Best approach when asking GP to refer DS? Possible Asperger's.

[ScramblyEgg]

DS is 3.5 and I've wondered for a while whether he might have AS, but also thought I might be imagining it.

Now his nursery teacher has said she's got concerns about his lack of social interaction, need for routine, and sensitivity to noise. She asked for the Ed Psych to observe DS at nursery but has been told she hasn't given enough evidence to warrant that, so she's asked me to get the GP to refer DS to a paed.

Is it best if I take DS to the appointment? I'd rather not discuss him while he's there, as he picks up on absolutely everything anyone says, but will the GP want to see him?

Should I say that I think it might be AS, or just talk about the specific difficulties / issues DS has? And how much detail do I need to go into, how much do GPs generally know about ASD?

Thanks for any advice.

IME, GPs know little about ASD or AS. I'd go armed with a written list of all your concerns and see if you can cross ref them to autistic symptoms, the triad of impairments etc. Have a look on the NAS website for some ideas. Then insist on a referral to a developmental paed (not just a general paed.) Tell the GP that nursery have also mentioned AS, (whether they have or not ) to grease the wheel.

No need to take your DS at this stage. A lot easier without him!

Thanks - good to know I don't need to take DS!

I didn't take ds . I just went with my concerns and that I thought his difficulties were perhaps because he had asd.

I went with a lists of my concerns and a letter from DS's teacher outlining her concerns too. The GP looked at it and went OK I'll refer you. He wouldn't tell me his suspicions as he did not want to influence me ( I was already thinking AS though).

We had a fight on our hands when we went, mainly because our GP at the time was useless. She insisted she would only refer to CAMHS (instead of paed) because (in her words) "ASD and ADHD are mental health problems, not medical problems and he needs psychiatric help for those things.." This after telling me that DS2 is "obviously not normal." We no longer go to this GP.

CAMHS thought she was a loon and basically sent her a letter saying that they weren't certain why DS2 was referred to them as he obviously needed to see a paed for possible ASD/ADHD assessment. We got a copy of the letter, she wasn't very subtle about it either.

It was actually DS2's school nurse that arranged the referral to the paed.

So prepare to have to be pushy about it if need be, but if GP is not helpful there is always the school nurse.

What EllenJane said. I didn't take DS2 as he would have hated me talking about him in front of him! I definitely said I thought it was AS as it is easy to be fobbed off with "he'll grow out of it/just a phase/lots of boys are like that" etc etc. School were not much use, they said they wouldn't refer him til he was 7. GP referred DS2 to the CAMHS dept at our local hospital who weren't much use either but we were very fortunate living in central London that we got referred to Great Ormond Street for diagnosis which was amazing (although I realise that's probably not helpful if you are not in London!!).

Hi, as a poster above I felt I couldn't take DS when I approached the GP -DS hears all and has a better memory than most elephants, things were pretty rough at school for him and I felt he was getting enough negative vibes without me saying things about him to another adult!

I rang and spoke to the receptionist - our receptionists are lovely - and she made me an appointment in DS's name with the DR who specialises in behaviour issues ( our practice is large and each Dr has an area of specialism - lovely system once you get used to it!). Before the appointment I made a long list of notes of my concerns so I wouldn't forget anything. The GP was actually delighted to see I had notes, listened carefully to me, noted that we'd been before about diet related behaviour issues, and referred me to the Paed.
There then followed a few weeks of two counties each refusing to see him because he went to school in one and we lived in the other..... but once that was resolved we got a diagnosis failry quickly and painlessly......

Worth knowing though .. That in some areas ( ie here in Cheshire east) CAMHS do assessment for asd. This is in fact who the gp referred my son to . They assessed and diagnosed him.

It's probably different for different PCTs (I'm in London) but I got ds referred to the developmental paed (Social Communication Clinic) through the Health Visitor when ds was 3yo - and over the phone, didn't even have to see her in person. It helped that, like you, his nursery also had concerns. Definitely mention that to the GP, it backs up the fact that you're not just a neurotic/incompetent parent imagining things.

Thanks everyone, this is really useful, loads of stuff I wouldn't have thought of.

I got refered to Development Paed. Kept being fobbed off by GP's, but like others suggested, finally went with list, and was determinded not to leave gp surgery without referal.
In the end, we also got a referal to CAMHS, and it was actually them that gave us a diagnosis of AS. She sent her diagnosis to the Paed, and we were seen by Paed 2 months later.
It works differently in every county. Some posters find camhs useless, others find paed's dismissive.
You are getting good advice here, just to keep both of them, in the back of your mind.

we were referred to CAMHS via our GP - DH and i booked an appt in DDs name, but went without her

i was a gibbering wreck having had very little sleep and co-operation from DD in her 4yrs on the planet, DH was almost literally holding me together, it was our GP who suggested CAMHS, and 7mths later she was dxd ASD

i'm still knackered, DH is still holding me up, but with the totally invaluable support of MNSN (and other places) we are able to cope a lot better.

one of the most useful suggestions we had from here was to start to keep a diary - not of the most challenging/quirky behaviour even, but day-to-day stuff, it's great if you can identify patterns in behaviours happening

i know if we'd relied on school to assess her, we'd have a very different story to tell..but that's a whole other 6 thread

ASDs are usually genetic, mention any eccentrics in either family.
There's a list at the bottom of this article you could print out and tick off anything relevant.

When we moved areas I was told by our paed in first area that if DS1 still had anxiety in 6 months that we should get re-referred by our GP. She effectively discharged us as she thought DSs problems were all linked to his previous school. Telling GP that alone just made him raise his eye-brows slightly. It wasn't until I gave him several real life examples of how DS was anxious that he made the referral as in his words "Oh, that isn't normal is it".
So go in with real examples of how your child fits the ASD criteria, don't just say "they like routine", give examples.

I agree with keeping a diary, make sure you include what triggers challenging behaviour/quirks/ any other issues and how you deal with them. Some Proffs sometimes try to blame parents for DC's issues but if you can show you are consistent you should be able to bypass this ridiculous notion.

Also agree with not taking him to the initial appointment, you are only going to get a referral. Take some notes with you about what concerns you have, even if you haven't had time to get much in your diary.

Good luck