please reassure me, if I ask for a second opinion - do I just end up with a really annoyed pediatrician?

[BumptiousandBustly]

Been advised that the pediatrician I am seeing is not brilliant - certainly not prepared to diagnose at this stage - what happens if I ask for a second opinion? Do I just end up with him being really annoyed and his colleague not taking me seriously?

i.e. Doc A says to doc B - oh she has asked for a second opinion - annoying woman, this is what is going on. So we see Doc B - who has already pre-judged based on what doc A said, and on the fact that I have asked for second opinion.

Anyone asked for a second opinion? Did it get you anywhere?

What stage is 'this stage'?

It is extremely common for Paeds to play 'wait and see' for sometimes years in the early years/ pre school stages? Particularly for developmental issues that may indeed just turn out to be delays? (for ASD as well as cerebral palsy, and many other 'developmental delay' type issues)

That said, some Paeds are crap, and if the child is 7 and everyone around you from school to granny is saying 'this is not right', then the paed's' annoyance levels are none of your concern.

It's reasonably common to shell out for private assessments though.

Should also say - Paeds are generally just a referral route for most people. They don't actually do anything much of their own.

Where in the system are you? For what?

We think DS has high functioning ASD - so there are no speech delays or anything - in fact if anything his behavior is going backwards, not forwards.

I guess I just don't really understand the system - I think the ped can give us a working diagnosis - and refer us on to hte team that do the actual diagnosis - but we can't get there without him - and I don't think we can get to that team by going private (also cost issues) and I am not sure a private diagnosis would be accepted.

He is four - so its not that he is 7 - but I am just really struggling with things, and want the certainty of it, IYSWIM. Its also all not helped by the fact that the pre-school are pants and keep changing their mind about whether his a) fine or b) totally refusing to interact with the other children.

It varies by area. Some gps will just refer to camhs as a diagnostic authority, so it depends where you are.

What is the paed doing? Is he reviewing in 6 mos? (fairly usual if not enough evidence)?

Do you have a diary/ list of behaviours? Sometimes a bit more time crystallises school/ nursery's thoughts. Have you sat down and discussed with the senco? Have they had area inco in to give advice?

Private assessment will at least tell you if it is worth pushing the NHS to take you seriously...

At the mo I would think about what a dx means? Does he need support at school? Are you looking to go on early bird parenting course or similar?

What difference will a dx make for you in the short term? Can you access this stuff without a dx?

It does often take a long time for dx to happen, especially where you have professionals (of whatever type - ie school) saying there is no problem, so it's a matter of getting your ducks in a row to prove need, or to pay and get it done privately if you need the certainty. The only reason that they wouldn't accept the private dx is if it was going to cost them money - so if school are saying he's fine and you aren't thinking of applying for SA, then there is no real need to worry about acceptance of dx.

A lot of folk read up and start using methods suitable for the dx in any case - in that hinterland is he/ isn't he period. If he is, they might help, if not, no harm done.

I think I would be concentrating on getting my ducks in a row and turning up at the next appointment with fairly irrefutable stuff that means further assessment is necessary - for whatever reason, what you turned up with this time wasn't deemed enough. Or I'd pay. We've done that in the past, too.

And I'd work out what you are hoping to follow an actual dx. Sometimes it's pretty much nothing... That's not to say it isn't worthwhile, but often there is no actual concrete difference, just a label. It does become easier to fight for what you need with a label, but it's helpful to know what you need, and you can start fighting even before, iykwim...

I don't know many people where the paediatrician was prepared to diagnose at the first appointment. In the few cases where they did, it was usually on the back of a shedload of information from the GP, school, speech therapist etc.

Mariamariam - its not hte first appointment - its the second.

madwomanintheatic - I think you speak great sense! For me its firstly, to be sure that is what we are dealing with and secondly to start the ball rolling for help at school - which he might well need.

However i do agree that the school should see that themselves, which will hopefully start the process from that end. I think it was just hearing that he is "not highly thought of" -that made me feel like maybe we should try and get another opinion, but I think it will hold off, get my ducks in a row and then, if he won't refer on, then get a second opinion.

in terms of what he could do - apart from refer on, he could get us access to the local autistic trust - which would be very helpful.

Do you have to have a dx to use NAS resources? Our local one was v own and had a great lending library... That said, I was already 'within' the community for a different reason, so not sure. It would be worth giving your local reps a call though, they are also great to pick their brains about usual routes to dx in your area...