Best route to diagnosis - GP or school?

[roisin]

OK, after much prevaricating (on and off for the last 4 years - much of it on here) we've finally decided that we need to get ds1 assessed. We believe he may have Aspergers, but probably on the milder end of the spectrum.

Oh wise ones: What's the best route to a diagnosis? I don't know the difference between ed psychs, developmental paeds, clinical psychs ...?!

We get on really well with school, so am quite happy to go through them if that's the best route. But that means it may take a while before we get things moving.

I've hardly visited the GP since we moved here 2 yrs ago, so don't have any relationship there; but will go that way if that's better.

Can anyone advise me of the pros and cons of different routes: I guess we're most interested in accuracy of diagnosis and subsequent advice, but also the timescale it will take us to get to the end result.

Money: We are not well off, but are quite prepared in these circumstances to spend some money if that will achieve a better (or unbiased) end result, or a much faster one.

How old is your ds Roisin? If your ds is under 5 then you can ask your HV for a referral. If not then I would say your GP.
For a very accurate diagnosis I would say that you would need a referral to CAMHS (child adolescent mental health services) or even a multi-disciplinary panel. Do you have a CDU (child development unit) near you as we unfortunately do not have one near us.
I am not sure about the ed pysch as we did see one to help with statementing but it was camhs, developmental paed. and the salt who eventually dx my dd.
I am sure that talking to your gp first is probably your best bet. Have the school mentioned anything to you?
HTH

Blossomhill - Hi! Thanks for posting.

DS1 is 7. He's actually OK in the classroom, within a very formal setting with superb, very experienced teachers. But I have had numerous discussions with staff about his behaviour outside the classroom, and outside of school.

This summer he seems to have drifted further apart from his peers in terms of 'normal behaviour', and people are starting to comment and the funny looks he's been getting for years are becoming funnier and more frequent.

If I go to see the GP for a referral, do I have to take him with me? What will the GP want to know? I don't want to discuss things with the GP with ds1 present. Should I just make a normal appointment?

I'm feeling quite emotional about this. I feel like I'm journeying into another country where I don't speak the language, and I've been avoiding having to visit for years

As a teacher, if I am approching a parent, especially if my concern is something 'mild' and something which is difficult to put your finger on, I sometimes subtley suggest that as the school goes through the ed psych root that perhaps the parents go through the GP route too.

If school starts it off, there may have to be some medical assessment at some point and it often speeds up the process if both avenues are pursued at the same time.

If as you say, any problem is mild, I would go to your gp with your concerns and tell him/her that you are going to approach the school too - and when you get the kids back to school, have a chat with DS's teacher - or last year's teacher would be een better.

The school will have plenty of experience of this sort of thing.

Hope this helps - good luck!

Thanks popsy that's really helpful.

omg - the ed psych root should be ROUTE obviously - blame the pregnancy brain!
good luck roisin

Roisin, I'm so sorry about the way you are feeling right now, it must have been a huge step for you to decide to get things checked out for ds1.
I know me situation with dd is completely different but at the end of the day, you will know one way or the other, you can work around any problems as/ when they occur or put it to the back of your mind otherwise.
Surely half the emotional rollercoaster is down to the uncertainty isn't it.

BTW, the games have been brilliant, will put chq in post tmrw.

Hi Roisin!

I have a dd aged 5 who has a speech and language disorder so do know exactly what you are going through. I can only say that the last 3 years of dd's life have been an emotional rollercoaster. I feel exactly how you do roisin that this is a club I do not particularly want to be a part of. On a positive note though once you do face up to things and your ds gets the help he needs then things do start to look up!
I would go to the GP alone first of all and if he wants to see ds then take him along at a different time. Maybe explain briefly to the receptionist and see how long an appointment you need. I know how you feel about talking infront of them it's hard isn't it?
Good luck and please keep posting.

Thanks you two!

Blossomhill - on another thread you mentioned a speech and language site, but I couldn't find a link. I'd be very interested to have a look at it if you can post the address.

Dingle - I'm delighted the games have found a great new home!

roisin the link is:-

spdlanguage disorder site

This is another good site for asd, very informative:-
asdsite

Hope that helps

I too would recommend following both routes - by all means see the GP without your son first, then he/she may ask to meet him at a later date, or may just write off to a colleague on the basis of your description. Having reached the point you're at (ready to embark...) it's worth getting on with it and taking up whatever is offered - you can decide later on whether you want to follow on with a (maybe private) second opinion.
Our ds1 was diagnosed with Aspergers 18 months ago, and overall life has become easier...

I am in the process of getting ds1 assessed although as he is only 4 we went via the health visitor who apparently spoke to the GP who then does the referral. It didn't matter that the GP has never met my son and the health visitor hadn't seen him since he was 15 months as we moved away 2.5 years away and have only just moved back. I should be thankful that the HV listened enough to take me seriously when I expressed concerns about ds. I suppose given your son's age that you could go straight to the GP. The referral has resulted in an appointment with a paediatrician at the local hospital who did a basic assessment on him and has now referred him to an occupational therapist (he could have dyspraxia) and a clinical psychologist. The GP referral also resulted in a speech therapy assessment for next week! (We are certainly getting our money's worth out of the NHS at the moment)! Unfortunately we are told the waiting list for the clinical psychologist is 12 months so that isn't very helpful as ds starts school in 4 weeks and obviously we want to know the best way of helping him settle in and make the most of it.

I would leave your ds at home the first time you see the GP. The paediatrician talked about our ds when he was assessed and I must say that we weren't very comfortable with it - he may have some strange behaviour but he isn't stupid and it isn't nice to be talked about particularly as he is a worrier and probably wonders what is going on. It is a shame that there wasn't a nurse who could have taken him away and distracted him for five minutes but there you go.

Somebody suggested to me on another thread that we approach the school for an educational psychologist assessment too but I know nothing about the process. We will be meeting the teacher next week so maybe we should mention it then. I don't know if that will lead to some quicker action but I suppose it depends on the area you live and the resources available.

If you want to go the private route the BPS (British Psyhcological Society) website can give you details of trained educational psychologists in your area. The website is www.bps.org.uk but that seems a bit of a lonely route to go on and what do you do with the assessment when you get it? Do the schools have to take the recommendations into account when presented with them?

Hi, roisin - got your text from Saturday too late to pass it on, due to poor reception and empty battery - anyway FWIW, if it helps, I didn't find your DS1 too different from "normal" when we met last week...
Obviously that was a fairly brief encounter but, still, good luck with whichever route you choose.

Thanks JanH - that has really cheered me up. Last Tuesday was as good as he gets, and I thought he was pretty 'normal' then too. But sometimes I wonder if I see him objectively or not.

This summer the boys spent a week with my parents (without me), and when I picked them up I was quite shocked by ds1's mannerisms and behaviour, and various sn indicators. And it did make me wonder how he appears to other people.

Hmmm.... Just wrote a description of his behaviour, and it sounds really awful. (And makes me seem completely bonkers for not taking him for an assessment years ago!)

Sorry, am not ready to post it on here yet.

Aww... dinosaur, what a lovely post That really cheered me up - well that, and the fact that he's been absolutely delightful today, a real pleasure to be with.

I'm now steeling myself to run the gauntlet of dragon on the desk at the surgery to make an appointment with the GP.

have been reading this thread and Roisin, what you say about journeying into a country you've dreaded visiting is such a perfect description . Our daughter is 4.5 and I've been concerned about her for the last 2 years, since we had our second baby and there was instantly such a marked difference in the way they communicated. I tried to push for some kind of assessment with my previous HV but was told that no, because she was doing imaginative play there was no way she had any kind of asd and also she didn't really take me seriously because I had postnatal depression. Think she thought I was being paranoid. But there are loads of things she does which just seem SO different to her 4.5/5 year old peers, and so many things that we have to do to deal with her which none of my friends have to do with their daughters. However all anyone ever does is scoff when I mention it and say 'but she's so intelligent - that's all'. I have a new HV now and so am half-thinking that perhaps I could get somewhere with her, but my last HV was very much of the opinion that if there was something, it was mild and what benefit was there to giving her a label for the rest of her life? Oh I dunno, I have done one of those lists previously of dd's behaviours so I cam imagine how you're feeling Roisin. Rambling, sorry, haven't really put this down in words before and it's v hard to do, but I just feel like I've failed her somehow...

Roisin, I just wanted to say that I did the same as you and wrote a list of all the behaviour that seemed to be a bit odd. It was not nice to see it in black and white but at the same time it did mean that I knew I wasn't just imagining things and I didn't forget anything when we had our appointment. I gave it to the paedatrician a couple of weeks ago and she has used it in the report we have just received. To balance it up I felt that I needed to write down all his good points too so that he wasn't just a diagnostic problem and actually it didn't seem quite so bad then, he is still my little boy who I happen to think is gorgeous (although I might be a bit biased, I suppose).

All I can say is that from my experience the label that my dd has (language disorder), has opened doors. I had the same thing that dd has a mild problem, which it is kind of mild but it does effect her day to day life. My daughter is very intelligent for her age but unless she was receiving the help she gets now due to her statement this would not have been channelled properly. The professionals are there to help and that was all I wanted for my dd. The earlier you get the help the better. The change in dd in 1 year is amazing and a lot of that is down to the help in the language unit. I need to take some credit of course