4 year old DS potentially ADHD / HFA, what do I do next?

[EdPops]

My 4 year old DS has been ‘flagged’ by nursery as potentially having ADHD / HFA. It’s no great surprise, it runs in the family and we’ve definitely noticed a few signs too.

A lot of professional titles were mentioned (Behavioural Therapist, Educational Psychologist, Child Psychologist, Speech & Language Therapist etc) with regards to who we should seek out for help with regards to assessments and putting a plan in place before he starts reception in September but I’m confused as to which of them would be best to find.

As a parent of a child with potential ADHD / HFA looking for help from a professional, what do I do next and who do I contact? I’m not completely enamoured by our nursery’s SENDCo lead and want to put some things in place myself too.

There’s 2 different issues.

1. diagnosis - the route to diagnosis will depend on the area you live in. In some areas it is via CAMHS and in others via community paediatrics. In some areas you can self refer. If you can’t in your area the nursery or GP will be able to.
2. Support in nursery/school - this is based on needs, not diagnosis. The nursery should be providing support already. If necessary you could request an EHCNA too, but you won’t have a finalised EHCP by the start of the next academic year. Have you spoken to the school DS will be attending?

I'll speak to the SENDCo at his new school next week with regards to educational support.

Who can I speak to with regards to getting DS any help he needs outside of the school setting? He can be quite boisterous at play dates and disruptive in out of school lessons (weekend swimming classes etc) and friends are starting to distance themselves from him as a result.

Should DH and I be speaking to a professional about strategies to help him? Would he benefit from speaking with someone himself?

There's definitely some issues here with behaviour, impulse control, understanding boundaries etc and we want to understand what it is but more importantly what we can do to help him.

You would need to start with a referral to CAMHS or paediatrics. You could also look at OT and SALT referrals.

In the meantime some people find Ross Greene’s book The Explosive Child helpful, also Yvonne Newbold’s resources. Keeping a detailed diary might help you spot triggers so you can try to prevent situations escalating in the first place.

For extra curricular activities have you tried ones aimed at those with additional needs?

This isn't really advice as we're in a similar situation - we think our 3 year old DS may have ASD with lower support needs, ADHD, or both.

I spoke to the HV and she referred him to community paeds (the route for under 5s in our area) on the basis of his ASQ-SE score and a list of concerns that I sent. We've been told that they are tightening referral criteria and the waiting list is really long.

Nursery have put in place an individual learning plan which I'm broadly happy with. We're reviewing it soon and I'm going to ask about an EHCNA as I think the paeds referral and their observations suggests he meets the test for assessment.

I've tried to get an appointment with a clinical psychologist but have really struggled - round where we are (SW London), everyone seems to have waiting lists even for private patients, or they simply aren't taking new enquiries.

Thanks - this is all really helpful

Do you mind me asking what this individual learning plan is exactly? I'm really concerned our nursery is falling short in terms of how this sort of thing should be handled, we were literally just handed a scrap of paper with 'observations' scribbled on in pencil listing such things as 'Has no empathy, cannot make friends, no impulse control...' etc. Potential issues were first raised in November last year and nothing other than this list has been produced.

Also, what is HV?

HV is health visitor.

An IEP should look at needs anpupil has, the support they need/are receiving and outcomes. It is then periodically reviewed.

If you don’t mind a bit of reading it is worth looking at the SENCOP, and IPSEA and SOSSEN’s websites.

The IEP is much more formal that what you've described your nursery has given you; it lists areas to work on and steps the nursery will take to help, and what expected progress would look like. It was agreed between us, the key person, and the Senco and we all signed. It also adds the child to the nursery's SEN register.