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

But wasn't this more of an off the cuff comment and wouldn't one expect a professional to tread more carefully

should it be something that needs a "tread carefully" approach? I could imagine this as a kind of "your daughter is not weird or ill" response. Two things stand out to me. Your wanting to "protect her innocence" and her response that the psychologist was rude. Where did she get the idea that "autistic" was an insult?

This. Honestly, OP, your responses (‘managing it at home’ etc) are what I’m finding concerning here. My anxious godson was also a comparative ‘late’ autism diagnosis at around the same age, and was absolutely involved in all discussions en route. He would have been far more anxious if not.

Yes, this.

The only person in the wrong here is you.

Despite seeing your DDs struggles with anxiety, poor diet, sensory issues and 'quirks', you won't seek an assessment which would mean she could access much needed help. You would rather she struggles with these things all her life than actually do something that could help her.

I imagine your reaction has a huge amount to do with your DD thinking the psychologist was rude.

I agree the psychologist could’ve spoken to you separately but at the same time at least she was included in the conversation about her health. I think it’s worth thinking about your views on autism - it’s not a dirty word or an insult.

In the car on the way home she said he was rude for saying she had ‘autism or whatever’
Perhaps he was blunt but it’s not rude to professionally suggest that someone has a disorder. I think it would be helpful to discuss your daughter’s views on ND and ASD

Yes they were wrong. Your child wasn’t there for an autism assessment. The student should have waited until they knew your child more and then spoken to you privately. Raising this hypothesis out of the blue after only meeting the child once is not good practice.

They handled it poorly. If you feel that the student psychologist isn't a good fit then speak with the department and ask to speak with a different one, citing your concerns (the wishes you expressed to protect her the session before, the bluntness of delivery and ensuing response from your daughter - keep it factual and not emotional) - my concern would be that this practitioner will say it's outside his remit due to suspected ASD but I'm a cynic. Great shout by an earlier poster re Vit D deficiency - definitely check that one (either GP or at home test kit to mitigate anxiety)

She’s seeing a psychologist. Their job is to diagnose psychological or psychiatric conditions.

Autism is the tactful option to suggest in DD’s case.

Why no intention of paying for an assessment?

While I can see that you are shocked I think that it’s good that it’s been suggested.

No, it sounds like it was a genuine concern to be raised. I don’t see anything unprofessional in the matter at all tbh.

I’m not a psychologist but, as a parent, I do agree it could have been handled more carefully. At that age, with those behaviours and anxiety, I’d want the heads up and be on the pathway to testing before I tackled the sensitive issue of breaking it to my child.

Students of course lack experience at the job, so I guess you will have to chalk it up to experience and to offer feedback for their further training.

My daughter had suspected autism at 12 - the therapist had a private conversation with us because a child with anxiety needs time to process things.

It’s a concern to be raised at this point with the parents not with the child, until the parents decide it’s in the child’s best interest.

If DD were to test negative it could cause worry and confusion over nothing.

A young relative of mine, not my own child, was suspected of ASD but he tested negative for that but positive for ADHD. There would have been no gain from floating ASD at that age, when he wouldn’t really have understood what it meant.

It's not the concern but how raised

Exactly.

possible the Psych also autistic, hence the bluntness and lack of ability to “read the room.”

I have ND child, before an appointment with Camhs when child 13/14, I spoke 1:1 with clinical psych before child joined. I told him that my child doesn’t like to be spoken “about” as if they are not in the room or as if they can’t understand adults. Please either be inclusive and include child in discussion, or talk to me privately after the assessment.

Psych did exactly what asked not to do, immediately started talking about child as if he wasn’t sitting there listening. Child got angry, kicked over the small table and walked out. Then psych all in a flap that I must go find him and “appt over” after waiting 8 months.
I received the clinical letter 3 months later with no mention of the table, no mention that appointment didn’t proceed or about my concerns. Next appt was with the nurse, who was more personable but on the whole CAMHS were a waste of time. We went private, 100% better.

Camhs just do, what they do. Feel that their education lacks some certain client / parent communication training.

These days autism isn’t something to say in hushed tones and the DC is 11 so she will already be aware of its existence (hopefully)- I would have no problem with this interaction personally.

I feel like your reaction might come from some subconscious bias, it’s not cancer or anything horrible so why wouldn’t he come out and suggest it normally? At her age she should be (imo) fully informed about anything medical/psychological going on and it will open up conversations to have together about the causes of her sensitivities/behaviours/feelings.

You need to be talking to her about these things, autistic or not, because they’re happening and to support her you can’t just shield her from everything that might make her anxious without giving her mechanisms to cope.

I have a dc on the spectrum. I’d say

1- the student was blunt. They might well be right re autism but presenting it like this put your back up and now you’re unlikely to seek a diagnosis. THAT is a mistake on their part. Same with the child.

2- school often have no idea if the child is on the spectrum. As far as they’re concerned, if the chikd doesn’t have meltdowns in class, everything is fine. Don’t rely on them to know of your ds is or isn’t in the spectrum.

3- you dint need to protect your dd ‘innocence’. If she is on the spectrum, she is living with it everyday. She can’t be protected from it because that’s her daily experience. I do get the wish to bring it up to her gently. Some times, it’s actually better if it’s done by a professional rather than a parent. But bluntness is not the way forward thete I agree.

Tbh I’d try to get an assessment IF the student teachers agree with that possibility. I’d have a word with them rather than just the student. Have the assessment if it’s a possibility. And if you’re wrong, then great! But knowing will make a huge difference on how you and the child psychologist will approach things with your dd. They would be more efficient knowing.

Let's say he was 'wrong' to say it in that way. But what if it's a really good thing he spotted it when others might have not? In that case it would be good to go back to him and say 'explain this to both of us' and 'if so, what next?'

There are so many adult women who wish someone had recognised autism in them as a child. He’s perhaps not gone about it in the best way but the bigger picture is that it’s hugely positive people are noticing this in girls now.

This 100%;

FWIW my 15 year old has autism. He was diagnosed at 4 and he has some cognitive issues as well. So we agonised over 'how to tell him' when he was old enough to understand it. We made all sorts of mistakes along the way but actually what works best for us is just to be open and matter of fact. That certainly worked better when he was diagnosed with ADHD at 12 and Tourettes at 13 anyway!

Given she has health anxiety I would really try to go private if possible. An 18 month waiting list I imagine will cause utter havoc with her well-being.

But- don't be afraid of autism. Most of us are at first because of course it's scary to think something might be 'wrong' with our beloved child. It's not 'wrong' it's 'different' and autism is so much better understood nowadays. DS says now quite often; 'I love having autism. But ADHD can get in the bin'. TBF though he is getting really good at managing his adhd (with medication) in a way that really works for him.... he channelled his ability to hyper focus for the mock Year 10 exams for example and did brilliantly.

Anyway- good luck with it all.

It was a question a professional is asking.
I understand if it caught you off guard.
He only asked if you had considered it.
As a psychotherapist based on what you have written Autism is a very good possibility.

I'm a Dr and I have been in the same position

If I suspect autism I phrase it as social communication difficulties that need to be further assessed

I would not have phrased it that way and I get annoyed reading some reports that state a child has autism without following the NICE guidelines for assessment

1000% this.

As a professional myself there is really nothing wrong with what he and said despite what people are here saying.

You're seeking a professional opinion. He asked a question. Your reaction to this question and your daughters is telling that you fear Autism. Something for you to think about. If she thinks he was being rude, ask her why? Why would suggesting Autism be rude?

You do not need and should not “protect her” from any diagnosis.