What would you guys do?

[kyz1981]

Really upset as I feel my SALT has an agenda and is so focused on her opinion that DS has a language disorder that everything seems to get turned round to this or dismissed as an age thing if it does not fit.

I feel she has stopped listening to me and others and made her mind up about DS after spending a few sessions with him.

Everyone else has told us that DS is on the spectrum and the Pead put me on Earlybird.

Now I know the SALT can't diagnose ASD on her own and she is part of team, but I now feel this is fragmented and can feel the tension between her and the OT - who is lovely- The SALT does not mince her words and is head strong but I feel she also turns everything to Language and attention, whilst I agree DS could have a Lang disorder, he has loads of other things that point to the social communication problems in ASD.

I also feel as if we are being observed as to ~"who is right" rather than this is DS these are his issues.

I just feel everything I say to her is twisted and used by her to indicate her being right- regardless of whether they are more ASD or lang or if nothing at all.

I am not sure how to deal with this tactfully and in a way that puts my view across without her jumping on it and telling me she knows best or needs to discuss it with the team, I am also worried that with one team member strongly opposed it may lead to no diagnosis just an mass of issues, Diagnosis is key to us as my DS will need an ARP.

I am also worried about making a big song and dance about it and pissing the whole team off and all the hassle that tends to go with that.

I am going to get an experienced private SLT and not mention the Lang disorder stuff and see what she thinks.

But i have gone from feeling that I can mention anything to SALT to feeling very uneasy and don't trust her, DH even said well lets move his chair and let her see DS meltdown - but I hate the idea of doing this.

What would you do?

Have you had a paediatrician meeting? It sounds like you may need to quietly go over this woman's head

We had one on the second of Jan and the SALT did not attend and did not see DS before this as was planned. We were supposed to get a diagnosis then but it was just left ...... in space until they had the SALT report.

Spoke to the lead DR and he said we would get a diagnosis before the next CDC meeting in September - led both me and DS to believe it was just a formality.

SALT drops the bomb shell on her second vist - has already spoken to OT and has tried to speak to DS dr but she is on bereavement leave- they have a team meeting every month so they all see and discuss then.

I just don't know how to approach it with the DR ? can I ask for a meeting outside the CDC planned ones? without SALT? - (not sure how that will go down).

Did think of approaching the OT and having a chat with her- she does not visit us though as we have private OT input - but wanted to be weary of not pitting one team member vrs another - something I don't want to get involved in.

My DH is going to be here when the next SALT session happens as he can't see her way of thinking.

I may have got it wrong but I just felt very pressured by this SALT and left feeling uneasy.

ZZZZ-its not the Dual diagnosis I have an issue with, its not even that she may see a Lang disorder without ASD, its the not giving me straight answers to how they link together and turning everything into a lang disorder or a 2yr old thing.

ZZZZ- I have asked her and she said she saw elements of both, but today when I saw her and told her that his receptive lang and understanding has come on a lot, however his meltdowns with change to his routine had increased- she put it down to him being 2 1/2 - whilst I am sure there is an element of this to it some times these were not an age thing.

ZZZZ- The only thing that makes me see ASD is thats what everyone's told me, from ED psyc, Private SALT, OT both Private and NHS, Nursery, HV- I guess he has a cluster of traits that individually could be this or that but together they seem to fall under the big wide umbrella.

DS has copied speech and it was believed little receptive language- this has come on a bit and his understanding is better.

He has never gestured, pointed or nodded his head, the only reason I am worried is it is not a Lang ARP my son would be in due to his sensory issues it would have to be out of area Lang school or a special school, as our Lang ARP has a strict 50% mainstream Arp ratio, where as the ASD one is child specific so DS could increase or decrease depending on his need- allowing him the option of retreating in bad patches.

The only person who can diagnose ASd or not is the paed. My experience of SALTs has been that they know sweet f a re ASD. However if your child already has some speech, this early, I would myself be considering trying mainstream - though perhaps with support

Do you know what sickof that is what I am secretly aiming for although I have been told by everyone he won't cope- he has auditory processing issues and other sensory issues that would require more input than could be provided - unless they dramatically improve - I can see us having to fight hell and high water to get him in to mainstream with support - as It would be cheaper and easier to put him elsewhere.

Hi kyz1981, it's confusing when each professional looks at their field in isolation, that's usually why the Paed is there, to bring it all together and form an overall view.

I have to say, to start with, that your statement that "I can see us having to fight hell and high water to get him in to mainstream with support - as It would be cheaper and easier to put him elsewhere." is absolutely untrue, I'm glad to say!

The cheapest option by far is to have your DS in Mainstream school with 1:1 support by someone who has applied for a TA post with no experience and just having OT/SALT pop in to see the teachers once in a while.

Most people have to fight tooth and nail to get a place in a language resourced unit or ASD resourced unit or special school.

DD1's school is a special school, for instance, and every year they have far more people who want places than they can accept. Those who they can't take end up in Mainstream with support until such time as they are failing so badly that County has to find them a place somewhere.

Your LA may have more provision for language issues than ASD, so your SALT may be trying to help you. Do you feel you can have a general chat with her about him?

Thanks Polter - That sounds like a great idea and would help with what I want which is clarification and an agreed plan to go forward without all the tone and emotions involved in a confrontation. I also can come across l as aggressive but tend to cry and forget the things I wanted to say.

I wonder what would happen if you agreed with her that there's
"clearly a language disorder alongside the probable ASD",
and asked about the pros and cons of delaying ASD diagnosis till school age.

The either-or approach to diagnosis is a)wrong and b)prone to split teams.

Lougle - they have 4 ASD units and 1 ARP for Language, there is one special school and the rest are mainstream, I am hoping your right but whenever I have broached the subject of mainstream with any of the profs even the ed Psyc tells me he won't cope and he needs a unit at the least.

The SALT is nice but does not "get sensory processing difficulties" seeing them as either being 2 (smearing and eating) or just pandering to some degree of LD brought about by people trying to hide from the truth- when I mentioned ABA she nearly had a heart attack and told me all about the history of ABA, she - she is well meaning but old fashioned in her views, whilst I don't doubt her knowledge as a SALT with the specifics of Language and understanding - I do hold different views to her on DS especially with the sensory cause of some of his issues, she is not afraid to put forward her personal opinions.

I think this may be where we lock heads but seeing as sensory issues have been diagnosed by OT/PEAD - she can't say too much.

Gosh there do seem to be rather a lot of people telling you what to do! Fact remains that it is your parental right in law to opt for a mainstream place, subject only to the school accepting. Have you started the statementing process, in case a 1-to-1 is needed?

See, now call me tactical, but if I knew there were 4 ASD units and 1 Language unit, and I had a child with severe language issues +/- ASD, I'd be thinking the following:

Child needs specialist unit
If child starts in language unit and is found to need ASD approaches, that's far more easy to accommodate than if he starts in ASD unit and needs a move to Language unit.

My tactical move would be to allow this SALT her say. If that means Language unit, ok. Once you have an ASD diagnosis, most language units will not take the child, because they are meant to be an environment where great progress is made and the child moves on.

I think that this SALT knows that if you get an ASD diagnosis, the language side of things may not be given as much attention as it could do.

So, in short, I'd be thinking 'what is his greatest need' and go with that. If you think it's going to be the structure of an ASD unit, push for it. If you think it's going to be the language-rich environment of the language unit, push for that.

sickof is of course right. In all bar very limited circumstances, you have a right to opt for mainstream. If you think your DS would be able to access that, then you can exercise that right.

MareeyaDolores- Thats what I did tbh - the last time, because I DO see lang issues with my DS as well as ASD issues, the problem being in my humble view, is that he has no social communication or gestures at all - for example does not indicate by rasing his arms to be lifted, plays to his own agenda and I think if you have a child with a cross over- one thing can't be sorted out without consideration of another - for example she can work all she wants on his understanding of a cow, sheep, pig etc but if he does not know how to use that in a social context it will never get used unless to repeat when asked. Kind of hard to explain but I hope you get what I mean.

You are absolutely right, kyz. It's vital that any language gain is functional, not just demonstrated in isolation.

It does sound like he hasn't made the connection about reciprocal interaction, doesn't it? That's not easy for you.

Are you saying she knows what he needs language wise, but not how to teach him?

Do you have hanen more than words?

Lougle- that is a good idea, I can see where your coming from and I agree to some extent but I want something that's can change to meet his needs and where if he is having a bad day then he can retreat, there have been times when it first snowed where I was unable to leave the house as he was so freaked by it- on the second day I had to carry the pushchair to the front door put him in it and carry it to the car so he did not touch the snow,- he is better in it now thank god, but not sure how issues like that or his anxiety could be dealt within a school that has very set policy.

Sickof that's why I am so upset if I am honest its everyone telling us stuff - we get our heads round it then someone says something else and its a whole new thing with no consideration of the tears, and everything else that goes with it- I just want everyone to have an agreed plan -with DS at the front and his needs rather then everything else- I only give a damn what its called when it impacts on his education options and schools tbh.

I am in the process of applying for Stat ass as he needs 1-2-1 at nursery and HV is in the process of applying for a special Childminder for the holidays as he does not cope well and would give me time with his sister.

Nb this old SALT is quite quite wrong about ABA. It was the only reason my DS (ASD, LD, massive language delay, disorder, the works) has functional speech today

MareeyaDolores- I have more than words and have been working on joint attention and things since he was 15 months so some things the SALT sees are copied routines like ready stead Go... and stuff he knows but he would never come and get me to do it - unless he was taught to. He can give very good joint attention when he wants to especially with Night garden, puzzles but not with almost anything else- The SALT told me I need to play with diffrent toys and show him these, but they do this at nursery and this is when the problems start.

I think she thinks once his understanding is there that the social side will come - this is a little boy who would not even look at me despite me trying everything when I was BF him, so I don't get this theory - also my Dad was HFA.

Kyz

I wrote an article (helped by the esteemed Moondog) about battling through the SALT system and getting my boy to talk . Have pm-ed it to you. May not be relevant as think your boy has some speech already

Sickof - I know - she is outdated on most things and does not mince her words-I do not hold her view on ABA and have looked at getting DS on a program but at the moment funds do not allow us - However NHS SALT has agreed to work with a private SALT so intend to find one who uses an evidence based approach and has a more up to date view on things such as the listening program and ABA and other things that OT have found that work well with DS.