyone struggles.

My DC is very bright, he can mask to a point. But he’s also incredibly unhappy much of the time. Much of his time at home is spent very distressed about how we don’t love him, how he hates us, how he wants a different life. We cannot ask or instruct him to do anything without meltdown. It’s soul destroying.

Yes, he sleeps, he can read and write, he eats (albeit the same meals every day) and doesn’t stop talking. But his emotional needs are truly exhausting and overwhelming.

nicknot · 17/09/2024 11:22

@ZombiePlanet

What? So when the NHS sends people to private providers through "right to choose" are their diagnoses invalid?

No not at all, obviously those clinical staff have already had their credentials checked.

I'm not against private assessment, I have done this myself several times, it hi k I have badly worded my comment as I didn't mean any of the stuff you said. However when people are paying for an assessment it is actual vital to query the credentials of the person conducting rhe assement.

ZombiePlanet · 17/09/2024 11:19

Equally I question the validity of any private assessment

What? So when the NHS sends people to private providers through "right to choose" are their diagnoses invalid?

If someone receives a private diagnosis from doctors who do work in the NHS and privately are the NHS diagnoses they issue invalid as well?

What is it you believe, that multi-disciplinary teams of consultant neurodevelopmental paediatricians, SALTs and OTs are all colluding and faking the ADOS assessments when they do them privately? Presumably you've reported your evidence for these allegations of malpractice to the GMC and other regulatory bodies?

Do you also question the diagnoses made by private doctors when people have private treatment for cancer or hip replacements or other medical conditions? Or do you reserve this totally unqualified overruling of medical professionals purely for the doctors diagnosing autistic people?

nicknot · 17/09/2024 11:19

@StaunchMomma

Of course all kids are individuals and ASD in all guises can present in so many ways BUT once diagnosed, surely the bigger picture is about getting each child what they need at any given time. Does a diagnosis change that in any way

No it doesn't but my comment was about not separating autism and Asperger's or diagnosing levels, nothing to do with what you have said here

ZanyPombear · 17/09/2024 11:18

The children attending school normally are then having meltdowns, suicidal thoughts and self harming at home. they just mask at school. This is why you can’t say that another potentially autistic child has less needs than yours.
there is actually a lot you can do at home to help yourselves until you can get help professionally. Assuming you don’t work? There are a lot of books and online resources. A routine, knowing what’s happening next, giving 20, 15, 10, then 5 mins warning before activity is over so they are prepared. Using a harness and lead, using sensory toys, trying very hard not to overwhelm them day to day. Using a sound machine. Not forcing them to do things they aren’t emotionally capable of. Etc etc

nicknot · 17/09/2024 11:17

@StaunchMomma

£800 is cheap, let's not pretend otherwise

Also I didn't say it's not valid, obviously I have no details of who did the assessment, merely that I would question it - which I'm sure you did. Be prepared over time for it to be questioned again and again; like I said would question the validity of any private assessment.

You don't need to be offended or defensive here, my NHS psychiatrist sat for most of my first appointment and researched the private clinicians who did my various assessments before he accepted them.

StaunchMomma · 17/09/2024 11:15

nicknot · 17/09/2024 11:12

It wouldn't help at all. DD would have been given an Asperger's diagnosis years ago, now she needs full time support. Cannot talk to anyone other than immediate family, has never been out alone despite being mid teen age - that's not an Asperger's presentation, however that's what she would have been 'given'

Of course all kids are individuals and ASD in all guises can present in so many ways BUT once diagnosed, surely the bigger picture is about getting each child what they need at any given time. Does a diagnosis change that in any way?

BackForABit · 17/09/2024 11:14

I wish there was a way for the education system to diagnose verbal autistic children in mainstream schools who are high masking / low support needs e.g. by groups of schools sharing a panel of a specialist teacher, an SLT and a Clinical Psychologist (similar to the set up if you get private assessment).

I don't know that being fast tracked along the same system is fair or a good idea (high masking children are often suffering a great deal) but I know exactly where you're coming from. Children with such wildly different needs all being assessed in the same (NHS) system is creating huge waiting lists and absolute resentment between the different groups of parents.

In practice, in our area at least, the more high care needs children were generally assessed pre-school age by a Paediatrician because it is typically more 'obvious' (e.g. no speech at all by 2.5 years etc). This is a good idea because Paeds can then spot potential genetic issues that often go along with this kind of presentation. Lower support needs children then got diagnosed by referral from school to CAMHS. This is all rapidly changing though as more and more parents are empowered to spot signs early regardless of presentation. A good thing in many ways but contributing to massive waiting lists and the situation you describe in your OP.

StaunchMomma · 17/09/2024 11:13

nicknot · 17/09/2024 11:09

I would be questioning the validity of a 'cheap' assessment. Equally I question the validity of any private assessment, however to get a reputable clinician it's usually at a higher cost

It wasn't 'cheap' and it is absolutely valid!

The clinic we chose AFTER LOTS OF RESEARCH actually takes on NHS patients for diagnosis in that area and meets the same standards, but well done on being part of another big problem in autism awareness currently - that of doubting diagnosis!

ZombiePlanet · 17/09/2024 11:12

No, I haven't made anything up thanks

Yes, you have. I have specifically pointed out in my comments numerous misrepresentations you've made/ claims that I've said something that I have not, just in your replies to me let alone anybody else.

It's one thing to discuss the practicalities of a system that recognised different levels of autism but it is another to suggest that different levels don't exist (which is your original position).

Again, you seem to be wilfully misunderstanding what I have said even though I - and others - have explained it very clearly (as does the medical research on this topic). There is no non-arbitrary way to categorise autism into "levels" because of the fact it is a spectrum with different impacts in different areas and different autistic people may be "severely" affected in certain areas and far less in others. Therefore, it would not be possible to design a system to categorise people into "levels". And - as also described by me and other posters and the research on this - profiles of support needs in different areas change depending on the environment the autistic person is currently having to deal with, whether they have had early intervention and therefore better coping mechanisms for certain aspects of the condition, whether they have reached complete burnout, whether they are subjected to constant ignorance and minimising of their disability and support needs by those around them and in society in general and therefore end up with their support needs exacerbated by the mental health problems caused by a lack of appropriate support.

It is not possible to categorise people into "levels" in any meaningful way for these reasons, and as such no such categorisation can "exist" without being arbitrary and pointless, and most likely extremely damaging as well as wasting yet more resources on regular reassessments of all autistic people in order to update their arbitrary categorisations that you wish to assign to them.

I have been absolutely consistent in what I have said.

As for resources, there is clear evidence that not providing early diagnosis and support is far more costly in the long run, both economically and in terms of the human cost to autistic people and their families. This is short-sighted and self-defeating and a classic example of why UK services, society and its economy is in such a mess. As someone who pays a high 5 figure sum of tax per year, I want it invested in long-term policies that are evidence-based, not in armies of staff who think their job is to try to sit around minimising disabilities and destroying children's life chances by finding excuses to break the law and force parents to fight them through tribunals to comply with it which children suffer and have their mental health and educations wrecked, but instead using the salaries paid to these people to fund frontline staff to actually provide support to children to help them thrive.

nicknot · 17/09/2024 11:12

StaunchMomma · 17/09/2024 11:10

There is a push by some scientists to reinstate Aspergers and other levels more formally for this exact reason.

I think this would really help.

It's part of the reason we went private. Our son could have absolutely waited years for a diagnosis. Our only pressure was him starting secondary and the need for him to go in with everyone knowing the situation. We

live in an incredibly ignorant World with regards to autism awareness and I do think the different diagnosis helps both kids, parents and schools to understand potential needs better.

I know it was changed in order to be more inclusive and to stop Aspergers being seen as the more 'acceptable' face of ASD, but if it is seen differently by professionals to the extent that the symptoms are separate, why not keep the diagnosis?

It wouldn't help at all. DD would have been given an Asperger's diagnosis years ago, now she needs full time support. Cannot talk to anyone other than immediate family, has never been out alone despite being mid teen age - that's not an Asperger's presentation, however that's what she would have been 'given'

StaunchMomma · 17/09/2024 11:10

There is a push by some scientists to reinstate Aspergers and other levels more formally for this exact reason.

I think this would really help.

It's part of the reason we went private. Our son could have absolutely waited years for a diagnosis. Our only pressure was him starting secondary and the need for him to go in with everyone knowing the situation. We

live in an incredibly ignorant World with regards to autism awareness and I do think the different diagnosis helps both kids, parents and schools to understand potential needs better.

I know it was changed in order to be more inclusive and to stop Aspergers being seen as the more 'acceptable' face of ASD, but if it is seen differently by professionals to the extent that the symptoms are separate, why not keep the diagnosis?