Son’s mother telling him he is ill when he’s not

[Dylan222]

My 12 year old sons mother has told him that he has ADHD and is that he is Autistic, her parents have also told him.

However he does not have ADHD and is not Autistic. It looks to be a type of child abuse called Fabricated Illness by Proxy. I have been working with his GP to get Social Services involved, his mother has been falsely stating to people for the last few years that my son has these conditions, however this week was the first time she has told him.

Any advice please on how I should approach it with my son? I have explained the situation as clearly as I can to him and confirmed that he does not have ADHD or Autism, but I don’t know whether to talk about it with him more or just let him come to me if he is worried about it.

Thank you

You don’t have much experience of either children’s services or autism, do you, spelunky ?

OP, I have been an NHS autism assessor for 20 years.

The assessment your son had would not meet NICE guidelines.
Such guidelines include developmental history - ideally from both parents especially in a case such as your where parents are very conflicted. An observation in a setting (usually school) and in the clinic. A formal assessment such as ADOS. A multidisciplinary approach is preferred. Where a child has been raised in a situation of domestic abuse or where there are high levels of confrontation in the parental relationship, this should be considered as a possible alternate explanation for difficulties a child may show.

Unlike the view of many posters, scoring on the ados above autism cutoff is not "a diagnosis" in itself. Children can score above cut off for other reasons - being very non compliant, selective mutism or other high level social anxiety, language difficulties, lack of social experience to a neglect level, etc. The ados score MUST always only be considered as part of the overall picture and should be triangulated with evidence from other settings. We always gather information from school. We are familiar with masking and our highly trained specialists can usually spot social communication issues even in maskers.

A score of 17 in the absence of posturing, echoed speech etc confuses me. But for the avoidance of doubt:

A parent cannot directly manipulate a child's performance on ADOS to impact the likelihood of getting a score in autism range, as they are usually not present.

A parent can theoretically read up on autism markers in toddler hood and mislead in the developmental history.

A high score on ADOS is not in and of itself a diagnosis of autism. High scores can be attained for other reasons. Hence why ADOS should never be the sole determiner of a diagnosis but part of a bigger workup. Triangulation is vital especially in "messy" situations like this.

My sons autism diagnosis didn’t meet nice guidelines either than and that was on the nhs.

Observation in school isn’t essential to meet the NICE guidelines.

Developmental history, social factors, potential differential diagnosis and co-morbidities could well have been considered during appointments with the DM. In fact at some point co-morbidities were considered as ADHD was also diagnosed. ADOS was part of the assessment, note part of, not the only part. There was at least 1 other HCP involved in the process as well as the doctor.

The validity of the diagnosis clearly isn’t in question by the NHS if they have accepted to diagnosis and refused to reassess.

My DD recently had an autism diagnosis, through the NHS, that according to you didn’t meet NICE guidelines (actually it did).

You also have no idea, from the OP’s rambling posts, if his ex completed a development history interview. The OP doesn’t know either, he is, to some extent, just making it up as he goes along and ignoring facts that isn’t keen on.

morph yes, quite possibly. Not all areas do adhere.
Including image from said guidelines which shows that diagnosis should not be based on the assessment (ados, usually) alone; 1:15:11 below.

But OP’s DS wasn’t diagnosed based on ADOS alone.

new patio Yes, they are guidelines of best practice, not the law.

Do feel free to continue to tell me that I don't know how my job works.

I never said op's wife didn't complete a dev history. Sounds like she did.

justkeepbuilding yes, that clarification was for all those many posters saying if he scored on the ados he was definitely diagnosed and that the assessment IS the ados.

I have no idea about the safety of the OP's son's assessment, but it certainly wasn't up to nice guidelines.

but it certainly wasn't up to nice guidelines.

You can’t possibly know that for sure. It may well have been. A school observation is not essential.

Thank you very much for the in-depth information, it is very helpful.

His mother was present during the ADOS assessment.

Thank you @Teenylittlefella thats certainly very informative and sounds more principled than the other the stories I read here today, which is what I'd expected for a diagnosis as serious as this.
For pp saying a second opinion should not be sought "in the interest of the child" , I don't understand.. . Misdiagnosing a child is probably more harmful and serious than spending a few hours or even days with a professional. It sounds like the ops child is resilient and can handle it.

In this case as there is discrepancy between parents and between school and maternal views, there should have been.

What are the mother's qualifications? Seems like there has been no formal diagnosis so why is anyone telling the dc and others that the dc has autism and adhd?

@America12 Senco and school are not qualified to diagnose him.
Neither is the mother and/or her parents

Your screen shot doesn’t say that. It states:

“1.5.9 If there are discrepancies during the autism diagnostic assessment between reported signs or symptoms and the findings of the autism observation in the clinical setting, consider:
*gathering additional information from other sources and/or
*carrying out further autism‑specific observations in different settings, such as the school, nursery, other social setting or at home. [2011]”

There presumably wasn’t discrepancies between the reported signs and symptoms and the findings of observation in the clinical setting. Therefore no further observations were felt necessary. Even if there were discrepancies it still doesn’t mandate a school observation - the use of “consider”, “&/or” and “such as” aren’t must.

Oh someone has come on to say that a diagnosis that has been accepted by the NHS doesn't meet Nice guidelines.

How interesting and convenient for the OP.

It is the OPs own posts that have led people to believe that the child was diagnosed using the ADOS as part of the assessment.

The OP literally said that the child was diagnosed.

Why are the vast majority of responders assuming dad (who has 50% custody) is wrong, child must have some kind of additional needs, and he's basically gaslighting the mother?! Would I'd be the same response if he'd posted as a female concerned that the other parent was making up diagnosis's?....... some people do assume autism/ ADHD diagnosis with no proof, and even after being told no, will keep doctor shopping until they get a yes- maybe dad is right and mum isn't? Although as devils advocate, I would have a joint session, with the ex wife on this circumstance to have it officially put as does not meet criteria, especially is social services are already involved.

And yet the 'opinion' given was that he is autistic.

How did your ex manage to get a private assessment done? Did you give permission?

@Teenylittlefella when did you qualify to assess?

From previous posts it's clear you are a parent of a child with additional needs. I've not seen you mention a professional role before?

Sigh.
If the assessor had consulted with the school, the father, the GP or the Early Help worker, they would have been aware of such discrepancies.
justkeepbuilding

I do not know if the mother or the father and other agencies are the ones in the wrong. But where parties disagree, triangulation of the assessment is best practice and maybe would have clarified more robustly the nature of this situation.

Joined the team in 2004.

Seeking a report from the school does not equate to a school observation. A report from the school could be as simple and as little as some or all of the yearly school reports given to the assessor by the parent.

Oh ok, when you've talked about your child with additional needs on threads I've been on before you haven't mentioned it.

Presumably being an assessor doesn't mean you know everything about autism given the past threads we've been on together then, I guess it wouldn't really.