GP appointment for someone who can't speak outside the house

[Pinkfluffyunicornsdancingonrainbows28]

Ds is 18 and has selective mutism. So he talks to me loads if we are at home and nobody else is there. But in a gp appointment he won't say anything at all. He has a gp appointment next week for pains in his leg. I'm thinking I should try and guess what the gp will ask so I can ask ds beforehand. Not really sure what the gp will ask though.

Will he write ? Could he text any replies to you?

I suppose things like how long had he had the pain, which leg, on a scale of 1 to 10 with one being the lowest how would he score the pain?

Could he write a couple of brief sentences before he goes for the GP to read?

Go with him surely? And just ask him to describe the pain. Logical question questions following on from that. When did it start? When is it worse etc

and how long has this selective mutism been going on?

Could you go with him. That seems the best thing to do. Does the GP know he has selective mutism?

Who does he see about the mutism and how does he communicate with them?

I would use the opportunity to speak about the much more serious issue is his mutism

Could you use chat gpt to come up with some possible questions the gp might ask so he can prepare written answers to those? And then take a notepad or iPad for DS to write answers for anything else that comes up in the appointment?

Did he make the appointment or did you make it for him? Can you ask him while you're alone in the house what he expects to happen during the appointment and how you could support him to get the help he needs?

Now does your DS plan to handle it ?

He's 18, he has presumably agreed to a doctors appointment, and he probably knows they'll want him to communicate somehow. What does HE suggest ?

The University of Liverpool Autism Hub is developing a tool you might find useful. Its a questionnaire to fill in before a GP appointment. The Autism Communication Tool. Read tge guidance notes

Guidance notes 1.,A.C.T.,guidance,Notes.pdf share.google/Xzl7FO7x2O4jmnPlA

2.,A.C.T,Tool.pdf https://share.google/aeqLT2Z2wBQgjXuMc

Edited to add more detail

My daughter has selective mutism, she is much better than she was (age 13) but now she freezes up if we are there as she relies on us to bail her out. As hard as it is I have learnt to prep her and leave her to it. Is the GP aware? If not could he take a note to inform gp of difficulties and maybe the main points about his pain, you might find he manages once the initial greeting is over. I sympathise it’s very difficult xx

That will be useful for us too. Thank you.

I would ask and write down as much as possible beforehand. Will he communicate non-verbally e.g. yes/no or pointing to body parts? Would he speak to you if e.g. the GP left the room? Would he write anything down? If not, you might need a follow up phone call if there is information you can't share during the appointment.

I'd hazard a guess that the OP has consulted every professional going about an 18 year old that doesn't speak, and isn't planning on tacking it onto the end of a 5 minute GP consult about his legs 🙄

Writing down the answers to some of these questions might be helpful: https://geekymedics.com/the-socrates-acronym-in-history-taking/

Can he text you the answers in the appt?

I’m aghast sometimes by what I read on mumsnet so not an unreasonable suggestion given that!

Thank you. He has always had this communication issue, although he has only been officially diagnosed with selective mutism since last year. GP is aware but I normally have to explain at every appointment. He doesn't talk to the psychologist who diagnosed him. On a really good day he will nod, shake his head and shrug or smile in response to questions but most of the time he won't do that. On a bad day he will sit with his hands over his ears and rock or shake (he has autism as well but no learning disabilities).

He won't write anything down at the appointment although he will beforehand. I haven't tried the dr leaving the room before, that might work.

The Autism Communication Tool Above will give you a good steer

This is an extract:

If you are attending the consultation for a physical symptom, you might like to include some of the details below
to help you describe your symptom:
Site
Where on the body the symptom is located.
It might be useful to mark on the body outline in box 7 where the symptom is.
Onset
How long ago did you start to feel the symptoms?
E.g. Since last week/for two months/for the last three days.
Character
You might like to include details of how the symptom feels. For example, is it a constant symptom? Does it come
and go, or does the way it feels change?
Radiation
Does the symptom ever spread beyond the main area?
E.g. usually in your ankle but sometimes spreads to your knee/starts in the right breast but can be felt in the right
armpit/ your hip but sometimes spreads to the back.
Associated symptoms
Are you aware of other symptoms that you think might be linked to the main symptom?
If yes, what are these symptoms?
E.g. Difficulty urinating and noticing back ache.
Blood in bowel movement and getting stomach pain.
Swollen knee and recently had a high temperature.
Timing
When do you get the symptoms?
Has the symptom changed over time?
Does the symptom come on during certain activities?
Exacerbating and relieving factors
Does anything make the symptoms worse or better?
E.g. Worse if I use that hand/touch the joint/walk on it, etc.
Painkillers are not working/paracetamol helps a bit/a heat pad is the only thing that works.
Severity
How severe is the symptom?
Healthcare professionals often use a scale of 1–10 to grade things like pain. You might want to use one of the
pain scales provided and see if this help

Just get him to write the answers down to routine questions . Pains in legs assessment will be obvious - point to where, when did it start, how bad, what makes it worse, what makes it's better, etc.

Hi OP, I have issues with speech periodically due to a neurological issue. My GP knows this so when I go I write in advance a letter with what I am there about, what the issue is, provide detail I can (as per the above type advice - where, how long, pain level, etc and what I hope to happen ie referral/meds/reassurance etc) and any questions. I email it ahead of the appointment to the surgery to pass to my GP and take a copy in with me. If you do this ahead of your appointment the GP can write back if there is anything else they might want to ask ahead of the appointment. Sometimes they'll reply via short message on your surgery/NHS portal? I've attended appointments where I've written a note as per above saying why I'm there, description/time/questions etc and I've passed it to the GP on arrival and they read it and take it from there. I don't normally have to do much but nod. I can however write any more info/questions down for them in the appointment.

Can you request home appointment? I know it's not easy these days.

He wouldn't speak in front of a stranger at home unfortunately. He had to have someone from the dwp come round to make me his appointee and he just sat there shaking with his hands over his ears, it was awful.

If you asked him the relevant questions at home could you record his answers on your phone?