What do you ask for?

[TICKLETUMBLE]

Hi everybody. I am now getting to the point of utter confusion.

My 5yo step son has been assessed at school due to issues with his behaviour (he is on Action plus with 10 hours of 1:1 help in classes) and there are so many references to behaviours and attitides which point in so many different directions I do not know where to start.

The only firmly stated thing has been development delay in social and emotional area with weak fine motor skills. However, he is fidgety, touchy - needs some kind of physical contact with another human or objects to push against, is impulsive with no forethought to danger or consequences, doesn't read social situations or non verbal communication, easily distracted, wants to play with others as long as its his game by his rules and he has to win, has difficulty writing and colouring neatly and does not really draw pictures to depict real things but just marks paper with squiggles and zig-zags(he will tell you that it is a blue line with a red zig zag, its not supposed to be anything in particular) which indicates a lack of imagination. Academically he has surpassed expectations and the teachers are very pleased with progress there so whatever issues he has, they are not significantly imparing his learning at the moment.

I had been pretty sure he has ADHD, but having looked into it and other conditions that are often cormobid or misdiagnosed he could be dyspraxic, have aspergers , have SPD....he seems to have little bits of symptioms and behaviours from all of these. If I can ever get his dad to agree to a formal GP referral...what do we ask for? Educational Phychologist? Developmental Paed?

Thing is tickle, it could be all or some. The good thing is that you're getting some support at school - is he statemented? Whatever route the paediatrician goes down, it's the support that matters.
In our LEA/NHS PCT, the level of support does seem to be dictated a little by what dx you get. This may not be the norm in other areas, but dyspraxia, SPD and ADHD do not get a great deal of support.
The school might have already had the Ed Psych see him already, but they 'should' have notified you of this - although I have noticed in our school that sometimes an extra child is just glanced at by the EP to see if they should do an assess next time they are in.
Re the dyspraxia and SPD, most areas in England you can do a parental referral - our PCT you can download a referral form on line.

Thanks for the feedback.

I'd like to know what it isn't, as much as what it is, to ensure the help he gets is the most approriate. I want to be sure we are all doing the right thing, and assuming it might be ADHD when it could be a host of things, then we could be getting it all wrong.

From your list of symptoms it could be ADHD with ASD or Dyspraxia or SPD. Without a professional actually seeing him and assessing him properly, anything we suggest is pure guesswork. I really wouldn't rule anything out, the lack of imagination and rigidity of play sound like he may be on the spectrum. Dyspraxia also has poor social skills symptoms. The sensory processing differences, could be due to hypo or hyper sensitivity, which could also be due to ASD.

My DS2 with ASD is very hypo (under) sensitive to physical movement and this makes him appear hyperactive as he is sensory seeking a lot of the time. He doesn't have ADHD, however. He has poorly developed personal safety skills but he's not deemed to be impulsive in an ADHD sense. But your DSS may have. My DS2 was also pretty able at age 5 or 6, before the literacy skills required more abstract thought processes, imagination and theory of mind.

If he's on SA + the school must have had some outside help, be it an EP or an occupational therapist (OT) etc. I'd find out who has been involved, try to get a referral to a developmental paed and tell the doctor that school have concerns and you feel it may be ADHD or ASD etc.