Suspect 3 year old PDA

[Corilee2806]

Hi all, this is something I keep coming back to with my son, 3 years 3 months but not sure how young it’s possible to diagnose?

I’ve discussed the possibility of a referral with his HV numerous times in the last year or so but he masks well in nursery and comes across as sociable so they weren’t seeing what we were seeing at home and wouldn’t support a referral.

In terms of why I think he fits the PDA profile, he has complete meltdowns when we ask him to do almost anything and this often escalates and can turn physical. We constantly feel like we are treading on eggshells at home and transitions such as getting ready, dressed, in the car etc trigger major resistance. We’ve tried potty training and not only does he not want to poo on the potty/toilet but it leads to days on end of withholding poo (and wees sometimes) to the point where he is physically ill and then we have the ongoing issues with constipation.

every 6 months or so I reach a point where I think oh he must just be a very strong willed toddler and I’m told by those who don’t see him in the home that there’s no issue, so I don’t pursue anything, but at this point I really do think there’s something underlying. What can I do without support of nursery?

If you suspect DS is autistic and the HV won’t refer, have you spoken to the GP? Have you looked at the ages and stages questionnaires? 3 years old isn’t too young to refer and diagnose. Most areas don’t diagnose PDA. Have you spoken to the nursery’s SENCO?

Have you seen the GP about the constipation?

The HV was happy to refer a year ago but the nursery he was in wouldn’t support us with a statement as he masks at nursery and has good eye contact and is social. He’s now at the school preschool and their view is that although he is often reluctant to do things when asked he is very low on their list of children they have concerns about, there are a number with quite significant additional needs. So I could speak to the HV again and see if we can try and do a referral without that supporting statement, just outlining what we see at home. The PDA presentation just reads like a tick list of his behaviours but I know it’s under the umbrella of ASD diagnosis, which he does fit some elements of.

its very difficult to get a decent GP appointment at the moment to discuss this, I’ve seen two different doctors in the last week about the constipation, they’ve prescribed lactulose but couldn’t be less interested and have written me off as a worried mum. He’s now not been for a poo for a week and is completely messed up by our potty training attempt. Have no idea what to do to help him and feel like the worst mum ever.

Do speak to the HV again.

Other DC having more significant additional needs is irrelevant. The school has a duty to make their best endeavours to support DS’s additional needs.

Try to get another GP appointment to discuss the constipation. It won’t be helping DS’s behaviour and development. Have you tried anything like Movicol or Laxido.

Yes I definitely will. I have had a good one who has supported us since he was a baby so hopefully she’ll be able to help.

The issue with the nursery is they don’t see what we see - I have a friend experiencing similar with her daughter and they say the same to her - it’s not helpful! But I guess that could be the effect of masking. I’m sure it’s not our parenting, lack of boundaries etc as we have a 5 year old DD who we parent the same way. And often suffers at his hands.

The first doctor we saw prescribed lactulose and it’s not working at all. This is because we struggle to get any drinks in him that aren’t water so thought this would be best, compared to movicol etc. However when he was still poorly (being sick presumably from being full?) I went back to the GP to try and get Movicol, she just rolled her eyes and said we needed to give it time, at least a week. That was a few days ago and no progress. In the meantime he’s so uncomfortable and his behaviour is increasingly unmanageable. I have no idea where to turn but will get onto the HV in the morning. Even she often takes a few days to come back.

Just wanted to come back to this as we’ve got the ball rolling on a referral with the HV, but some of the questions seem quite geared towards an older child in school, she said we should do an ASD referral rather than CDC as he’s about to turn 3yrs 4 months - is that right?

we have to do a form for parents/carers and then the playgroup he attends will fill out the other one. However he isn’t starting pre school til September - does anyone know if I should advise them to just fill out the relevant parts?

sorry for the questions, new to all this!

The referral process will depend on where you live. It isn’t the same everywhere.

If the playgroup will complete it that would be better than waiting until September for the preschool because they won’t know DD straight away.

Thank you - yes, I want to get something in now rather than having to start the whole process again in September as I think it will take a while for them to get to know him.