Who diagnoses ASD? We got an 'autism advisor' with no medical background

[Gillway]

Hello. DC is school refusing and I'm applying for an EHCP. To date we've had 3 assessments and my question before I go and book expensive private ones is, are these going to be of any use in the EHCP process and was the final one conducted correctly?

1. When DC was 10, a highly qualified Registered Ed Psych assessed DC to have Dyspraxia, Dyslexia and high IQ.

1. When DC was 11, an NHS clinical team made up of a Consultant Paediatrician, a Specialist OT, and a Senior Physio diagnosed DCD, Dyslexia and 'social communication to be further investigated'. One of the clinicians said DC would probably end up with an ASD diagnosis BUT we were to go away and consider if this was helpful given that DC was excelling at junior school. If we felt DC needed, we were to return for further exploration. So all DC's 'significant' motor skills problems were listed in great detail but nothing was written about sensory or social communication issues.

1. Now nearly 13, DC has (perhaps in retrospect predictably) found secondary school too overwhelming and anxiety is causing inability to attend. Usual Senco strategies are being employed (parent meetings, threats of prosecution) while DC is moved ever downward in groups further away from potential. We demanded that the previous NHS recommendation was acted upon for 'Further investigation of social communication issues'. So we have just had an NHS 'ASD Assessment' conducted by a consultant community paediatrician and someone called an 'Autism Specialist' on one page of the report and called an 'Autism Advisor' on another. This person has no other credentials and upon research no medical / clinical background. Their report mentions tons of sensory and anxiety issues but ultimately states that because DC was observed to have good social communication skills in school and at the clinic (basically he is an excellent masker), a diagnosis of ASD couldn't be given and further assessment required. The previous OT and physio based report was ignored.

Like, really, FURTHER assessment?!?

I now know that private assessment is going to be necessary but just for the record please, does a team consisting of a consultant community paediatrician and an 'Autism Specialist / Advisor' authorised to decide whether or not DC has ASD?

Thank you.

Did dc have ADOS? That’s the generally accepted ‘test’ for ASD. Consultant community paediatrician ‘diagnosed’ sibling rivalry before ASD was officially diagnosed 2 years later. Such a waste of money and time not to diagnose then and there!

Thank you I'm looking up ADOS and scrutinising the report now ...

Module 3 of the ADOS 2 was utilised. Apparently different LAs can use different interpretations of NICE guidelines. This could include the 'autism advisor' who it transpires does have a psychology qualification. Having two NHS reports in a row ending in 'Further assessment required' is shoddy and wastes not only my DC's educational years but also tax payers money. Going private. IMIP thank you for responding. All the best.

Did you get a score? A report of strengths and weaknesses?

Score? I'll double check hang on (but don't think so) ...

There's no numerical score and the strengths and weaknesses are written up in paragraphs. Things like 'he said he loves watching American sitcoms with Asperger type characters such as Big Bang theory but it didn't feel like an obsessive interest.' The fact he watches whole serieses back to back all through every meal and even on while gaming all day didn't seem to matter. Lots of inconsistencies and no reference to the previous OT and senior physio's report.

Thanks IMIP I've glial the threads with ADOS info!

Update: the local NHS 'autism specialist' who assessed my child is also a freelance 'SEN consultant' working mainly for the local authority. When she assessed my child, was there a conflict of interests between actually giving a full and accurate diagnosis and ensuring cost effectiveness for the LA?