I've finally got DD2's paed report. It's a bit meh, tbh.

[lougle]

So, the long-awaited paed report has arrived.

Firstly, despite me telephoning to ask that they change her attended school and them confirming that they would do so, it's been sent to old school, not new school .

Secondly, it is fairly accurate but the conclusion is 'not overly worried about her, but would like to keep an eye. Didn't see ASD symptoms, but she is passive and didn't initiate conversation.

The referral to audiology is made but the referral to SALT isn't explicit, although SALT is copied in.

It majors on the clumsiness, etc., when I feel that it is language etc., which shows DD2's biggest issues.

Arrgh..I don't know. I had prepared myself for it to be a bit 'meh' but now it is...am I making a fuss over nothing?

The thing is, I'm not sure she ticks the boxes for ASD sufficiently, or at least if she does, she's v.hf. However, I'm certain there's some language problems and all the time she's sitting looking pretty, she's not learning as well as she could be.

I'm not even sure if he has referred to SALT. It's copied in to SALT, but it doesn't explicitly say 'refer to SALT'.

I would say delay and think about it for a week or two. It could be a blessing in disguise which gives you a chance to book a SLT of your choosing first.

'Managing' hf dc seeing the mainstream schools SLT service usually get the first few subtests of celf-4 as a brief screener, and are then discharged without further assessment as 'scores within normal limits'. The difficulties were informally spotted by dd1's SLT I think? You could ask her if she does private assessments, or knows anyone she'd recommend.

If theres no money and its the same LEA/trust, it might be worth making waves to try and get the same therapist (they'll say wrong team, wrong age wrong sector whatever, but persistence often pays off )

Thanks polter, I didn't take offence! I was just saying that I also realise she's not clearly one thing, but I do think something needs seeing to

Mareeya, yes a SALT from DD1's school and another SALT I have great respect for have both said that my quotes from DD2 indicate quite significant disorder and that it needs looking into.

I get confused myself

I know what you mean. Her speech is very formal, I think and not like other children I know. It's pedantic. It seems that she doesn't come across that way at school though (I think because she lets other people do the talking and blends herself in).

For that reason, I'm doubting that even a SALT will pick up on it in person, because they have what, 30 mins? She'll probably just say 'yes' to everything

Lougle, you know what I am going to say! Much as Polter has, that the language you've reported here is so similar to my dd2 who is very probably going to be formally diagnosed ASD.

We had a 2 hour assessment of dd2's language by private SALT. She stopped assessing quite early on and changed tests when she realised that the disorder was severe yet not easy to pick up from the 'usual' tests. She warned me that NHS would struggle to detect the severe problems with their tests, and she was spot on, NHS could not see it.

Also since aged 4 SALT, Paed, me, HV, nursery, SENCO have wondered whether my dd2 is on the spectrum. We have been on/off with this for four years. It has sort of 'unfolded' and now it seems she is.

Dd2's language (interpretation and use) remains strange at times but is now streets ahead of where it was. It required 9 months of intensive and expert help to develop language and facilitate learning. To me it sounds as though your dd2's language needs similarly thorough investigation. Give the Paeds office a call and do what you need to do to get a tip top language evaluation.

Thank you, Handywoman. Can I ask what tests your DD's SALT changed to?

Just looked quicky at reports from 2009, when dd2 was 4yrs 1month old. Her private assessment was a mixture of Preschool Language Scales-3 and some of Derbyshire Picture Test.

NHS assessed by asking the famous 'put the spoon on the table' and (I quote the report) 'briefly with parts of Renfrew Picture Action Test'.

Thank you

Reading the NHS report brings to mind what MareeyaDolores mentions upthread. The 'put the spoon on the table' questions that made up the bulk of NHS assessment is little more than a screen. This can mislead folk into thinking that all is well. Dd2 passed this screen with flying colours despite severe problems (receptive language more than 3 standard deviations below the mean).

There are a few things going on, I think.

DD2 woke up about 30 minutes ago. She was hungry so DH suggested 'a glass of milk' and she heard something completely different. So, I'm not sure why, but she mishears quite regularly.

She also doesn't differentiate between comments addressed to her or about her, vs. comments addressed to another person but in her hearing. So she often gets cross because she thinks we're talking to her and we're not.

But she would pass with flying colours anything that was concrete and direct. So, put the spoon on the table, identifying nouns, etc., would be absolutely fine, because it's just recall. The difficulties come when she has to formulate responses or with more abstract concepts.

There the issue lies. Every time I explicitly teach her something, she learns it, because she is a bright little thing. This then hides the fact that had she not explicitly learned it, she wouldn't be able to pick it up and absorb it as other children do.

Today, she said 'good bye' to a lady we know. She turned to me and said 'I said good bye and looked at the lady when I said it, Mummy.' That's because I explicitly taught her 'eye contact: good bye'. Of course, the paed letter says 'appropriate eye contact.' Well, yes, because I've taught her 'look at someone if they speak to you.'

We taught dd2 eye contact also, Lougle with help from our private SALT. She learned, 'touch on the arm means look at the person's eyes' very Pavlov dog style, day after day, week after week, month after month. She can often have that 'stiff gaze' though, particularly when animated.

dd2 also struggles with passing comments. She historically misheard a lot when younger, partly due to poor joint attention and lack of eye contact (therefore struggling with consonant sounds).

You are right, Lougle there seems to be a lot going on.

I think the mishearing can also be an element of pragmatics, e.g. what sort of thing is your Dad likely to suggest when you wake up in the middle of the night? Kids who struggle with pragmatics are really clutching at straws a lot more when listening, because they aren't generalising as efficiently from contextual cues.

I think I might have to, Justa. I can't afford to, mind. But I think you're right, nhs may not have the time to delve into the complexities with a child who is superficially ok.

A rubbish evaluation is worse than useless. Compare 30 min of 'Where is the green cup?' with this

That's made my heart sink, mareeya. I understand what you're both saying. Provision is so patchy. But then you get someone like moondog, who I'm sure would pick up these things and I think Arrrgh, because while I could possibly scrape together enough for assessment, Icertainly couldn't even entertain private therapy.

Thank you both. zzzzz, I agree with you, in essence, and I know that Moondog has posted similarly before - a label is not what I'm seeking, in the sense that I don't see DD2 as being a statement/DLA/'services' candidate as things stand right now. So, in that sense, I don't need a 'label' to secure those things.

However, I only discover that DD2 has difficulty with something when a mix-up happens and she gets really cross because she's heard things differently or misunderstood in some way. Because she is quite passive, if she doesn't understand in general, she just keeps quiet or moves on.

What I am seeking is a clear picture of a) what the difficulties are, rather than what problems those difficulties cause in day to day life (I can see those) and b) What I can do about it, preferably in a SMART way and, crucially, what I can do to help school recognise that "nice" "compliant" "August-born" is not necessarily a child who is achieving her potential, or even her 'norm' without such difficulties.

I feel that if I don't get someone to recognise her struggles and help me (and school) to set the right foundational concepts, etc., then there could be bigger problems later such as self-esteem/mental health issues and that we could get to a point where it's too late to fix it 'easily'.

At the moment I feel like at best I am 'scattergunning' the issues as they come. At worst, I am missing things because I don't realise they are an issue until she melts down.

For example, if a child says to DD2 'my teacher's really nice, is yours?' DD2 would say 'yes' and think that the child has a nice teacher. If the same child said 'my teacher's like Miss Honey (from Matilda)' DD2 would think that the child was saying that she had a similar (or same) name and the same hair colour and type. She doesn't understand 'like' as in 'similar to in personality', she understands it as 'looks like'. As she has a pecularity of describing people by their hair, she extends that to 'has the same hair as'. But I only know this because I happened to say 'is your teacher like Miss Honey?' in the car last week and got an indignant 'NO! Because Miss X has a different name and different hair!!' If I hadn't said that, I wouldn't know that that's how she sees it.