to refuse to send 4 year old DS to a psychologist?

[Blumke]

Have never posted on AIBU before but this subject is eating up at me and I can't get enough distance to see if IABU or not. I have altered some details so as not to out myself in RL but essentially what follows is the jist.Sorry this is so long. Please tell me what you think.

I am a Brit living abroad having married a local. I have a 4 year old son who is bilingual in English and the local language although his English is definitely stronger as he is home with me. We have a designated healthcare nurse for him who carries out all his vaccinations and yearly checks. The system here includes developmental checks from 1 year onwards. The child has to perform certain tasks and the nurse satisfies herself that all is well.

All was fine at 1, 1.5, 2 years. At our three year check the nurse was changed. Our present nurse doesn't speak English and the test is conducted in the local language. The three year test consisted of around 30 tasks. First some physical skills - throwing a ball, stacking blocks, pressing pop-ups. With some cajoling from me DS did these. Then the nurse brought out a book with line drawings and asked him to draw first a vertical, then horizontal, then zig zag lines. DS totally refused to cooperate with her . She then skipped to the picture identification tasks but he grabbed the book and tried to see a particular picture and became angry when she went through the verbal tasks - " What's this?" " Which picture is bigger?" " Which one doesn't belong"?. I can honestly say that he can do all these tasks if he wants to but unfortunately he stubbornly refuses to demonstrate this with the nurse.He failed this test and we were allowed to resit 2 months later.

At the resit the same scenario repeated itself. DS lost interest and refused utterly to cooperate with the nurse. She said that he had less than 5 out of 30 and if a child failed their check they should be referred to a psychologist. I felt this was unfair but weakly felt cowed and agreed. But I felt so bad and felt it was so unjust to my son that I phoned the nurse the next day and retracted the referral although she really pushed saying that she had wide experience etc and that this kind of failure needed investigation.

A year later we are back for our 4 year check. This time both my husband and I attend with our son. From the outset DS completely refused to cooperate with the nurse. He didn't want to leave the toys in the waiting room and had to be allowed to take a toy with him to the nurses room. Same scenario as before. DS completes the first task threading beads onto a small wire. He started to enjoy this. However then the nurse brought out the line drawing book and asked him to draw a circle, a vertical cross and a diagonal cross. He squiggled a bit and then asked for the beads back. We try to get him to draw but he says he doesn't want to. She moved onto the picture and verbal tasks but then he would not cooperate at all. Unfortunately he had a tantrum, he his worst behaviour for several months and right in front of this nurse.

She then said he had failed and recommended a psychologist referral. She said she was particularly worried by his behaviour in the waiting room as it was typical of a 2 year old to refuse to leave the toys but not a 4 year old. She said most 4 year olds don't even need their parents with them and complete the tasks on their own with her. She really pushed. I saw my husband was wavering and spoke to him briefly in English stating that we were happy with our son, DS's nursery group are happy with him. We then produced his nursery report ( he has 1 morning a week - it will be three in the autumn) and this seemed to quiten the nurse and she asked for the contact details of DS's nursery worker. We left the appointment agreeing to leave it at that and she will investigate further by speaking to the nursery worker.

I feel so angry and alone. The culture here is very placid, quiet , compliant and I know my son is a bit different (as am I) in that he, like me is very lively, loud, stubborn and determined. He can be hard work but he is a delight and we are so happy with him. Am I deluded? We had no real concerns and have had no complaints from his nursery and have not worried at all until these checks. Please help. I know that a child's own mother is probably the least impartial judge in the world.

[exoticfruits]

I would try and request a different person to do the tests.

[pigletmania]

My dd aged 4 has (possible ASD) awaiting a dx, her current problems are social communication difficulties and speech and language delay which was picked up by her pre school. Here we tend to send kids to pre school at around 2 and at 3 are entitled to certain amount of free hours per week. We were also concerned about dd lack of social interaction and social communication, as were her pre school and that she was emotionally delayed so we went to the SALT drop in, who then referred us to the Paed. We are awaiting a dx, but its in collaberation not just with the Paed, but all the other professionals involved with dd.

You know your child the best, there is noway that someone can get a full picuture of a child from 1 hour in an consulting room. Not all kids are the same, some are more advanced developmentally and emotionally than others, does not mean there is a problem. I Know some NT kids who are 4 who would also refuse to do the tasks and throw occasional tantrums. We knew there were problems with dd that is why we also sought help ourselves and agreed with pre school to follow things up. Its up to you, you are the parents.

[TiffanyToothache]

Yes, the different person to do the test / second opinion is the Psychologist!

[youarekidding]

" He only really listens to me, my husband, grandparents and has come to like and usually obey his nursery worker. I don't know what this indicates......"

Well why are you dead set against finding out 'what it indicates' when in fact it could be nothing.

[blackeyedsusan]

in my experience dd has a strop when she can't do something and doesn't want to say she can't or even have a go. though she has been very good at doing tasks for ot. (did have a bit of a strop in pt though now i come to think of it. )

I do think it is worth taking up the referral, to put everyones mind at rest. there is no harm in it. (unless it is not hideously expensive)

[pigletmania]

I also think that different countries have different expecations on what children should be able to do at various ages. My dn is 4 and BIL and sIL moved to Italy, he attends a pre school there, and at that age they are expected to write their letters and numbers neatly. Some children in the UK incl dd cannot even hold a pencil, and it is considered to be fine here, but would not be in that country.

[bubblesincoffee]

My ds sailed through the developmental checks, and was actually quite advanced for his age. It didn't stop him ending up with an Aspergers diagnosis though. These tests can only ever tell a certain amount, a referral does not mean that there is something wrong with your child.

The point is, they are doing their job, which is to help your child. There is a chance, however small, that he may need intervention.

Why are you so determined not to take him to the next appointment OP? I really am struggling to understand your reasoning.

Wouldn't you rather take him and be told he is fine than ignore proffessional advice only to run the risk of being told he is struggling with something, years down the line when it's too late to give him the best help possible?

[kingbeat23]

Psychologist is different to psychiatrist.

dictionary.reference.com/browse/psychologist

dictionary.reference.com/browse/psychiatrist

Go, if everything is fine, you have evidence to show this nurse that you are right. If there is an underlying problem that you are not aware of, then you will have help to manage it.

[pingu2209]

My brother's friend has a son who is 16. He has severe dyslexia. At 5ish the school (very expensive private school) believed there were issues and wanted to get the boy tested. The parents, both high achievers, could not believe they had a child who was not 'normal' and/or would struggle at school. This was not something they had envisaged when they planned and dreamed of their family life. It was not something he wanted and could not believe. This happened to other people, not him, a high achiever.

To this day, my brother's friend regrets not getting his son tested for dyslexia because without the test and full confirmation of what was wrong, the school could not put into place all the systems to help the boy. His father knows that this set back his son by years, and he openly admits that the reason he did not want tests was because he could not believe anything was wrong with his son.

I too come from a very high achieving family both academically and in our careers. I personally found it very hard accepting that I had a child who would not be like me, successful. I felt very guilty about these feelings for a long time, but have since found out that many many parents feel exactly the same.

Like my brother's friend, it was my own views that stopped my son from an earlier diagnosis.

Please think long and hard about why you don't want your son seen by a psychologist? Clearly there process will not harm him as they are so used to dealing with children. If you are saying no to the test, think about why you are saying no.

[IgnoringTheChildren]

youarekidding: "We do have these 'tests' here in the UK for all people who are saying its wrong/ over zealous etc. Its just in the curriculum here as our children start school before 7."

But the difference is that in the UK these skills are assessed in the a setting that the child is comfortable with, by a person that the child knows, in a relaxed manner and not all at once! Hence the "developmental checks" provide a more accurate picture of the child's abilities and progress.

I'm not convinced that seeing a psychologist for further testing would be completely harmless for your DS (although it wouldn't necessarily be harmful either!) The people who say they've taken their children to psychologists have done so in the UK - I'm sure that psychologists in the country you're in are "well trained" but the cultural differences and expectations could still make the assessment uncomfortable for your DS. It's not something I would chose to do on the basis of 3 meetings in which your DS was asked to do boring activities by a nurse he's not very keen on, particularly when no-one else is voicing any concerns.

[IgnoringTheChildren]

x-posted with loads of people as I'm a slow typist!

[justcallmemummypig]

I can't see why your so anti him being evaluated, if nothing comes of it then thats great, but if something does come up, then surely the earlier you are aware ofit the better, especially before he starts school.

I must be honest I don't think his reaction is normal at 4, I would be horrified if my dc had behaved like that at 4, but you don't seem to be.

[Blumke]

I will go to a psychologist if the nursery worker recommends. She is a wonderful woman with 10 years experience and 5 children of her own, 20, 18, 17, 16 and 5(!) and has seen everything I am sure. She sees my son regularly on his own and she describes him as bold, fully involved and a bright boy. I brought his nursery folder which contains his drawings and craft and reports from his nursery worker and this was the one thing that pacified the nurse and so she agreed to talk to the NW.

The issue with the psychologist is that systems here are unified. It will be in his medical records, school records etc. Unfortunately there is still stigma attached

[kingbeat23]

Then the issues you have with the psychologist and it being in his medical/school history will be the same as you taking him to the assessments and him failing the tests on different occasions, them suggesting a psychologist and you refusing to take them up on the offer.

I understand a worry that is lingering in the back of your mind that is that his is fine and it is just a bad situation to be in, but surely, if there is nothing to worry about, then you will be in a better position than you are in now, in terms of almost clearing your name, as it were, and proving that it is just the assesment and nurse combo that is causing the problem and not the test in itself.

[youarekidding]

Yes but it being in his school records will not affect him. It will be there in case anything else is flagged up as a record of anything that has happened.

As I said ^^ My DS managed to do spectacually badly on some areas of DEST, mainly fine motor and spacial memory tasks. Its logged. Now he is entering juniors and still struggling with these (but coping atm iyswim?) if they have concerns and look at his records they can see he has always had difficulty, skip the bit in the middle, and give him the correct support.

Where the fuck are you OP? Do children really fail exams, fail to get into uni because at 4yo they had a temper tantrum when asked to do something and got referred to an expert for their own benefit?

[MumblingRagDoll]

Can't you just not take him for assesment until he's 5 or 6? that's still a year until school begins...I know I wouldn't take mine!

[MsTeak]

So a trained professional who specialises in this area thinks your child may possibly need some assistance, and you'd rather take the advice of internet randoms who have never met your child yet feel qualified to rant and rave about how ridiculous and obviously wrong this is?

Um, well,.....


Also developmental checks are very common in many countries, surely the UK has them too?

[razzlebathbone]

I'm not so sure about this 'you know your own child' stuff. I mean of course you/we do but we also love them the most too, so we tend to see them as perfect.

I know someone whose son (aged 3) is obviously very very different to the average (sorry, for want of better term here). He does not make eye contact, the only talking he does is repetition of phrases and so refers to himself in third person, will draw circles over and over again for hours, plays only on his own, repeats lists of car models but does not respond to people or his own name and other things but his mum and family don't see anything unusual at all. Maybe they're right but if he were mine then I'd be wanting an expert opinion.

I was worried about my son's speech and purposefully asked lots of friends and family what they thought because I didn't want to rely solely on my own judgement. As it happens they all thought I was needlessly worrying but Inasked HV for referral to SALT anyway because I feel it's my job to ensure I do my best for him and it wouldn't do any harm. The SALT is really lovely and says she's really pleased to see I have done so even though he's not yet two because most parents don't bother until someone else picks up on it much later on.

I'd go with the referral. But if he/she does raise concerns then perhaps get a second opinion too.

[vess]

What harm can it do?
Usually it's fun for the child, and you'll learn a lot of fascinating stuff about him. We had to pay quite a lot to have DS assesed for dyslexia when he was 6 - he enjoyed it, and the results were really helpfull. If someone was to offer an assesment for free, I'd jump at the chance, even if I thought there was nothing wrong.

Kids in the UK go to school at 4, and are definitely expected to do as asked (kindly) by people they don't know very well.

[MumblingRagDoll]

But that doesn't mean they ALL manage it vess My DD certainly didn't and there's nothng "wrong" with her!

4 is very young and the UK is one of the only countries that puts kids into formal education so young.

[Blumke]

Yes it is true. His two failures at 3 and 4 will now be in his medical records.

I think my head is clearing slightly. I think I should have a long talk with his nursery worker when he goes back after the holiday and ask her for an honest assessment. If she feels that something is not right. We will take up the referral. I just feel that my son is growing more social, compliant and interactive all the time. His local language is coming on in leaps and bounds although it has some way to go before it is on the same level as his English.

I suppose that worries me, we would almost certainly get a psychologist in the local language and thus they would get a weaker, less expressive and more frustrated version of my son. I know some of the pictures in the book he would have named in English no problem, but not have known the local word.

[snailoon]

Move back here.
YANBU

[pigletmania]

The trouble is the language difference, to. The op son might not be able to understand what is being asked, especially if the nurses English is not very good.