Is the child psychologist in the wrong?

[almostalwayslaura]

We have started seeing a child psychologist with my 11 year old daughter. Has major issues with health related issues, manifesting in many ways but mainly wobbly teeth. For example, if she has a wobbly tooth she completely shuts down, can’t talk or open her mouth - sounds extreme but I’m not exaggerating - it is extreme. I have been managing this myself at home however this presented itself at school and teachers/school nurse got involved.. hence the child psychologist referral.

today was the first appointment LG attended, the first two were parent only. At the first appointment we were told we would be seeing a student psychologist. The student today, after a few awkward silences and speaking to her about a few different things turned to us and bluntly said ‘have you ever considered she has autism?’ I was flabbergasted at the bluntness - obviously I am aware she has a few quirks and sensory processing issues (examples include food and being unable to touch her own neck… strange I am aware) but I just can’t believe he just came out and said it in front of her??

was he in the wrong? Am I over thinking this? I don’t know what to do or whether to return to appointments?? I am completely lost on how to support her as due to her age, periods will begin soon and i cant even begin to imagine how her brain will cope with this - she had a femur break and was in traction in hospital for 6 weeks and i do think this is the root cause but autism? I’m shocked. Any advice on what I should do would be greatly appreciated.

Thank you

No they were not wrong. It’s absolutely fine to raise potential concerns. It’s what I was thinking reading about her shutting down and then you do one to say she has ‘quirks’ and sensory issues. What’s wrong with mentioning it in front of her? If she needs an assessment she needs an assessment. You can’t do it in secret.

Was he mentioning this because their service will assess for autism? Hopefully OP if your daughter is diagnosed this will help school to put the correct support in place for her and there are services that the psychologist can direct you to support parents too.
As you’ve spent two sessions with him without your DD he likely has made extensive notes and discussed your case in supervision which is where the idea of further assessment will have been explored and ‘approved’ as a line of enquiry beforehand.

Autism is not a bad thing but I understand you may have wanted time without your DD there to process and ask questions. Don’t get hung up on him being a student - usually this means degree, masters, a fair amount of work experience and being part way through a doctorate. That said I think ppl in these roles should be open to feedback and if you feel there are ways he could improve his way of communicating, tell him? But don’t let that sidetrack you from getting the support for your DD.

Parent seeks professional’s advice. Received professional advice. Said professional suggests a possible diagnosis to consider. Autism diagnosis range from 18 months to years depending on the trust so the earlier the pathway is started the better. A professional making the referral will carry clout and weight and help your child access the support they may require and if not the support at the very least an assessment.

Parent’s reaction “I am flabbergasted”

He didn’t diagnose your child with a terminal illness and give her months to live!

A young Dr did much the same to my 13 year old listing various "problems" (this was during a EHCP assessment - we already knew he had autism from age 7/8) but it was just the tactlessness I felt extraordinary. It turned out that this young doctor (almost in tears that we had taken her words the wrong way)had themselves a diagnosis of autism and dyslexia and she felt quite strongly about helping neurodiverse patients /there was nothing to be embarrassed about ....could this be what was happening here...?

Whilst I have zero experience of this situation, I'm a bit surprised that anyone workday announce a possible autism diagnosis in front of a child of that age and in those circumstances.

It’s a bit of a shock when you first hear this, especially if it hadn’t occurred to you before. It could be an underlying explanation for some of your DD’s issues, so I think it’s good that he mentioned it, even if he didn’t do it in the most gentle way.
if you feel you have lost trust then I suggest you ask to speak to their supervisor. Don’t just stop the appointments.

Having been through the process several times with my DC I would say it absolutely normal for them to be included in discussions when attending appointments at age 11.

It sounded like a question rather than a diagnosis, but may have been better not to ask in front of a child with health anxiety!

Is there a manager you can feed back to?

I picked up that your daughter had a serious injury to her femur. My eldest (not the one with autism) had a three month recovery from a broken upper femur aged 9 and two broken wrists on other occasions - and was later diagnosed aged 17!!!!! It took that long.!!!! with vitamin D deficiency. This was affecting all sorts of sensory issues and attention issues and of course his bones. He was diagnosed with dyspraxia at 13 too so a degree of neurodiversity
So please check her vitamin D levels - a lot of neurodiverse people for one reason or another have low vitamin D levels and it exacerbates other issues ie anxiety

If it’s any help - I’m autistic myself and before I got to the end of your post I’d already though it. Sorry if it’s shocking for you to hear - I would actually put money on that student being on the spectrum themself if they were that quick to suggest autism. Your LG may well have completely fabulous coping strategies which might be why it feels so leftfield for you to even consider.

Vitamin deficiency or folate deficiency is such a simple thing to check but for some reason it is not the first thing that people ask when your child is having problems. A good diet does not prevent vitamin D deficiency or even B12 deficiency sometimes (a friend's daughter suffering from anxiety, it turned out needed injections for B12)

I’m quite experienced at assessing autism and while I wouldn’t be this blunt about introducing the topic, I more often than not involve young people in the conversation if it’s something I’m reflecting upon. It’s not anything to be ashamed about (which is what you sound worried about) and sounds like there’s a good rationale for querying it so I’m not sure why you’re surprised it was brought up. However, I think it’s always okay to give feedback in how you felt and that may be taken on board - but no need for whispers and talking behind backs and in euphemisms.

I am also a bit concerned that if your daughter has major health anxiety you feel justified in just "managing" this at home. Yes, professionals can be interfering and judgemental but your daughter sounds very distressed even if it is "only" because of that traumatic hospital experience...and that alone might warrant her getting some outside support.

It's very hard to do everything running on the inside track and tbh forming very strong fixed opinions of what has caused certain behaviours in children - bullying/autism/vitamin d/puberty/trauma doesn't really allow for many many reasons and many many solutions

It could be all those things, some, none.

They did the right thing to ask you if you'd thought about it, to find out whether you hadn't ever heard of it, or were already on the assessment pathway or she'd already got a diagnosis - you don't know unless you ask.
However it was very wrong to say this in front of her

Im confused Op.
Are you saying that your daughter had a traction break years ago and that is what you think has caused her extreme reaction to certain things ie. Having a wobbly tooth, touching her neck?

why did you feel you needed to handle this all at home?

I like the transparency involved in asking this question in front of your daughter.Autism is nothing to be ashamed of and you need to make this clear to your child.

I’m sure the student has more knowledge than you, what makes you think you are more qualified than them?

Because she is my child and taking her to see a doctor etc would just exasperate this? It took an emotionally draining meltdown to get her to see the psychologist for him to ask so bluntly in front of her if we thought she was autistic? To be perfectly honest I’ve always thought she had traits of being neurodiverse however the school do not see any issues in any other areas.

This is not about him being a student - this is about the lack of tact in his manner around a child already filled with health anxiety. He followed this up by saying he did not help people with diagnosis’ that would be another 18+ month waiting list.

I’m not sure what the issue is really. You openly say you aren’t sure how to support her through this, the professionals are trying to help and it’s a valid question. Autism isn’t a naughty word to be whispered in private.

Thank you for this information, this would never have occurred to me otherwise. Her diet is poor so I do absolutely think she will have some sort of vitamin deficiency however I don’t know this has effect of things you mention, is this taken in injections or can you get certain times of tablets?

Tbf I only read first paragraph before thinking about there possibly being some ND as mum of two autistic children. Wobbly teeth were a nightmare for one so much so I asked their paediatrician whether any other parent had asked for them to be removed to stop the torment. He said it was pretty common in his experience.

For a child with health anxiety, for this to be brought up in front of her without any hope of anything happening about for 18 months, could open up a whole lot of other symptoms and behaviours.

Imagine you go to your GP and he says that you might have cancer but you can't get tested for 18 months. For a child with health anxiety those 18 months are going to be similarly distressing.

He is a student and unfortunately in the NHS you are unlikely to see a qualified psychologist because your daughter doesn't like having wobbly teeth. Maybe consider going private if you want to be seen in a timely manner. Yes he could have been more subtle about it but it is a valid question and perhaps at 11 one that your daughter might have considered herself if she has friends who are neurodiverse. It might explain for her a number of differences that she feels but is able to mask. It is also something that he probably discussed with his supervisor since the last meeting with you as parents and the supervisor recommended to enquire about. He probably wouldn't have mentioned it though without even meeting her.

You need to consider has your daughter mentioned it again? What was her reaction at the time? It may be that you leave the question to settle and come back to it in a few years. He might be thinking that this case is far more complex than it appears on paper and that maybe there are other issues which will need to be considered. It is good that he is recognising his limitations and that you have a realistic idea of treatment goals.