Considering sending the following long letter to GP - If you have the time, do you think I should?

[perpetualworrier]

Dear Dr

Re DS1 Age 7

I am writing regarding my son, as I have a number of concerns regarding his development. I have decided to refer to you in writing in the first instance, as I am reluctant to discuss these matters in front of him and also, I suspect that I would forget most of what I wanted to say if I came in for an appointment!

Firstly, I am concerned about his motor skills. His reading and verbal communication is excellent and I am advised he is well ahead of the targets for his age group in these areas. However, he is finding writing very difficult and really cannot master the correct pencil grip. He finds it practically impossible to use a knife and fork and things such as buttons are a real challenge for him. He is very reluctant to participate in the usual exercises for improving these skills, such as threading beads, lego etc. and positively refuses to draw or colour. As far as gross motor skills are concerned, although I don?t think we have a future sporting star, he can swim, use a two wheel scooter and can throw and catch a ball reasonably well, though he is loath to do so. He is struggling to ride a bike.

My second concern is his social development, as he somehow seems a little out of kilter with his peers. He can converse well with adults, if a little shyly at first. He is often described as friendly by other adults and if we visit friends or go to the park etc, will always find someone to play with and they will play well together. However, he does not seem to have certain friends who are important to him. He likes to go to places where there will be other children to play with, but does not seem to care who they are. At school he has attached himself (the SENCO?s words) to two girls who are academically far below him and not at all articulate. At Beavers his best friend has learning difficulties and amongst my friends? children, by far his favourite is a boy with a severe speech delay. Whilst these are all lovely children and I am not at all surprised that he likes to play with them, I and his teachers are surprised that he does not also play with children who are as lucid as he is.

He also has a few idiosyncrasies in behaviour; he dribbles a lot, makes loud screeching noises in the course of his play and laughs loudly in a way that sounds forced. He doesn?t seem to engage in imaginative play in the way that his younger brother does. He has a strong dislike for any show of affection. If another child puts an arm around him, he looks horrified, he pushes away goodnight kisses from his parents and would have to be badly hurt before he wanted a cuddle, although is calmed by a cuddle in that circumstance. He does however, like to hold hands if we are out for a walk.

This all sounds very negative and this is not at all the way I feel about my son. He is very happy, always goes to school and comes home again with a smile on his face. He fully participates in games at Beavers and the Church Kids Club he goes to. We have no issues regarding bad behaviour and other adults we meet often tell me what a lovely child he is. He eats and sleeps well.

I don?t really believe that there is anything seriously wrong, but the school have raised concerns regarding his lack of progress in writing, in comparison to his clearly apparent intelligence. I have also had complaints from the school regarding inattentiveness. I just don?t want to be in a position in a few years time, where I am told I should have asked for help for him sooner.

I appreciate that you are not going to make any diagnosis without seeing him, but would value your advice on what, if anything, I should do next.

Yours PW

I originally asked for help on the general board as feel that my concerns are trivial, compared to some of yours, but I also know that you are the people with the experience to tell me either to snap out of it, or get Ds some help.

Reasons for not sending it so far are:

-DH is not concerned.
-School are not concerned, beyond thinking that he could try harder with his written work.
-He has come on a lot socially over the last term or so and now has 2 friends in similar ability groups.
-I don't want to start a load of tests aimed at highlighting his "shortcomings" and damage his self-esteem, which is high, despite him not being outgoing.
-If he does have a problem, it is likely to be minor compared to those with "real" SN, so unlikely to be any real support?
-Don't want to have him labelled, if really he's just a bit different.
-Worried I will be seen as fussing/pushy mother by school.

Really sorry this is so long and thank you very much for getting to the end.

Hi,

From what you have writen i would say yes send it to your GP, the discription you have given about your DS could have be writen about my DD (along with a few other bits) shes 5 and is Dxd with Aspergers, not that im saying this is the issue with you DS of corse.

The best advice i was ever given was to trust my gut insticts you know your DS better then anyone and if you feel that there is a problem then you are probably right.

As for him being labelled, try not to worry about this (easy said...i know). The assessment process for ASD is very long and drawn out and they would only lable a child if indeed they needed one.

Hope this helps.

GPs know bugger all about this sort of stuff so tbh don't expend too much energy (I work in this files as specialist salt) Maybe a few bullet points and request for referral to relevant professionals will suffice?

Better to seek advice now at 7 rather than leaving this another couple of years or especially when he's about to enter secondary school.

I actually think this letter needs to be personally handed to the developmental paed on your initial visit. It will save time too.
(If you can as well, take along examples of his school work. If you can film your son too doing stuff at home, this will help the dev pead as well. That all sounds pretty heavy but it will help the paed).

I think your DH is in denial. Trust your gut instincts always - there is something amiss here and deep down you know it.

Labelling should be seen as a "signpost" for getting additional help, it should not be seen as a stigma by anyone.

You as his parents are his best - and only - advocate. No-one else is best placed to fight his corner but you. I cannot stress that enough. Your son will thank you for getting him assessed further now rather than leaving this a few years down the line.

I would actually visit your GP and ask for your son to be referred to a developmental paediatrician asap. They are the ones who would eventually make a diagosis. As Moondog correctly surmises GPs know bugger all about this and would refer you anyway.

We are all "different" to each other, nothing is therefore wrong with being different. Everyone has a place. Nature loves diversity, humans hate it.

Let us know how you get on. See your GP asap and get that referral in place.

Thank you all so much for your help.

DH may be in denial, but the way he sees it DS is strong willed, knows his own mind and happy to be different, all good qualities. He is very unlikely to be led into bad behaviour by other kids, as he really doesn't care what they think

I appreciate GP is no expert in this field, but surely I have to start with him to get any kind of referral?

Actually I have lots of confidence in our GP. My mum once contracted a rare, but not serious, infection from sheep. No idea how she got it, but GP did loads of research "because I'm interested" and called her with details a few days later! I think he would respond well to having things set out in writing and also, I have never been a fussing mum health wise. I think DS1 has seen GP twice in his life! Hopefully this will encourage him to take me seriously.

Only prob now, is that, as if letter isn't long enough already, I keep thinking of other things to add. e.g strong need for routine and dislike of surprises (even nice ones) e.g we usually go swimming on a Sunday, if I was to suggest we go today instead, that would really upset him. I don;t notice it much now, as I've got used to giving him lots of notice of our plans, but I suspect it's not entirely normal/usual.

"I appreciate GP is no expert in this field, but surely I have to start with him to get any kind of referral?"

Yes you will need to start with the GP. But don't give him that letter but instead only bullet points. Keep that letter you've written for the developmental paed.

No doubt about it to my mind, your DH is in denial. Another big clue from your last post is your son's dislike of any change in routine. This needs to be pointed out to the health professionals and your GP. Do not be fobbed off.

Get that referral asap!. I do not mean to sound so forceful btw but you are your child's best and only advocate. No-one else will fight his corner for him and I would also think that school life is becoming gradually ever more difficult for him.

A referal will more than likely be a long wait, so you will plenty of time for your DH to get his head around things.

The thing is as parents we often dont see our childrens quirks as after all this is all part of who they are. I never realised untill DD started school just how differant she is to her peers.