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.

[pigletmania]

and that can make him frustrated or non compliant. Yes the behaviour imo does sound like a 4 year old. I think the expectations of children now are too high, they are still very young. In my mums country, Armenia they don't start school until 7, so the child is emotionally and developmentally ready, here they start them at 4.5-5 years, which is quite young.

[razzlebathbone]

OP do you speak the native language at home to him? Why is his English better than the language of where he lives?

[pigletmania]

Its only since dd has turned 4 she is getting more compliant, and her understanding is better. Her speech and lang is also getting better so less tantrums. But she is prone to tantrums if tired, or unwell which is the same for an NT 4 year old too.

[pigletmania]

not tantrums, I mean becoming whingy and whiney and grouchy

[pigletmania]

razzel unless he was born in the UK and raised part of his life there, and has moved to the Country in the last year or so. Also op son does not go to school yet and may not mix with other local kids of his age, so his grasp of the language may be limited

[Fecklessdizzy]

I would let him see the psychologist ... Where's the harm?

We had the same thing with DS1 at the same age, the school didn't know what to make of him and so we went all round the houses with various professionals who didn't really know what to make of him either. He rather enjoyed all the attention and if there had been a problem we would have been able to get to grips with it early ...

We had the same problem with the pictures too! When asked what letter a picture of a dinosaur began with he said T rather than D and when the nurse said he'd got it wrong he pointed out it was a Tyranosaurus ...

[pigletmania]

DD does better in these tests when we are not there, the Ed Psych did some verbal treasoning tests on her which went really well, but when we went to Paed when dd was 3.5 she refused to do some of his tests and was grumpy and grouchy. I think it was because it was an early appointment, and she had been up since 5 am

[Blumke]

Sorry I must go to bed. It is the middle of the night here. But please post . It has been so good to get this off my chest and it has made me think.

[Vicky2011]

OP I'm assuming you explained to the nurse that she was speaking to your DS in his second language? Of course that could be a red herring but hard to imagine it's not at least part of the reason he reacted as he did.

FWIW I wld be worried if my DS had reacted like that at 4, but he was with childminders from 4 months and only has one language so not really a fair comparison.

[vess]

To MUmblingRagDoll - of course they can't all manage it, but there are certain expectations, and things they are supposed to do and learn. They keep an eye on those who can't manage it to see if they improve with time, and if not, they might need extra help. It's not actually that different from what the OP has been offered, it's just in a different setting.

[CinnabarRed]

If it were me, I'd take up the referral irrespective of what his nursery worker thinks. The two "fails" are already in his records so no harm done by seeing what the psychologist has to say. Any psychologist worth his/her salt will be able to distinguish issues with understanding the local language from underlying issues.

[shemademedoit]

Op: my guess is: it sounds like you are in France. My 4 went through tests just like those, although by 4, they were at nursery, and all the tests were done there (so much like being at school, and they all did as they were told: probably because I wasn't there!)

Re language: is your son getting enough exposure to the language with so little time at nursery? Could he just be unsure of the language? Or unused to school-like tasks?

Re: psychologist: in France it is totally normal to be referred to someone like that. Even our smallish town has an educational centre: full of psychologists! they are to help you, not judge you. We were referred there by DS3's school. I knew he wasn't thick (like the school said: he couldn't/wouldn't do the work for them) After talking to him over a long period, we were advised to leave that school and have him jump a year: he's never been happier (he was also found to be slightly deaf and needed to be moved to the front of the classroom) My advice would be to try it: what harm can it do if you go in there with the right attitude? He may find the tasks with the psychologist fun, and you'll get that nurse off your back. And if there is a problem (they take many many sessions before saying anything: it's not a half-hour judgement against you or him!) then surely it's better to know?

[JeelyPiece]

I think it's a shame your DS can't speak fluently the language of the country he was born in. If this is the reason for him failing the tests, though, a psychologist should be able to establish that.

[marriedinwhite]

OP - in the different culture where you are living, do 20% of children fail to adequately progress in literacy and numeracy whilst in education for several years? Are there significant problems due to anti-social behaviour and embedded bullying in education. Are a significant proportion of young people consigned to failure and lack of achievement? If you answer no to all of those questions then perhaps where you are now, things are a lot better than they are here in the UK because problems are identified and dealt with in a proper way with early professional help and support.

If you answer yes then the approach of the nurse is probably over the top but I think your post may be illustrative of much deeper issues than whether the suggested approach is right or not for your son>

[exoticfruits]

I think that he sounds a perfectly normal, very young DC, who hasn't taken to the nurse doing the tests. From his point of view I can't see why he would want to please an impatient, unsympathetic woman that he has obviously taken a dislike to.
However it might simply be easier to go down the route of the psychologist and hopefully get one with a good rapport with DCs and with common sense who will realise it was a personality clash.
I once had to take my DS to one, not something I was keen on as I thought all sorts of problems might be put onto what was simply the frustration of a perfectionist personality. As it turned out he was a lovely man with common sense who just gave DS some strategies for coping.
If you hold out and refuse it will probably be on his records-much better to take advice. You should be able to put your points in the meeting-if not, insist on giving your views.

[cookcleanerchaufferetc]

I don't understand why you are concerned at your son seeing a psychologist and having it on his file, when his file already shows he has failed two of these tests. It would appear more damaging to have on his file the mother refusing further investigation I would have thought. Why not let him have the referral and take it from there. Hopefully the result is he is a normal kid with language issues, the worst case scenario being there is an issue which you would then be able to investigate yourself.

[PfftTheMagicDragonhideGloves]

I think that you are totally overreacting.

This woman is doing her job. Your son, as she sees, has not completed all the tasks, and has exhibited behaviour that she would normally refer to a psychologist for.

Can you imagine how you would feel, if two years down the line, you realised that your son needed to see a psychologist and this woman had done nothing? You would be outraged!

She is not suggesting anything radical. A psychologist will chat to him, in a friendly setting. She will be gentle, and kind. She will watch him, and assess him. And you will know, one way or another, whether your son needs additional help or not.

I think that saying that your son can do these tasks at home really doesn't mean as much as you think it does. He is in a familiar location, he feels comfortable, he has a routine.

I would certainly not be taking the opinion of a nursery worker, who sees him for one session a week, as truth. I think that you are being understandably defensive. But the right thing to do for your son is to see the psychologist.

[mollschambers]

Hmm.

I think you should allow him to be assessed. If no action is required surely that too will be noted in his records?

For all those saying that he's fine that's a pretty big assumption. We can't possibly know that.

[exoticfruits]

I do think it sad when small DCs have to jump through hoops and can fail when practically babies! However it seems to be a question of 'when in Rome........'-go with the system. (I think it is quite nice to have a DC who doesn't meekly go along with it).

[shemademedoit]

Er.... I'm not sure the kids who pass their developmental checks are 'meekly' going along with anything,

[Pagwatch]

The op is confused and anxious and understandably so.

I was in a slightly different situation as when ds 2 needed investigating no one would agree with me. But I kniw how having another person seeing things in your child which you don't see can shake your confidence and make you very stressed. Plus it kind of require you to then look at your child differently which feels a bit like you are betraying him.

The op has talked about stigma and this thread illustrates her point. Instead of discussing rationally whether it is worth seeing the psychologist given that the testing situation seems to have hindered her son from showing himself in his more usual light, the thread is populated by those who seem to think psychologists are lining up to tell hapless parents that their child are not 'normal' -as if a diagnosis of something like dyspraxia or aspergers will suddenly mean a child becomes a different being standing outside the rest of humanity.

It also spectacularly misses the point that for some conditions the earlier the intervention the better the outcome.

If there were no harm in just waiting until 6 or 9 or 11 until the social or verbal or behavioural difficulties were far more obvious because social interaction naturally gets more complicated, then everyone would wait. But there is a cost to waiting.

In this case I would wait 6 months if it helped op be clearer in her own mind and maybe get her son out and about a bit more. But I cannot imagine how difficult 6 months of peering at your child and wondering would be.

[tabulahrasa]

I've never understood why anyone objects to assessments, unless they suspect there is an issue and don't want to acknowledge it.

If you genuinely believe that your child doesn't have an issue, you say, go for it, you're wasting your time though, surely?

[CinnabarRed]

Excellent post Pag. My DS1 had mobility issues caused by being double-jointed, and early intervention means that he is now, at 3.8 years, aligned with his peers. I do appreciate that behavioural/psychological referrals are not the same as physical ones, but DS1's motor delays were so profound that they caused him to miss many non-physical milestones. I am now very much an advocate of accepting any referral that people more medically knowledgeable than me recommend. After all, in this age of austerity no-one is going to waste resources on unnecessary interventions.

[lubberlich]

Children develop at different rates. I hate this cookie cutter approach where boxes start being ticked just because a child falls outside of their randomly constructed perameters.
If there is something of concern in my son's development or behaviour I will be the one to approach the specialists because myself and my family know my son better than some psych nurse who has encountered him for a few minutes.

[tabulahrasa]

hmm, maybe lubberlich, but in my experience parents often aren't the one to notice developmental issues, especially the subtler ones.

For what it's worth, DS passed all his developmental checks with flying colours, he has a speech disorder which has left him with what SALT describe as significant difficulties, co-ordination difficulties caused by joint hypermobility and muscle hypotonia and Asperger's syndrome. Other than his speech I was blissfully unaware until about a year after he started school.

When he was referred by the school for autistic assessment, my exact words were, well send him if you want, but he's not autistic....lol. I also know from other parents with children with a similar diagnosis, that they did not notice it either, not at that age.

I now think - how in the hell did I not notice it, it was blooming glaringly obvious, rofl, but of course I knew very little about it at the time.

There's never any harm in getting an assessment, they're not invasive, in fact most children enjoy them (playing with a friendly adult who wants to talk about you, that's most young children's dream day out) if there's no issue you have it confirmed and if there is an issue you can access the appropriate support.

It's hard enough to get support when everyone involved agrees that there is an issue that needs addressed, no psychologist wastes resources on a child if there's no issue. So if there's nothing there, where's the harm in having the assessment?