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what to expect from development assessment

10 replies

Babybum21 · 25/10/2021 21:32

Hi all,

Hoping for some advice from others who have gone through a development assessment. Our DD is now 30 months. I’ve had concerns about her development since she was 3 months. She has been on the slow end of the spectrum with most her milestones although gross motor has improved lately. But it’s her social and communication which is particularly delayed with not much development until recently. Until 28 months she had limited eye contact, did not respond to her name, did not use gestures (she did wave at one point but stopped and very occasionally gave a high 5 but not at all consistent), very limited imaginative play and imitation skills and did not want to interact with us. She had lots of words but only to label things on a flash card and did not really use words functionally. Her understanding was poor and she cannot follow any kind of one step request. She is always on the move, flitting from activity to activity and can be hard to hold her attention. She is always jumping, even at night in her cot where she could jump for hours in the middle of the night. Occasionally spins when she is upset. New places and people usually result in a meltdown. I did the MCHAT R a few months ago and she scored 13- so high risk. We have struggled to contact the health visitors and had been unable to get her 2 year check done until v recently. Just under 2 months ago after being frustrated at lack of any practical advice as to how to help her I started reading up about speech and language development and after doing very intensive play with her at home, we have had a huge improvement in eye contact (she now makes spontaneous and frequent eye contact), initiating play with us and attempts to communicate with both words and occasionally a full hand point. She still doesn’t understand us and is now showing signs of frustration at her inability to communicate with frequent tantrums. Whilst she is so much better than she was a few weeks back, on her 30 month ASQ she only scores one thing for problem solving, communication & social skills so it’s quite apparent she is lagging behind her peers. We have had one virtual assessment with the child development team at the beginning of year (referred by GP) and are on the wait list for a ‘full developmental assessment’ face to face which they are hoping she will get before the end of the year. We are also on wait list for SALT. I’m a bit confused as to what the development assessment will do. Could the child development team potentially diagnose ASD if they felt she met the criteria or would the assessment just be the starting point and we would have to be referred elsewhere for a diagnosis. I do feel that there is an issue, that it’s shouldn’t have been this hard to start seeing progress but I am now wondering if with her being under 3 and now showing signs of improvement that they would want to sit and wait for another 6 months. Has anyone been through this process and could shed any light about what to expect?

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danni0509 · 25/10/2021 21:45

So first face to face with us when ds was 2 was discussing every developmental milestone and history from pregnancy onwards, they did a physical check on ds and requested a blood test but he wouldn’t have that so they missed that bit, they wanted salt to do an assessment and then he had to have a hearing test, once both those had been done he got referred to the child development centre for a 6 week assessment, every Tuesday afternoon for 3 hours. They have specialist nurses / teachers / physio / salts attending these assessments so they see a full range of people. They visited nursery and did a home visit too.

After he’d had that we had another appointment and he was diagnosed with autism on the spot. He was 3 and a bit when he got his diagnosis, he was referred at 2 by our health visitor. But waiting times etc meant a good 18 months of appointments, this was way back in 2016/2017 so no covid complications.

All areas do it differently, our area it is practically unheard of to get an autism diagnosis before age 5 but ds was very obviously autistic.

Do you use makaton / pecs cards with your dd? May help with a bit of the frustration especially when you say she doesn’t understand what you say. May be easier for her to look at visuals like pecs to help her understanding.

Babybum21 · 25/10/2021 22:11

@danni0509 Thanks so much for the response! So I think we’ve done the first bit with the going through development history and she’s had an initial assessment with speech and language and had a hearing test. So I guess it’s the next bit you describe we are waiting for. 6 weeks of assessments sounds very intense!

I am a bit worried about how our nursery will engage. We have been having issues where they have been overstating her abilities on the EYFS reports. When I challenged them on what she could actually do with examples it became clear that she was doing far less at nursery than she was even doing at home… We are in the process of applying to a different nursery who have a SENCO and early intervention with small groups but I don’t know if she will get a place and when it might start.

Makaton, I’ve struggled to get her to engage. If it’s not an activity she’s interested in she quickly gets bored and I can’t get her to copy. PECs I should really try - this is probably a fail on my part- but I can’t work out how to get started with the first phase. How to work out how to get her to understand to exchange the picture for the thing she wants. Wish there was more practical support available on how to implement these strategies!

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Babybum21 · 25/10/2021 22:17

How is your ds doing now?

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Lillian72 · 26/10/2021 00:45

Hi @Babybum21 I think it varies from area to area as to how it all works with the assessments. I believe if it’s a paediatrician carrying out the assessment then they can diagnose if they have information gathered from other areas such as speech therapist report and nursery. Although I’m not 100% on this. There are also some paediatricians who won’t diagnose very young children and will want to wait 6 months and see. Those who know less about autism probably.
Just on the PECS front, it should always be introduced by a professional, so I wouldn’t do it yourself and definitely not a fail on your part.
You could use pictures yourself to show your dd things like your car when you are going to get in the car, the bath when it’s bath time etc. Unfortunately there is so little practical advice for parents and it’s up to us to work things out for ourselves.

ASDmummy2019 · 27/10/2021 15:46

I’m possibly at a similar stage so don’t have any advice on the what to expect part but we have been introducing objects of reference with DS. We’re still in the early stages but it’s definitely helping that he knows how to show us what he wants. Very similar to PECS but I found it was easier for him to understand and I’m hoping a gateway to PECS in the future. We only have about 4 at the moment, bedtime, drink, snack and bath. I’m hoping when we FINALLY hear from SALT they’ll be able to help with more. Hope this helps xx

Beanie1981 · 31/10/2021 05:28

Can I ask what speech and therapy books you found useful for the imaginative play please? Our 18month has regressed and we have having intermittent issues with eye contact. It's really disheartening.

Vittoria123 · 07/07/2024 20:54

Babybum21 · 25/10/2021 22:17

How is your ds doing now?

How’s your little girl doing?❤️

Babybum21 · 07/07/2024 21:57

Vittoria123 · 07/07/2024 20:54

How’s your little girl doing?❤️

Hi, she’s doing really well! She had a ASD diagnosis just after turning 3 and went to a specialist nursery which helped us get an EHCP for school where she gets lots of support. She turned 5 not long ago and her speech has really come on in the last 6 months - she can talk in short sentences and we are starting to have some back and forth conversation. She’s also starting to play with other children and lots more imaginative play. X

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Vittoria123 · 07/07/2024 22:02

Babybum21 · 07/07/2024 21:57

Hi, she’s doing really well! She had a ASD diagnosis just after turning 3 and went to a specialist nursery which helped us get an EHCP for school where she gets lots of support. She turned 5 not long ago and her speech has really come on in the last 6 months - she can talk in short sentences and we are starting to have some back and forth conversation. She’s also starting to play with other children and lots more imaginative play. X

Thank you so much for your answer . I am going through the same with my 17 months old DD . I am convinced she has ASD but my biggest fear is that she will lose her smile and kind nature . Is your little one struggling with behaviours / tantrums ? ❤️ thank you again and feeling very lonely atm

Babybum21 · 07/07/2024 22:27

Vittoria123 · 07/07/2024 22:02

Thank you so much for your answer . I am going through the same with my 17 months old DD . I am convinced she has ASD but my biggest fear is that she will lose her smile and kind nature . Is your little one struggling with behaviours / tantrums ? ❤️ thank you again and feeling very lonely atm

It can be so difficult at the beginning wondering what the future holds. I think I was sure of ASD around 2/2.5. But a lot can still change in a relatively short amount of time regardless of a a ASD diagnosis or not. She started making some slow progress after turning 3 and that gave me hope that she would be able to communicate and make connections with others in the future. Can still struggle with emotional regulation and tantrums/ meltdowns but it’s a lot better now she has developed more understanding. She’s generally quite a happy child, often smiling. Probably around 2 years behind in development against most domains but making progress at her own speed.

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