Can anybody help figure out these SALT and OT assessments please?

[KOKOagainandagain]

DS2 is 6 and in year 2. He started school at SA+ as he had speech sound delay and was visited in school. All seemed well in reception for the first term and then the IEPs began to contain more objectives and phrases such as avoiding eye contact, not responding to name, talking and making noises inappropriately, fidgeting etc. The school and the SALT and OT have been conducting a number of assessments. Trouble is I don't know what this means. I can understand the individual tests but I can't put it all together to see the whole iykwim. Can anybody help please? (Excuse the length)

Renfrew Action Picture Test (age appropriate)

Assessment of Comprehension and Expression 6-11 (ACE)
Sentence comprehension SS 8, 25th percentile
Inferential comprehension SS 9, 37th percentile
Naming (vocabulary)SS 13, 84th percentile
Syntactic formulation SS 10, 50th percentile
Semantic decisionsSS 17, 99th percentile

Clinical Evaluation of Language Fundamentals - 4 (CELF-4)
Concepts and Following Directions 75th percentile
Understanding Spoken Paragraphs 91st percentile

Test of Abstract Language Comprehension (age appropriate)

Developmental Test of Visual Motor Integration
Visual perception SS 123, 94th percentile
Motor co-ordination SS 96, 40th percentile

Test of Auditory Perception3 (TAPS 3)
Thinking and Reasoning SS 114, 82nd percentile
Test of Reception of Grammar (age appropriate)

The Squirrel Story Narrative Assessment

Listening and attention 0 - 3, 3 ? (age band 5 ? 5.9) interactive listening, appears to enjoy the story may ask questions; retells with interest

Story structure 0 - 4, 1 ? ( age band 3.3 ? 3.11) some sequencing of ideas with central character topic or setting. Arbitrary links with limited cause and effect.

Story content 0 - 3, 1 ? (age band 3.3 ? 3.11) basic content produced in reduced form with picture prompt. Mainly action sequence to a story using the picture cues; no natural flow.

Level of Language used 0 - 3, 1 ? (age band 3.3 ? 3.11) longer sentences but little variety of construction. Grammatical immaturities. Little use of connectors ? mainly using ?and?

Gesture/non-verbal 0 - 4, 2 ? (age band 4- 4.5) some self generated use of non verbals ? eg tone of voice changes

Vocabulary 0 - 3, 1 ? (age band 3.3 ? 3.11) more specific vocabulary emerging but only as recalled from text

Total score 0 ? 20, 9 ? in the sample from which this data is gathered the age range of those children who achieved a score at this level was between 3.3 and 4.5.

He is to be assessed by the EP in the next couple of weeks.

atm DS2 is termed Speech Language and Communication Needs as he has been seen by SALT since a toddler (he is now 6) for delay. I don't see this as the end of the assessment process because it is signficant whether the SLCN are associated with ASD. Children whose primary need is classified as SLCN are less likely to get a Statement. He is currently on SA+ and has 3 hrs 10 mins in total with over half being whole school interventions such as gym trail. I am discussing the amount of support he requires with the SENCO so I would like to know what the assessments 'mean' in those terms.

In terms of persuing the medical ASD route, the matter is complicated by my comm paed. DS1 is nearly 12 and has a diagosis of ASD which his comm paed disagrees with. DS2 was referred by SALT and saw the same comm paed. She is of the opinion that DS2 is not on the spectrum either (largely I think because she views me as a diagnosis chaser). Do these assessements rule it out? Pragmatics profile by teachers is avoiding eye contact, not responding to name, figeting and making noises and talking at inappropriate times, problems with appropriate distance etc. OT assessment of hypermobility, shoulder instability, difficulties with core stability and difficulties with proprioception.

I feel as though I can be easily fobbed off because I don't know the 'code' and so what results 'mean'. This happened with DS1 (lea home tutor pending tribunal hearing) and I really don't want it to happen again. I also don't have an NT child with whom to compare him and I don't know what normal looks like. Because DS2 is a doddle at home compared to DS1 I feel like I have overlooked things. Most problems are at school and are seen and reported by teaching staff - the same teaching staff that didn't see problems in DS1. His behaviour is much less problematic for me and at home and so I don't have the same urgency as I did with DS1. It feels weird.
Can you help at all?

I'm very grateful. TIA.

Bump for you

He has some amazing strengths (99th centile semantic concepts means only 1% of dc are above him in this skill. Example is knowing 'bus' and 'train' are both 'transport' words). This is totally out of kilter with his sentence comprehension, where he's in the bottom 1/4 of his class. And he's 2y behind in telling stories, ie performing at only 2/3 of his age. Ok at 6, not ok at 18y.

Lots of asd dc are 'spiky', but so are some slcn dc. Theres a very muddy area between 'complex slcn', and asd, have a look at semantic pragmatic disorder stuff (keeps being re-named, now being thought of as an asd-type issues) and someone who deals with a lot of borderline dc ought to see him. If the comm paed thinks you're nuts, it'll be harder for her to think clearly

Sounds like the school are sorry, and trying to do a proper job this time

Do you think it is likely that a GP referral to another paed (dev rather than comm) would be good enough or is he likely to need specialist assessment through a tertiary referral (say to the Lorna Wing Centre)? How can I persuade the comm paed to do a referral if she thinks I'm a MBP-Mum?

Go sideways, ask SLT if anyone in dept is a semantic-pragmatic specialist. Or to GP and ask for great ormond street social communication disorder unit.

Or just be very upfront, "we both need to know if I'm right or if i'm reading too much into this, whose expert second opinion assessment [present list of suitable options] would you personally recommend as most reliable ?"

Don't think a MBP momma would be upfront so personally would do 3.

Thanks maria excellent suggestion. Do you think anyone/where else in particular should be on my list?

I have been sitting on my CAST questionnaire that I am due to return to the comm paed - partly because my home experiences/obs are of him are of him interacting or not with DS1 or in a context dominated by DS1's behaviour. I have been trying to observe him when a friend visits from school but they obsessively play on the PS3 and DS1 won't leave them alone - if he's not directly interfering he is reporting perceived rule-breaking to me every 5 minutes. Given that DS2 is only 6 and all children that age have their moments he doesn't stand out too much but even the ht/senco thinks his interactions with classmates will become harder in future years.

With DS1 the parental CAST questionnaire was positive but the school one was negative and as a consequence the comm paed refused to refer him for ADOS. I had to pursue independent assessment/consultation which cost the best part of £3k. Do you think that I should ask the school for a copy of their completed questionnaire? I know it sounds crazy but I feel that I don't know the answers to some of the questions - I think 'no' but DH thinks 'yes'. I tried asking DS1 about how DS2 had been in school at breaktimes etc and he painted a very different picture to the one I assumed (basically doesn't play with other children or communicate well with them). I feel like I don't know my own child.

I've been on the borderline/complex path for over 4 years now with DS1 with the situation coming to a head and culminating with him out of school and tribunal looming. I so wanted DS2 to be less complex when I finally realised that he was not NT. Sorry for the moan - feeling guilty and sorry for myself today.