Full developmental assessment with Paed on Wednesday, what to expect?

[susie40]

This is for DS 3.5 who has speech delay and hyperlexia. He didn't have a 2.5 check as they didn't do them in the borough we used to live in. He's seen a SALT and DH and I are currently on Hanen course. This appointment came from referral by HV, really we just want to know whether or not he is on the spectrum and if so what sort of extra help he should be getting.

I'm sure lots of you must have been through this, so are then any questions I shouldn't forget to ask? And are we likely to get dx then and there?

Hi Susie
We went through similar assessment with our ds2 age 4 a few months ago.
His assessment was carried out over several weeks with weekly multi disciplinary appointments. Basically it was a large playroom with a few families all with a child being assessed. Each child was observed by a developmental paed, Clinical psych, occupational therapist, physio, SALT & playworker (plus some students). It was structured similar to a playschool with some freeplay & a more structured activity each week the majority of time was spent with a different professional each week & some more formal assesments were also carried out on a 1 to 1 with each discipline. Also loads of opportunities for questions between us all, At the end we were given feedback & a reports of identified problems etc.
I am sure it varies from place to place but it was very thorough & not at all intimidating all made to eba s relaxed as possible, although I was exhausted by the end DS2 seemed in the main OK with it.
Good luck with your appnt.

Here we have an initial assessment with the Paed and then get referred for a full multi-disciplinary assessment if the Paed thinks the child needs it.

The way the Paed appointments work here is that you sit in the Paed's room with your child and answer lots of questions about your child's development, whether you had a straightforward pregnancy etc. It's worth taking some notes with you to refer to. You've probably answered all these questions before but still have to go through it all again unfortunately. While the Paed is making notes they also observe your child to see how they behave. Ds1 spent his appointment making lines of train track and throwing things at the door. Ds2 spent his under a chair flicking the power socket on and off. They will be looking for things like what your child does with toys, whether they come and show you things and share their interest, how/if your child communicates. They may also be looking at how your child moves and their fine motor skills. They measured head-size and gave a general physical once-over. In some areas the Paed will want blood tests to look for things like Fragile X. Ours didn't. At the end of ds1's Paed appointment we were asked if we had any ideas about what the problem was. When we said ASD the Paed said that she agreed but that ds1 would need a full assessment to confirm it. With ds2 (different Paed) we were told that ds2 certainly seemed to be on the spectrum but that he too needed a full assessment. The Paed didn't make ds2's dx official until a year later. Ds1 was given his dx at the multi-disciplinary assessment.

The multi-disciplinary assessment involved seeing professionals for an hour-long appointment. They usually paired up for this. The Child Psych and SALT set up puzzles and games and looked at story books with each ds. The OT had lots of games and puzzles which she used to assess fine motor skills with. She also helped us to fill in a questionnaire about sensory issues, which she later graded. The Physio had balancing equipment and slides set up so that she could assess fine motor skills.

I think the big question to ask is "What happens next?" You should ask what kind of help/therapy your ds will be given. Ds1 got very little help other than SALT but ds2 was offered sessions in the sensory room and the professionals all help the pre-school staff and SENCO with ds2's IEP targets as well as SALT sessions. If you are given a verbal dx then ask when you will be sent it in writing. It will make things easier for you when you have something on paper. I would also ask about what level of help is available when ds reaches school age. Often you find that there is a lot of help given at pre-school age but that it disappears when your child starts school. Our Paed campaigned for a long time to get extra services put in place for school-age children so there is now more available here than there used to be.

Write down any questions you want to ask the Paed, otherwise you may forget as soon as the assessment starts.

Good luck.

The ideal is a multidisciplinary assessment, but doesnt happen everywhere.

Where I work the paediatrician sees the child then decides who sees tham next, unless its an obvious case for physio, salt etc, in which case they might see first.

IMO better if everyone sees then you dont get something missed out - eg sensory issues missed because Paed didnt think OT neccesary.

Good Luck!

Obviously the Physio assessed gross motor skills.... doh!

Hmm, not sure if it is just the Paed or others too - the letter says it may take up to an hour and a half so maybe he'll bring other members of CDT in if he thinks it necessary. Coppertop, great idea about writing down a list of questions, I'll get on to that tonight.

The main issues apart from the speech delay are (1) sensory stuff, very picky eater and refuses to wear coat (2) he can read, until recently better than he could talk (3) obsessed with hot wheels cars and the multiplication tables

Your ds sounds like a cross between my ds1 and ds2. Ds1 used to randomly read out words from around 2yrs old but didn't really talk until 3ish. Ds2 is the coat-refuser and loved Hot Wheels (now replaced by Transformers). Both are very picky eaters and love numbers and maths.

coppertop, I have a series of photos I took of DS in Woolworths at about 2.5. Told he could choose a toy, he ignored everything else in favour of a poster of the times tables which he spread out on the floor in the middle of the aisle and studied avidly for ages. Hot Wheels didn't come till a few months after that.

I put all the number posters up in the loo in the hope it would encourage him to use it - he just puts the lid down, climbs up on the seat and starts reading out the sums.

LOL at ds just putting the seat down and reading the posters instead!

Just in case I'm not around before, good luck with the assessment. xx