HV insisting on coming out

[IDontLikeMondays88]

I wonder if anyone could give me a bit of clarity on the best way forward here.

I recently instigated some contact with the health visitor - I wanted to chat about DS’s behaviour. I thought I was just calling for some general advice but this has now set a whole chain of events in motion.

His behaviour is very good at nursery, less good at home. He hadn’t been sleeping that well leading to tiredness and then tantrums but by really focusing on his sleep things have been a bit better. We also hadn’t been used to him having tantrums particularly (he is now 3.5) so it was also a case of working out how to deal with it. Naively I felt phoning HV for some advice would be helpful although from speaking to other mums his behaviour seems pretty normal for his age.

however after feeling things were a bit better the Heath visitor wanted to visit again. I said this wasn’t necessary but she is basically now insisting she comes out again as she said she observed him walking on tip toes during her visit (nothing was said about this at the time and I didn’t notice this - although I did think he was a bit anxious that she was there). this is definitely not something he generally does.

she wants us to do the 42 month ages and stages questionnaire with him. I have reviewed I think he will score ok in this - think he will do well at the communication and social/personal sections maybe less well and gross and fine motor skills (but still probably medium in these areas).

however the HV also phoned nursery who mentioned he was noise sensitive and also that his speech can be repetitive in that he will echo things he hears others saying. I was already aware of these issues. He is on a waiting list for a hearing test and the repetitive speech I was keeping an eye on. He can communicate well and I feel at home anyway the repeating is getting less and less. The top toes walking I genuinely don’t think is even a thing.

I am worried that regardless of the questionnaire score based on what has already been said we are going to get referred for either autism assessment or to speech and language and am now absolutely terrified that there is an issue here that I am not seeing. The questions at the end of the questionnaire are very widely worded.

anyway have any thoughts

Also nursery haven’t mentioned the noise sensitivity or repeating to me! So they clearly weren’t thinking this was that big a deal?

It sounds like this has all come together quickly, and you're rather in shock. That's completely understandable, but I'd try to take it as a positive that the HV is being proactive – waiting lists are very long, so if there is something there, you want him on the list as soon as possible, particularly as he's likely starting school next year. If there isn't something there, he won't get a diagnosis. From what you and nursery have said, I can see why she thinks it's worth another visit, but equally (just from this post), it seems on the border – I wouldn't like to guess whether she'll ultimately decide he ought to be referred or not.

I guess the other thing I would consider, regardless of the outcome with the HV, is asking nursery for a meeting to discuss their observations, what you've noticed at home, and how you can both best support your son. Our nursery offers meetings like this twice as year for every child, and are very happy to help support with anything that crops up in between times, so I don't think it's at all unreasonable for you to ask to discuss this.

Apologies if I have misread your post, but it sounds like possibly you are also worried that you haven't spotted something that you should. I suspect any good parent asks themselves that (having just been asking myself if I should have spotted my one-year-old's apparently-symptomless ear infection earlier, before it led to a perforated ear drum), but we need to try to give ourselves some grace. We try to be informed, observant, caring parents...but we're not (most of us) doctors or developmental specialists. All we can do is our best with the information we have at the time, and then try to learn more as the need presents itself.

Thanks for this. I feel extremely stressed about the whole thing and I think that is making it difficult for me to be logical about it.

i did already seek a feedback meeting with nursery (before all this came up). They didn’t mention noise sensitivity. They mentioned the repetition and I specifically asked should I be concerned about that and they didn’t really say yes or no. They certainly didn’t suggest I should do anything further about it. So I guess I also feel that these things weren’t things that nursery were actually too bothered about. however at home anyway I have been looking out for repetition and honestly in the last few days it has been very minimal indeed. Things like “I would like a drink” and he’s said “I would like a drink too” which isn’t even actual proper echoing. That said about 3-6 months ago it was much more noticeable.