advice on what i should be asking for please

[cheeryface]

ds2 (12) has been having major problems since starting high school although i think there may have been things below the surface before then.
after a teacher suggested aspergers and he had become suicidal i had him referred to camhs.
i actually think that if anything he fits the bill for ADD-Inattentive more but nevertheless i feel frustrated at the way camhs are dealing with it.
since september we have had a couple of apppointments with camhs , with i think a social worker for autism. after me keep stressing on the phone to her we finally got to see the psych.

she must have had the info on ds2 from the social worker who was also there (i had given her a sort of diary and description of his behaviour previously) and she spent 30 minutes tops doing an ados test with him.

she said although his eye contact was poor , he didnt really gesture and he didnt show interest in her when she was trying to get him to ( said something about her holiday and he didnt reciprocate) she said she was ruling asd out.
i had said he has no imagination and she said thats not true as he was able to make up a scenario with some random objects.
i mentioned add and she said that he was able to concentrate on the tasks . i have read that kids with add are able to concentrate in some situations. so should that be ruled out so quickly ?

we have now been left with fortnightly appointments with the social worker woman who is going to apparently get to know ds2 better and give me and him some strategies to help his behaviour.

tbh i am not happy. i want to know what the hell is wrong . surely the efficiency of the strategies would depend on whats wrong with him.

so far she has suggested nothing that i havent already tried. i have done parenting courses in the past and am well versed in charts and praise and traffic light systems !

i seems to me that we are going to get the bare minimum unless i know what im on about and push for it as they are short staffed and waiting lists are massive.

can anyone tell me what i should do ? what should we be getting ?
should asd be ruled out after meeting with ds2 for 30 minutes ?

thanx for any advice

Sorry, cheeryface, what sort of psych saw your DS? If it was an Ed Psych then they are not qualified to DX or dismiss ASD or ADD. Was this a clinical Psych? Even then, you usually need a suitably specialised paediatrician or a multi disciplinary team (to include a paed or other qualified specialist) to DX.

i think she was a clinical psych . they have no info from school other than what i have told them and i dont even have that much info from school as they havent been very helpful either. they sent me a report home which told me how much hes struggling etc
i had thought that once we had got to see the psych we would have more appointments with her until she found out what was going on. seems not.

Wasn't sure about the clinical pysch, PipinJo, thanks. I can remember a thread about it a few months ago and there was a lot of contrasting opinions. It does sound like he/she has been rather quickly dismissive of AS or ADD, though, cheeryface so I would agree with PipinJo's suggestion of a second opinion.

Gaargh. 'This test rules x out'. Drives me crackers. IT IS NOT TRUE. Tests just don't do that. They provide some evidence for or against suspected diagnoses. The test result PLUS the other information helps make an estimate of the likelihood of the child having condition x. So if it 'looked' pretty definite before the test, then a borderline or 'high normal' result definitely doesn't rule it out. It just makes the suspected diagnosis less likely.

Here's a link explaining it for anyone who might want the equation!

And conversely, a positive ADOS test result doesn't necessarily prove that that a child has an autistic spectrum disorder rather than some other condition research.

If this social worker really annoys you, print out table 3 from this link, highlight the last line, and ask her if you could see the psychologist again to explain why an ADOS module 3 is apparently being used alone to 'rule out' an ASD when sensitivity (this means pick-up rate) can be as low as 49%.

That said, many of the strategies which would help a child with ADD might also be useful in a child with ASD or indeed a neurotypical one. So perhaps the social worker meetings won't be a complete waste of time, providing of course she goes straight to the 'advanced' behavioural strategies rather than the blinking obvious.

Thankyou all very helpful. I am going to phone the social worker today as i think she has probably done naff all about having someone observe in school also.
everytime i look at his books the teachers comments are ' see me ' and 'unfinished , why ? ' etc etc yet no one phones me about it.

i have spoken to someone in the pupil office and the best she could do was email all his teachers asking for feedback on him. the feedback was stuff like 'struggling' 'badly behaved' 'lazy' 'head constantly on desk'

who should observe him in school ? a educational psych ? what can they pick up on ?

Good advice already but you also need to remember that the support your DS gets in school should not depend on a diagnosis. SEN support is 'needs led' which means that they should be looking at how they can support him as an individual and tailoring all intervention to suit him.

My DD1 struggled when starting high school and now has a place in a base which means she has a safe quiet refuge when things get difficult, support to organise herself, enhanced home school communication, social skills as part of her curriculum, a card to tell the teachers that she may leave lessons and return to the base if she needs to, a pass to allow her to collect her lunch before the other pupils enter the dining hall and bring it back to the base to eat it. These are just a few examples and most schools should be able to find a way to do these things whether they have a base or not.

If the Ed Psych isn't involved you need to ask the SENCo to arrange for this to happen.

Sorry this is a bit rushed - school run.

HTH

thankyou for that. On monday after ds2 had flipped in the morning , gone missing , threatened to kill himself and trashed my house myself and a friend managed to get him into school albeit rather late.
i explained to the lady i have been speaking to in the pupil office what had gone on and she was asking if i thought he was any better at this school than the last one.
i explained that he is really disorganized and keeps getting detentions for forgetting things and she said its difficult because the teachers wont give one child a detention and not another.
i also had a letter before the half term to tell me that his behaviour and effort score was in the bottom 10 , could i explain the importance of behaving etc and that he would be put on report if it didnt improve.

tbh i have no idea anymore what is wrong with him. i suspect the teachers and maybe even camhs are thinking hes just a hormonal . naughty lad with low self esteem. maybe they are right. i dont know how to get to the bottom of it all.

For a start there is no reason whatsoever why they can't let your DS off detention for forgetting things. It's called differentiation and each child must be treated as a individual.

A wise person said to me that all behaviour is communication. Your DS is behaving in the way he is for a reason. You need to try to work with the SENCO to work out what is going on for him.

Clearly he is not forgetting things on purpose. If he is being rude and aggressive he may well be experiencing high levels of anxiety. Has the SENCo arranged for anyone to observe his social interaction? She should have done this if the school is raising the possibility of AS.

Have you read any books about Asperger's Syndrome? This one has been my bible since DD1 was first diagnosed when she couldn't cope at High School. It might be worth you getting hold of a copy and seeing if it explains your DS's behaviour for you.

Could you find an activity to do with your DS during which you could see if you can get him to talk about what he finds difficult? One activity I found really enlightening was to ask my DD to design her perfect school. This gave me a very clear picture of what she found difficult. I would chat shoulder to shoulder doing some sort of task together as this can make it much less threatening than face to face.

The good news is that you can work with the social worker and show her that you are using appropriate behaviour management strategies so she can see that the problem is more complicated than they may think. You can also ask her to help you find solutions to the school issues which may open everyone's eyes a bit.