Pead Report should i write and clarify

[OMGGG]

ive been posting a lot lately so apologies...

ive received a report from paed and one paragraph is causing me concern, am i being over sensitive?

it writes....
we agreed that DS would complete a task and recieive a hug and a well done from his mother. in return she would do the same, so thst DS has the opportunity to givr her a hig on occasion to.
we discussed that DS is possibly trying to excert an element of control over his home environment, but currently only knows how to do this through challenging behaviour. he therefore needs opportunities to be good and helpful, which are positively rewarding with parentsl warmth since at present the only reaction he gets is negative, because of his poor behaviour, which may further reduce self esteem and therefore tesult in further demands for attention.

now i may be being ridiculous but i al not happy about this part as DS is always given warmth and affection and more so because of the difficulties i know he has. i know he is not behaviouring like this because he is a naughty child and being delibrately aggressive so i dont trest him as if he is. i am firm, but i pick my battles as some are not worth the fight. his behavioir stems from frustration and his difficulty to express his feelings and having to switch from one task to another ie stopping doing lego and eating dinner, going to bed etc.
i play classical music to cslm him use reward charts reassure him hug him tight and lots of praise.

should i write to clarify this or leave it. i get the deeling from appointments with her thst she thinks im a crap mum and its not true.

Seem you are not happy with it being implied that it is the only reaction he gets?

You could write and ask for the word only to be removed.

so it reads "which are positively rewarding with parentsl warmth since at present the reaction he gets is negative, because of his poor behaviour, which may further reduce self esteem and therefore tesult in further demands for attention"

my ds displays 'challenging' behaviour (ie self harming) to get my attention, as he cannot express himself or put into words what is bothering him.

My ds displays this behaviour as its his way of having some control over his emotions, feelings, environments where he feels he has no control, no choices (ie school).

However it is recognised that he has ASD and associated problems, which are ultimately responsible for his difficulties.

So I suppose it depends on the tone and context of the rest of the report as to whether she is saying parents reaction is responsible for the challenging behaviour or child displays challenging behaviour due to x,y,z and parents need to be careful how they respond to it.

thanks that is teally the only bit about challenging behaviour in report the rest of it seems ok and highlights strenghts and weeknesses.i will wait until i next see her and speak to her about it then.

she doesnt seem to listen very much to what i have to say. however im sure the communications disorder clinic will be thorough although the report says ds will be seen by her at the cdac.

If you not happy with what is written, if you think she has misunderstood or not listened to what you have told her, then write. She may or may not change her report, but at least you will have a record of your disagreement with what is written.

Just be very precise with what you want changed and why.

The point she is making is a valid one (I have no idea if you think this applies to you or your ds though), IF your ds does display challenging behaviours, IF you respond negatively to this behaviour. SOME children MAY display challenging behaviours as a way of seeking attention and controlling their environment. When children behave poorly and we do respond negatively, it becomes a vicious circle. Attention is attention for some, good or bad etc, etc.

IF that was written about my ds, I would disagree with it as although I am aware and need to be aware that he displays challenging behaviour to get my attention and let me know that he is not happy. My response isn't the cause of his unhappiness. Me not giving him enough attention isn't the cause of his attention seeking. It is his way of communicating his unhappiness to me. So his difficult communicating, is the cause of his challenging behaviour. If you see what I mean.

well thsts what i think aboiut my ds - he is frustrated because he cant communicate his needs to be. the behaviour stems when he is task changing or stressed it has nothing to do with me being negative to him. i sm aware of his needs more than anyone.
i dont think this part of the report reads like this.

we are continuing with this nhs service for a second opinion re private dx. can i request to be referred somewhere else at this stage? im not comfortable with this paed. i would like to get a referral to GOSH, my private psyc told me i should request to see the HfA centre they have there.
do you think it is reasonable to request that the second opinion is carried out with them rather than local paed.

plus ds agressive behaviour only occurs at certain times when he is expected to change activity/task. he is the sweetest boy the rest of the time.

PM'd you

Deffo contact to put on record you are not happy with what was written. Even if she doesn't change this. I've done it in the past.

Its hard to second guess what this paed may or may not be implying without having read the rest of the report and the context of her comments and knowing your ds and his diificulties

For example a CAMHS report I have says it CAN be a learned way of controlling the environment. So adults (not just parents) around him need to be aware of this and how they respond as this could enable the behaviour.

However the rest of the report makes it perfectly clear, that his ASD and confusion around social understanding, interaction, difficulties expressing himself etc is the cause of the behaviour and the self harming is his way of communicating and managing his anxiety and confusion.

Within that context its a helpful comment. If that comment was written on his own or without identifying the possible causes of the behaviour, it could be unhelpful and open to misinterpretation.

You are there for a second opinion to identify the cause of the behaviour. Does she try to identify the cause of his behaviour within her report? She is referring you to investigate further to try and identify the cause?

Do you feel it is more an advisory comment, until they investigate further?

If not write and ask that the comments be reworded to give a true reflection of what you actually told her.

she did say to me that ds is showing many signs but she has to investigate further i guess.
the report talks about what school say what SLT said what private dx says then goes on to the para above. personally i think the rest of it is fine but i dont like that paragraph one bit. my ds does not only get negative reaction from me. also she mentions that my husband goes out everynight and i have to do it alone. she asked me about this and i told her husband goes to the gym and she said so the burden is all on you and i said its fine im happy for him to go to gym . why did she add that?

Break the comments down and decide what you want left in and what you want reworded and then ask politely for it be changed. So;-

"we agreed that DS would complete a task and recieive a hug and a well done from his mother. in return she would do the same, so thst DS has the opportunity to givr her a hig on occasion to"

Is this what you agreed with her? if so, leave it in, if not say this isn't what you agreed to, its inaccurate and what you did agree to.

We discussed that DS is possibly trying to excert an element of control over his home environment, but currently only knows how to do this through challenging behaviour. he therefore needs opportunities to be good and helpful, which are positively rewarding with parentsl warmth since at present the only reaction he gets is negative, because of his poor behaviour, which may further reduce self esteem and therefore tesult in further demands for attention"

Is this what you discussed with her? if not say this isn't what you discussed, its inaccurate and tell her what you did mean or what you did discuss.

"also she mentions that my husband goes out everynight and i have to do it alone. she asked me about this and i told her husband goes to the gym and she said so the burden is all on you and i said its fine im happy for him to go to gym . why did she add that?"

Because that is what you told her and she has formed an opinion based on what you said. That is what she is supposed to do, gather all info, analysis and form an opinion.

thanks claw. i dont see what my husband going out has to do with it though. but thats fine really.
she did tell me to give ds a hug and well done after he has done something well but i do that anyway and i told her that im also using a reward chart that tends to be working.

a big fuss is made when ds d

ds does good on something. i dont need her telling me how to praise my own child. maybe im
being too defensive.

i also told her that i had done a behaviour chart for over a month and the behaviour is stemming from change of routine/task/activity.

she asked me what i do when he behaves like this i told her there is no point getting cross as the behaviour gets worse , im firm and remind him its time for bed or time to do whatever and im using timers and breaking things down slowly and in bits for him which seems to help.

yes she did say all of the above that she has written but she said it over me and didnt listen to what i said.

she hasnt mentioned about the timers or the rewards akready in place for ds.

i got the feeling from the appointment and our phone call that she was implying something. i even asked her on the phone did she think it was my fault and she said no, she is sure i am a very good parent and that she can see i love ds very much and want the best for him.

If you didn't feel listened to, then there is absolutely nothing wrong with following up what you wanted to be heard or what you were trying to tell her after the appointment.

You can be very polite about it and explain you would like it reworded to give a better reflection of your ds to avoid any confusion.

For example ""we agreed that DS would complete a task and continue to recieive a hug and a well done from his mother. in return she would do the same, so thst DS has the opportunity to givr her a hig on occasion to"

Could you please include 'continue to' as I explained this is something i do already, along with the reward chart etc, etc.

"We discussed that DS is possibly trying to excert an element of control over his home environment, but currently only knows how to do this through challenging behaviour. he therefore needs opportunities to be good and helpful, which are positively rewarding with parentsl , to avoid further reducing self esteem and therefore tesult in further demands for attention"

Could you please remove "since at present the only reaction he gets is negative, because of his poor behaviour" As i explained, ds gets regular positive praise and attention and i am already using positive reinforcement strategies such as x, y and z.

Something along those lines? or you could leave is as it is and not ask her to change what she has written, BUT for her to insert a paragraph about the strategies that you are already using.

"Mrs OMGGG has already put in place some positive reinforcement strategies such as x, y and z which she says are having a positive impact on little OMGGG and improving behaviour" kinda thing?

thanks claw, im going to do what u have suggested politely.

thanks so much for taking the time to assist me with this.

im a bit soft and i think people see this and take the pee out of me but i have a hidden strong side where it comes to messing about or anything to do with my kids.

also i havr another child who has been raised the same way as ds who has no such issues.

hopefully paed is right private dx is wrong and ds is shy and socially delayed thats all. i doubt it though. a mother knows when something isnt quite right, always have.

did i say already i spoke to gosh they said i am within my rights to ask for referral to them, i am going to.

any ideas on how to broach that one with paed?

is broach even a word...haha

thank you massively

also i think paed is against labelling children as kept saying that labels arnt important and why would i want a label and that too many parents seek a label because they rhink that they will be entitled to help and actually nothing changes

i just need to know what the correct dx is if there is one so i can help the best way i can. plus i feel it may open doors if not now later on in life if things become more noticeable or more difficult for ds

Trust your instincts.

A label does help, although it shouldn't, support should be given on a needs basis, it often isn't. Support is usually hard to get and a label can make it easier or clearer for everyone concerned.

This paed has already told you the private dx is wrong?

I don't have any experience of GOSH, however if they have told you are well within your rights to ask for a referral to them, did they say who can make the referral?

Most referrals can be made by your GP, i would be tempted to ask my GP for the referral if poss and by pass paed. You can inform the paed at a later date after the referral has been accepted. Keep your options open.

yes claw im going to see my lovely gp tues he is very good and i know he will help if he can. hopefully i can bypass paed for now altjough gosh will liase with her for on going appointments etc if dx is given as they just do the dx.

ungenuine dx was paeds exact words.

cost me £1200 - grrrrrr

if i have to go private again it will only be to gosh i think.

do u think it looks bad to go seek another private dx if i cant get the referral. paed might think im off my rocker keep assessing ds. just want someone who knows what they are doing thats all and that listens to me.

i really need to stay within the nhs system

How does this paed know the dx is wrong BEFORE investigating?

Why has she referred to child development clinic?

What criteria will the CDC use?

What criteria did private dx use to give dx?

Why are you asking for a second opinion? do you think private dx is wrong?

Why would you seek a second private dx, if you already have a private dx?

just her personal view swayed by senco

possible because i said i wanted nhs dx

multi displinary, ados

cognitive and objective assessment, school and clinic obs, cars2, adi, ados

wanted nhs dx important to get so asked for them to proceed

because paed is doubting

paed is seeing ds in cdac next appointment - she will play a big part in this process, she is already biased in my view

It just seems a bit pointless already having a private dx, going for a nhs dx, then going for another private dx.

Unless i have misunderstood, you got private dx, you agree with it, however you ask for a second opinion?

Who wasn't accepting your private dx? and what makes you feel that they would be more accepting of a second private dx? Seems the process is going in circles or maybe its late and its me

lol its not you. i need the nhs dx so that had to be done. i will write to paed about report then we will wait see what cdac assessments bring us. if it conflicts with private dx i will def seek gosh referral - think this would them be tier 4.

this makes sense doesnt it?

however i originally was going along the lines of getting private dx again from someone so credible that it could not possiblr be ignored. ie prof david skuse

should i add on my letter to paed so she is clear that i totally agree with private dx, etc