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SALT assessment opinions needed

34 replies

maddiemo · 13/06/2004 21:26

Ds4 is 2yrs 7mths. He has three older brothers one of which has autism.

I have had mild concerns about some aspects of ds4s development. He has many behavious which are on the autistic spectrum but does not seem to have an autistic personality( by which I mean he sems fairly switched on and with it as opposed to ds3 who often seems blank.)

He was referred to SALT and we luckily got a cancellation. At the assessment he refused to look at the toys and took off his shoe and played wuth the buckle. It took a long time for the SALT to get him to interact in any way. She feels that his comprehension is at a two year level and also his language. What concerned her was that his communication, listening and attetntion skills are considerably more delayed. I did not ask as I was shocked at how poor he seemed. She feels he only uses language on his own terms, which is true. He can say "want biscuit" and other two word phrases. However he mostly just whines or screams for things and we have to say to him "out swing" or whatever and he will then repeat it but will not spontaneously use it. He is not consistent on namimg common animals and seems nowhere near recognising colours. When she did get him to interact he would not follow her instruction even if he could understand it. Everything he does is on his own terms. For example he could understand "Give me the fish" but would pick up the bird instead. He could not follow "Put dolly on chair" etc.
He spent a large part of the session trying to escape and whining and saying "lets go". He acn use longer phrases but I can tell these are learned. The SALT said he has good eye contact (but so does autistic ds3). He has been referred for some SALT sessions.

To be honest this appointment was him at his best. We have been seen by audiliogy twice where he has been so distressed they had to open the door and let him out of the room as they were afraid he would injure himself (throwing body against door, banging head on it way beyond calming down). He has also been seen by ds3 paed who could not get him to interact so I had to carry out the tasks. Ds4 was also very distressed at this appointment. The paed did not seem too worried but noted that he had some behaviours and will review at three.

I am not really sure what to make of ds4. He says hello and bye unprompted. He seems with it and perky. He recognises people. He imitates well but cannot yet extend this. When playing with trains he makes choo choo noise. He goes to mother and toddlers, he seems fine but will shy away from children if too noisy and always spends part of the session laying on the floor staring at ceiling.

On the down side he spins objects, lines up and flaps (although the flapping may be copying ds3). His speech shows no sign of becoming conversational. He often lays his head on the floor sideways or upside down and runs cars or trains through his line of vision. He has a lot of routines although these seem about dominance rather than security(for ds3 routines are definately about feeling safe). He has masses of tantrums although they are pretty much over not getting his own way. He is very repetive and will say "want biscuit" over and over until biscuit is in mouth. He gets very distressed when the hairdresser comes to our house,she is unable to cut his hair. He will not allow GP etc to touch him. He will only look at books on his terms.

I could go on and on ( in fact already have).

Any opinions or advice welcome. My head is spinning.

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maddiemo · 21/06/2004 21:43

BH I am not really sure about this myself. I think it is about senses co-ordinating. My ds4 cannot play with a toy and respond to langauage at the same time. He over reacts to many everyday noises. He strips off his clothes and seems to find them hard to tolerate. He does seem quite social in one to one but finds groups hard work. He gets very distressed when we walk into a room and the door is shut behind us.

I know it can exist in many children with autism, cp learning difficulties, communication difficulties. I am not sure if it exists as a diagnosis on its own. It was the SALT that mentioned it to me so maybe you could ask dd's SALT about it. When we get to see the portage people I will let you know what they say about it.

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janthepan · 21/06/2004 22:03

I've been reading this thread and can only offer sympathies to you all...you see I am an SLT adult neurology specialist she adds hastily, it's a good 12yrs since I worked with children. My middle son has dyspraxia and is statemented, we've just found out that his assisted hours are to be cut from 10p/w to 5, in the meantime he struggles and gets so frustrated and lashes out and I get cross and it all escalates. I guess what I'm trying to say is that as a parent you know your child best and any SLT worth anything should know to take notice of you (fab grammer there!). Find out as much as you can and be assertive, which is dead hard when you have a child with SEN...I find teachers the hardest and I married one! Good luck to you all

blossomhill · 21/06/2004 22:08

Thanks Maddiemo

Jimjams · 22/06/2004 13:39

maddiemo- it can be diagnosed by itself- The book the out of synch child kind of separates it from all the other disorders.

Hang on until BIBIC- they are great for sensory stuff.

maddiemo · 22/06/2004 18:22

Jimjams Thanks, I will look out for the book. Do you know who a child would need to be seen by if a diagnosis was necessary?

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Jimjams · 22/06/2004 19:56

not sure- probably OT and paed I would guess.

maddiemo · 13/09/2004 13:18

We have just had our Portage assessment.

Ds4 came out at 18 months receptive and 2yrs expressive for language. He is 2yrs 10 mths.

We decided not to go for Portage visits as I have most of the activities from DS3 and am already using them and do not feel in need of personal support. Instead we are going on the waiting list for one to one support at nursery. The Portage teacher felt that nursery would be make or break for him and give them a real opportunity to assess him socially.
She will chase up SALT and said that she felt he would be a candidate for her language disorder group, but that he cannot go on the waiting list until 3ys 4mths and that the referral must come from SALT as health finance the placement.

Looks like it is back to the waiting lists then. He is making good progress though, so I don't feel too concerned at the moment.

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Davros · 13/09/2004 13:52

What is a waiting list for 1:1? I didn't know there was such a thing but I no nothing about m/s schools

maddiemo · 13/09/2004 14:36

Davros

He will attend a mainstream nursery. The LEA will fund a 1:1 support assisstant for two nursery sessions a week without the need to resort to a statement.
I think this is a fairly new program and is all to do with early intervention for sn. It was not available for my ds3 in 2001. He attended a mainstream nursery unsupported for a year and then transferred to a sen nursery when he could no longer cope mainstream.

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