What is the law re assessment where one parent supports and the other doesn't?

[MyLovelyGirl]

Hi, just want to get some idea of what the legal position is here.

I am divorced from DD's father. I am the resident parent, but as we were married and living together when DD was born, I believe we both would legally have parental responsibility.

I have thought for years that DD may display some type of neurodiversity. I don't know whether she may be on the autistic spectrum. She doesn't fit into the descriptions I read on the Autistic Society or the NHS website, but I know girls present differently. She does have some issues around social cues and emotional regulation.

The SENCO at her primary school also wondered whether DD was on the autistic spectrum. When DD was transferring to secondary school, she was very concerned that emotional support be put in place for DD, and wanted to refer her to the school nurse and pass information over to the SENCO at DD's new school. ExH was very obstructive to any of this happening and it took lots of cajoling and pussyfooting around him to get this minimum intervention to happen. In the end, though my daughter was referred to the school nurse, the school nurse only ever met with me, never my daughter (so DD isn't aware she was ever referred). The SENCO passed information to the SEN department at DD's new school. It turns out the new school lost the information and the SEND department deny that any conversation took place. It is only recently now I have made some noise that the SEND department have rung DD's old primary school for the transfer of information to happen again.

DD is now 12. She approached me a couple of months ago to ask whether I thought she may have a special need and asked if I could arrange for her to be assessed. This came totally from her. I have never raised the possibility with her. She has a couple of friends on the autistic spectrum at school and sees some things in common between herself and them.

I approached DD's father with this. He is absolutely adamant that DD shows absolutely no signs whatsoever of being on the autistic spectrum. He emailed me detailing all of the indicators listed on the Autism Society website with a counter argument of how she doesn't display any of this behaviour. He feels that I should sit and look at the website with her to "prove" to her she is not on the spectrum. To be honest, the arguments he provides are compelling and plausible. For example, DD is able to make friends, communicate well, makes eye contact, is creative. On meeting DD she seems very talkative and playful.

As far as I'm concerned though, DD is experiencing difficulties and wants to get to the bottom of why, and I think we need to listen to her and not discount how she feels.

I emailed school to ask for their support in helping DD with this and in approaching ExH. They were only able to say "take her to the doctor".

About 3 weeks ago, I discovered that DD has been self harming. I'm finding it difficult to get to the bottom of why, as DD finds talking about upsetting things tricky and we can only talk about it in short bursts at a time before she shuts down. From what I can gather, it happens when she's angry and frustrated or been in conflict and I think is to do with the struggles she has with emotional regulation.

I found out about the self harming after she disclosed to a friend in school and the friend took her to the SEN department to disclose who then referred to the safeguarding lead. Safeguarding lead telephoned me, I made an appointment with a doctor the next day. She has been referred to CAHMS. I also telephoned the SENCO at her primary school to get her take on why she thought DD might be on the spectrum, bullet pointed it in a report of the phone call, gave a copy to the doctor and a copy to school.

I'm still waiting to hear from CAHMS

On another matter, DD came out as gay a few months ago. DD's father has decided that this is the reason she is self harming (despite the fact that we and her friends are supportive).

I want to get DD assessed. She wants to get assessed. Her father does not agree. As the SENCO at DD's old primary has told the SEND department that DD's father was always very anti any intervention, the SEND department have said to DD's head of house (who seems to be the only member of staff at DD's school that will communicate with me) that there is nothing they can do about advocating for DD in this because her father doesn't agree with getting her assessed. DD's head of house has explained to the SENCO that part of it is it needs to come from school and not from me (as ExH has me down as a bit of an idiot) and is trying to sort out a meeting with both me and ExH present.

Are they right? Do DD and I need her father's blessing for her to be assessed if he also has parental responsibility? Frankly, if I can sign something and get it underway I will do it.

Sorry. That was really long

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bumping again. Wondering if I've put this on the wrong board?

I'm afraid I don't know! Have you tried contacting SOS!SEN? They offer free legal advice. Or IPSEA. Hopefully someone will be along with some advice. You sound like a great mum and it's a shame your ExH isn't on board.

Thank you so much for your reply. I'll look into both of those.

I think right board but it's a very specific question and this board doesn't move that fast. We're all busy with our children this time of day :)

I didn't want to read and run but I have no idea. Referrals vary by area. In our area CAMHS is the route and you have that anyway, and parent or school or GP can refer. I think all you can do is push forward until you are actually prevented from making progress by the lack of his signature.

I think taking her to a GP is a good idea. Reading up on teens getting the contraceptive pill without parents knowing might also be useful background, if not directly relevant. I think there is a thing about children being deemed medically competent to give their own consent without parents needing to be informed. Her seeing the GP might be the start of kicking that off.

But above all, diagnosis can take months, if not years. I would encourage you not to focus on the diagnosis but on getting her the help now anyway, reading up on it and seeing if some books aimed at teens on the spectrum might help, etc etc. If you pin all hopes on a diagnosis that could easily be a year away, it kind of freezes you.

I would put it to your ex that if she's not on the spectrum, she won't get a diagnosis. You're not pursuing diagnosis, you're only asking for an assessment. You, your ex, the SENCo, the teachers, the GP... none of you are qualified to diagnose whether someone is NT or autistic. The best way for him to prove he's right is to let her be assessed by someone qualified to judge. Either way she learns something about herself, and you can hopefully target the right help and strategies better. But I'm sure you've tried that. Sorry I've written far too much for someone who can't actually help

Not at all MinesATreble - your post is really helpful and your insights have given me some food for thought.

I just feel a bit as though maybe I've failed her by not pushing for this before and pussyfooting around her father.

She had seemed to be getting on so much better at secondary school than she did at primary school, so it had kind of fallen off my radar. She's kind of in the misfits tribe - but she has a tribe and folks that like her for who she is and I thought she was happy.

The revelation that she's been self harming is horrible and just doesn't feel like something I can help with or monitor unless she marks a visible part of her body (I've been able to spot a couple of times, but initially she was marking parts of her body that are hidden by clothing).

Sorry - not sure why I'm going on about this - just feel a bit out of my depth and ineffective ATM

It sounds like you're doing a great job and that you're doing your best to get your daughter the support she needs. 12 is a tough age to be esp if you realise that you're 'different'. Going from primary to secondary is a big change and can be a shock. It's brilliant that your daughter is so self aware and she's lucky to have such a supportive mum.

Thank you for your kind words. I really appreciate them. It is true that puberty is certainly not helping matters!!

Your daughter is 12 and seems to be quite level headed from what you describe. Book a double appointment with the gp if you can and tell them she would like to speak to the doctor by herself if she is comfortable with this use the first half of the appointment to allow her to talk to the doc as she has to you outlining her own concerns then join them and have a talk together saying that you want to arrange an autism assessment. Don't even bring up your ex at this stage unless the gp asks and if that happens then you can say that he isn't supportive but your main concern is your daughters welfare and that you are there to support her and advocate strongly for her. Your gp cannot refuse to make a referral so choose your words carefully. Don't ask for the referral tell the doc that that is what you are there for and leave no wiggle room.

He emailed me detailing all of the indicators listed on the Autism Society website with a counter argument of how she doesn't display any of this behaviour. He feels that I should sit and look at the website with her to "prove" to her she is not on the spectrum

How absolutely stupid of him, that list is by no means diagnostic, no internet list is, they cannot "prove" autism one way or another, all they can do is suggest it's a possibility and recommend medical diagnosis by medical professionals.

Did he use the NAS list for girls and women? Does he even know women present differently to boys and men?

Anything on these two links ring a bell?
taniaannmarshall.wordpress.com/2013/03/26/moving-towards-a-female-profile-the-unique-characteristics-abilities-and-talents-of-asperwomen-adult-women-with-asperger-syndrome/

everydayaspie.wordpress.com/2016/05/02/females-with-aspergers-syndrome-checklist-by-samantha-craft/

I don't know the law but am sure if one parent was obstructing a medical investigation - which is what a diagnosis is - then their viewpoint ought to be overruled as being not in the child's best interests.

Perhaps she could ask for a diagnosis herself, there are several medical things she can do at 14 without parental consent.

Have a look on this website, looks interesting. English law only.
childlawadvice.org.uk/information-pages/young-people-and-medical-treatment/

Your daughter may wish to know her rights, her father may not wish her to know them though!
lawstuff.org.uk/ English law only.
Interestingly the medical answer on lawstuff.org.uk/sex-health-drugs/healthcare-and-medical-treatment/
"What if I want medical treatment and my parents or guardian refuse?
You will be able to receive medical treatment without the consent of your parents or guardian if the doctor or nurse thinks that you are mature enough to understand the consequences of the treatment.
If the doctor or nurse thinks that you do not understand the consequences of the treatment and your parents or guardian do not give consent then the treatment will not be given"

This is more of an observation than advice, have you looked at the family, both sides and seen if there are any "quirky" people who could be possibly undiagnosed autistics? Autism is thought to be at least partly hereditary.
Take a good look at her father, my personal observations from experience and reading comments on this site and others lead me to surmise that some men, with undiagnosed Autism, usually HFA or Asperger's do not want their children to be diagnosed and can be very oppositional.

Apologies, I read your OP as her being 14, she's 12. She has very good self-appraisal about her differences for her age.

Maybe too young for the traits on the linked lists in my post above, but I'm pretty sure the medical advice still applies.

Another thing, undiagnosed kids can mask through Primary so well but they crash at secondary school.

Going to specsavers as soon as they open in the morning ...

Link to people discussing what it's like from an NT perspective being in a relationship with adults with Asperger's/HFA. May give you some clues as to what type of behaviours to look for in the wider family.
www.mumsnet.com/Talk/relationships/3325419-married-to-someone-with-asperger-s-support-group-here?pg=1

Thanks very much for all your comments. I really appreciate them and this is helping a lot.

BlankTimes - I really appreciate all the time you took sending links - I will have a look at all of theses.

Re her father displaying autistic traits - I think it is extremely likely that you are correct. I have thought this is the case for a long time. Black and white thinking, special interest in certain topics and unwillingness to deviate from them in conversation, doesn't see the point in being polite to people (the word 'courtesy' has the same root as 'courtesan' apparently, and he won't prostitute himself for anyone - actually that final one might just be an indicator of him being a bit of a tit).

On my side, I have a lovely brother who has, through therapy, come to the conclusion that he is probably on the spectrum - as soon as he told me this, lots fell into place about challenges that he has faced through his life. I'm not sure whether he's going to pursue diagnosis or not.

Re. masking - I actually think DD's better at it now she's at secondary school. I personally think she uses certain You Tubers for inspiration in phrases and expressions she uses in conversation in order to fit in. She's also changed her laugh, which used to sound very forced and fake at primary school and now sounds much more natural if that makes sense. I think she appreciates the fact that there are more people at secondary school and she finds it easier to make herself 'invisible' - and also that she's been able to find her tribe - though clearly even though she more obviously 'fits in', she's still finding things very difficult.

Thanks very much again everyone

Read the Tania Marshall link. Actually, a lot of stuff on that list sounds like me... (A friend of mine who's going through diagnosis at the moment said she wondered if I was on the spectrum, so I did a few tests - always scored extremely low though - but this is making me rethink…) Blimey. Confusing innit?!!

I can see how a lot of that could describe DD too.

It sounds to me like you're absolutely not failing her in the slightest. Sometimes things need to go wrong first, that's how we know there is a problem. On the "ask me anything" board there's an "ask me anything, I'm autistic" thread where the OP describes herself as having being diagnosed quite early, at age 9. I find that quite liberating.

Back to your original question about parental permissions. The BMA usually consider that permission is required only from one parent to provide treatment. In practice if parents disagree doctors will try to mediate to help them reach a decision. For non-reversible procedures I imagine doctors would be very cautious. For an assessment (which has also been requested by the child themselves) I imagine that they would proceed in the best interests of the child - especially one who is self harming and therefore high risk. Best of luck

Thanks so much for your responses and your kindness.

Tartan - that's good to know about the BMA , thank you

I'd have thought that logically the school's and local authority's duty to identify and provide for special educational needs would override your ex's right to object to assessment, especially where both you and your DD want it. Technically if a parent were preventing their child from receiving help that they need, it could be seen as neglect resulting in the LA stepping in to take the decision in your ex's place.

She seems quite level headed. You’re not failing her. Book a appointment with the GP and tell them you wish to talk to a doctor herself.
Avoid mentioning the ex husband but if asked questions say that he was not supportive and that you are focusing on her welfare. Legally the GP is supposed to humor your wishes so make sure that you think carefully about what you want to say. Be pushy. Explain why you want this assessment. Be prepared to push.
Good luck!!

Thank you