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.

[Claw3]

The psychologist will not accept the referral if he/she doesnt feel there are grounds for it.

Sounds to me like the failing or his ability to pass the tests is not the problem, its the lack of cooperation, following his own agenda etc which are red flags.

[WriterofDreams]

I'm a former psychologist who used to do developmental tests so I'd like to give some perspective on this.

Having worked with a number of different children with a range of disabilities it would become fairly obvious to me pretty quickly if a child had genuine problems that needed intervention. Often however the parents would be unaware of the problems and would only become aware of them when I carried out the assessment and showed them the results in black and white. For example when talking to a child one time it became immediately clear to me that he had specific language impairment. I asked his parents about his language and they said it was excellent so I said nothing until I did the test. I carried out the TROG - the Test for Reception of Grammar, and straight away it became clear that the child didn't know the difference between singulars and plurals, and couldn't pick up subtle clues in sentences about the number or colour of objects. At 5 years of age he should have been well beyond that level. The thing was in familiar environments he was functioning really well as he'd learned enough to get by in those environments. But as soon as he was somewhere new his lack of ability to extend language to new situations became obvious. The parents were really surprised but luckily with SALT help he came on really well and in the long run had very few difficulties.

There might be nothing at all wrong with your son. But if there is, wouldn't you like to know for sure and get some help for him? The psychologist isn't going to label him "abnormal" and doesn't brand children for poor behaviour. That's not his/her job.

[cestlavielife]

take him to psychologist for assessment -ask if there is one who speaks English. it is ikely that someone well trained in that field will have knowledge of English.

ask if the answer in English is ok.

his "failures" are already in his records...if he does need extra help is better to find out now not at 7.

performing well for close relatives, in the home etc is quite typical of children who do have underlying issues. celarly your DS is doing quite well but he may ahve some underlying issue and could do with soem extra input now, so that by 7 he is not struggling at school. it isnt a failure to look into extra help.

and if he catches up and is fine then when he is 21 no one will need to know....

[knittedbreast]

i would be worried that they may udge his behaviour on the cultural norms of that country- they might not understand or accpet the behaviour of your child and so diagnose issues that are not there. For that reason i would agree to tests but in the uk and say we will sned a report home.

[exoticfruits]

I think that you will have to go along with the assessment, but I do think that people on here are reading a lot into a very young child who was being tested in his second language by a nurse who had no patience and wasn't prepared to take time getting to know him and gain his trust first. Hopefully the psychologist will be better and doing more than ticking boxes.

I wasn't saying that those who pass developmental checks 'go meekly along with it' but there are many DCs who could pass them with ease who simply don't want to do it-particularly true of boys I would say. Mine had a particularly annoying habit of saying afterwards 'mummy why did that man .......?'-

[ButterflySally]

I think you should get him assessed by the psychologist.

I am in a profession where I regularly assess young children. We take information from a range of sources - observation of the child in their natural environment, discussion with parents / nursery staff who know the child, plus some formal assessment. This helps gain an overall 'picture' of the child. When assessing a child formally, the assessor is also looking for other behaviours which a non-trained person may not notice, e.g. the child's approach to the task, the strategies the child uses, the child's attention and listening, adult support needed to complete the task (e.g. does the child need the adult to provide extra cues and prompts to help them complete the task, or can they do it on their own). Extra information, such as the child speaking an additional language is absolutely taken into account.

When you have assessed many, many children and are familiar with child development plus different difficulties and disorders that can affect children, it can become quite apprarent quite easily whether or not the child has difficulties which require intervention. We know what we are looking for and wouldn't label a child as having difficulties if they weren't.

Conversely, we would want to identify a child having difficulties so intervention can be put into place. The earlier difficulties can be identified, the better the outcome for the child.

I obviously can't speak for the psychologist in the country you live in, but I would imagine if the process is similar there, the outcome (either way it goes) would be in your child's best interests.

[Blumke]

Hi there again. Thank you for the posts overnight. Real food for thought.

We took DS to a paediatrician today for a second opinion. She was also of then opinion that his social and emotional development was not suitable for his age. So we have asked for a referral to an English speaking psychologist. I dropped into the health centre and told the nurse and apologised for not taking her advice. She was very nice and she said she understood that the psychologist element can sound very scary for people not used to their system and that it is a standard intervention here often used simply to help develop strategies to deal with certain temperaments. I explained my worries that my son would be labelled and stigmatised and she was very reassuring. We both ended up in tears!

It is good to see professionals as they can have a totally different perspective. The only problem that remains is dealing with dealing with professionals iyswim.
I am coming round but I could not tell anyone from my hometown. I know things like AS, social anxiety etc, are freely discussed on mumsnet but where I grew up these kids are headbangers and thickos and their mothers are simply neurotic. If other people have experience of this type of situation what did you do?

[Claw3]

You develop a very thick skin!

A second opinion, was a very sensible idea, glad to hear you are getting this sorted.

[mummytime]

I would suggest you go to the special needs boards, to get a lot of help and support, whatever your sons needs may be.
I think you might find attitudes in the UK have changed a lot. Although I have still heard the old quotes "An Autistic child is a naughty middle class child" and "A dyslexic child is a thick middle class child". However I like to believe those kinds of attitudes are dying out.
Most people do back down when challenged; and to be honest from my childhood it would have helped to have more people's special needs acknowledged. I think "mainstreaming" has helped a lot, as parents don't need to fear their children will be ghettoised if their needs are acknowledged; although conversely sometimes it is hard to get the special provision an individual needs.

[Claw3]

Would also add its not the label that will stigmatise, it will be your ds's lack of social and emotional development that others will notice. Early intervention and receiving the right support to develop these areas is the important thing.

[Blumke]

Sorry just to add in regards to langauge. He does speak the local language. . He speaks nothing but with my husband, paternal grandparents in nursery and when out and about. But his English is still significantly stronger as he spends most of his time with me and his sibling.

[NunTheWiser]

I know it can be very confronting when a healthcare professional or teacher raises a concern about your child. The most important thing to remember is that these people are acting in the best interests of the child, however the parent may feel about things. It could be something, it could be nothing, but there is nothing to lose from professional advice and everything to be gained. If your son does have some issues, early intervention is crucial.
All 3 of my DC have ADHD. They sailed through all the early health checks because they were mostly concerned with physical milestones, rather than the social. All three began to stand out at around 3-4 as being slightly different to their peer group. Be prepared for the fact that given your DS's young age, a psychologist may be able to tell you that something is going on, however not be able to give you a definite explaination or diagnosis. It might be worth having a chat with family on both sides before you see the psychologist to see if there are any traits or issues that may be a factor. Many issues such as ADHD, ASD and dyslexia have a strong genetic or familial component so if there is a sibling, parent, grandparent , aunt / uncle or cousin with things like this, it's very useful information for the psychologist to know.
Good luck to you. The SN board here is great. No matter what test or condition is out there, someone on the board will be able to give you information, advice or sympathy.

[Ben10isthespawnofthedevil]

I'm really pleased that you have decided to get him assessed. Our understanding of DS is completely different now we have started to look as behaviours as symptoms of "something" rather than just behaviour problems.

[CinnabarRed]

NunTheWiser - may I ask in what ways your DCs started to stand out when they were 3-4? DS1 is very "hyper" on occasion, and I have wondered in the past about ADHD, but his key worker thinks he's just normal 3 year old boy.

[pigletmania]

That is good op. In the long run you did the right thing. I know how it's like to be a parent in denial, especially when the differences aren't glaringly obvious. To me it became more apparent when dd got older.

[tabulahrasa]

"I know things like AS, social anxiety etc, are freely discussed on mumsnet but where I grew up these kids are headbangers and thickos and their mothers are simply neurotic. If other people have experience of this type of situation what did you do?"

Loads of explaining, lol, like I said I didn't have any experience of AS - I had experience of low functioning autism and so completely discounted it for DS.

So you find out all you can, you explain to everyone and you accept that some people will still think either your child is somehow abnormal and stupid or that you're a bit of a nutter, there's not much else you can do.

For what it's worth my DS is very bright, his teachers are expecting him to get good exam grades and go on to Uni to do a science subject - he'll cope with the work, whether he'll cope with uni itself is a different matter, but I've got 3 years yet to prepare him, lol.

[HarperSeven]

Perhaps he doesn't like the nurse! Talk about creating problems where there aren't any. Go with your instincts and tell the nurse to mind her own business.

[Poweredbypepsi]

tbh I would take him to be assessed. My son did badly at his 2 year check and was sent for more tests etc here. It was no problems at all the further tests showed no problem and all my son saw was going somewhere else to play for a while it wasnt traumatic at all.

[JenaiMarrHePlaysGuitar]

That sounds more positive, OP.

fwiw my ds is dyspraxic and has related emotional/social issues. I had no idea until his teacher brought it to our attention. Things are getting waaaaaaayyyyy better for him now thankfully, but I rather wish it had been picked up when he was 3 or 4 rather than 7.

[meriden]

He sounds normal to me. Mine wouldn't come out from behind the sofa when his new teacher visited us at home at age 4.

[Pagwatch]

The op has been back and explained that she has decided to go ahead with the assessment as she thinks there may be issue to investigate a bit further.

So could people read the thread before they post deeply stupid ' of course he is normal' shit

[exoticfruits]

I think that is perfectly normal meriden-you wouldn't wish him to be referred, you would just expect the teacher to be able to set him at ease and coax him out-in the same way I would have expected the nurse to spend time winning his trust before she started testing. However it is never worth fighting.

[robingood19]

I see what you mean.

[pingu2209]

Blumke - I heard this in a film:

If you have always dreamed of going to Italy and excitedly board the plane headed for Rome, you can't help but be sad and dissapointed when you find out you caught the wrong plane and you have landed in Holland. Holland has lots of lovely things to see and you enjoy your time there, but you can't help but think about Italy and what it would have been like.

Being a mum of a SEN child is like that. You have your hopes dreams and aspirations for your growing bump. You nurture your baby and dream about their future for them. When you find out they have SEN it is like finding out you caught the wrong plane. You still love them and have lots of joy from them, but you still wonder what life would have been like if they didn't have SEN. You can feel cheated and become angry at times.


For people who have been brought up in high achieving or aspiring families, SEN children are often perceived as "headbangers and thickos." It is very hard to come to terms with the fact that your beloved child may be one of those "headbangers and thickos" that you looked down upon only a few years previously. Families with money, good careers etc, just don't get children with SEN. SEN children are only for poor families or families who are all generally thick and uneducated.

Life throws us curve balls. It makes us reassess our previous assumptions. If your lovely little boy has 'issues' you will be facing a learning curve that will make you realise that you were wrong in the past. It will teach you tollerance and patience. It will give you a greater understanding of those who are not so blessed/lucky as others.

When you experience this type of perception in real life, you will feel anger and the desire to protect your child. But you will also feel pitty as you realise that the person who thinks it is narrow minded and just plain wrong.

I can not tell you it will be easy. I have dropped 'friends' like a stone when I encountered such attitudes about my son. Other people have surprised me with their open and loving attitudes to all of society, gifted and tallented as well as SEN.

Good luck with it all.

[mollschambers]

OP - Sounds like you're handling it really well. Best of luck.