Vague and depressing joint clinic report.

[TotalChaos]

Well the depressing is a given really....

Despite the fact I was verbally told they thought DS probably wasn't on the spectrum, but needed a further eye kept on him re speech/social problems, this isn't referred to at all in the report. No mention of ASD at all. Just a reference to DS having a subtle social/communication problems. No mention of speech disorder, only speech delay.

The section on non-verbal communication (which I would have thought would be of particular importance in separating off speech delay/disorder from ASD) was scanty. All it said was that DS's eye contact was variable, and that DS waved good bye, but they couldn't tell if it was a learnt gesture.

Most annoyingly - I was verbally promised that DS would starting having weekly SALT in school nursery, going down to monthly if DS is progressing well. But all the report says is that monitoring and intervention required for his delayed speech, with appointment to follow, and that his social skills should be monitored by SALT.

So all in all I feel we have been fobbed off again. I'm going to chase up SALT now re:Ds but am not holding my breath. Would there be any point in me writing in to remind them of what was promised SALT wise at the meeting???

I get a bit annoyed when people speak in a patronising way about learned gestures. DS1 can now wave 'bye bye' and say 'night night' but we didn't really teach him to do it any more than we have taught DS2 who is NT. The main difference is the age at which it happened, about 3.7 years as opposed to about 12 months. Also, DS1's understanding is more functional and controlling - He says 'night night' when he wants you to leave the room and won't say 'bye bye' unless it is me that is leaving - he won't say 'bye bye' if he is leaving the house

Yes that rather irritated me too. As it happens it wasn't a learned gesture, but even if it was, do they just expect me to sit on my arse and not teach DS stuff like that?

thanks for your suggestions Tclanger. will be speaking to private SALT later this week, as she's observing DS at nursery. feel a bit embarassed at speaking about speech disorder, since last time I saw her I asked her about APD, am scared of seeming a bit Munchausens about it all .

oh I'm not bothered about the eye contact - it's not something that comes to me naturally, and it doesn't inevitably correlate with ASD anyway. DS said very very little at his first nursery - he started at 2.5 (I was hoping it would improve his language, as HV etc suggested - ha bloody ha).

Re:speech disorder - I must confess that I would prefer that as a label to speech delay as that will possibly play a bit better in terms of me pushing for statementing etc. And I do genuinely feel it is the appropriate DX anyway - because of the pronouns/echolalia and general weirdness of DS's speech development.

I am very sorry to hear how unhappy your boy was at pre-school. DS's private nursery were at least pretty kind and well intentioned (all keen to be huggy/cuddly with him, like he was the class fecking teddy bear), if nigh on useless regarding SN.

Sorry about your crap letter. I wonder why they don't have joint clinics with salts included? Our paed says language disorder, psychaitrist dismissed ds2. Psychologists have been our champions as they have witnessed his behaviour they say asd. We are just as confused as ever with school looming in september. Complex is a word I am sick off. Keep going! (we only get salt twice a term). But he has some extra salt help via school action plus and outreach from a sn school. They also have a programme for him to work on in school. Don't know if that helps at all?

there was a SALT as part of the joint clinic!

Thanks for the post Spacegirl, gives me an idea as to what to aim for. DS has been at this nursery since end Jan. His old private nursery were useless, no IEPs or anything. New nursery is waiting for SALT to send a plan of work to do an IEP for him. But technically DS isn't on any School action atm (but surely he should be on School action plus as SALT are involved.). TBH it's like living in la la land - that school try their best, but all the other pros just seem to think that if they ignore DS he will either go away or magically cure himself.

Sorry the letter was so unhelpful. Please don't feel worried about being accused of Munchausens. I would have said that it is very difficult to tell the difference between a language disorder and an ASD and indeed I would think that different doctors would have different opinions.
I think that to fit the ASD criteria a person has to fit the triad of impairments in ways that significantly impact on their life.

It is so upsetting when people get your hopes up about the help you are going to get, you leave a meeting thinking you are all on the same page, and then when you get the formal feedback nothing is certain. Grrrr.
I am not in the UK, so I don't have anything useful to say really, just sending you some positive vibes and hope your DS gets the help he needs.

thanks ladies for the further replies. I think that a language delay/disorder can easily mimic the triad of impairments (language problems aren't going to do wonders for anyone's social abilities are they....).

TinySocks - you do wonder whether they make these promises as a twisted joke, or with good intentions, or just to get you to go away happy...

TClang - will e-mail you to reply to that point, feel more comfortable putting ltd stuff abut ds school on somewhere so public

this border between SLI and ASD - takes my thoughts back towards SPD again, which has alternated between being off the spectrum to off again....

Our joint clinic didn't have a hint of a salt! I am chasing ours at the moment to see what she thinks. Story of my life. School action plans make the school accountable to you and your ds! It also means that they have targets to aim for whatever class he is in - transferable. Otherwise you could have a sympathetic teacher and then one that isn't etc. Early years forum are the source of help with plus services. I have tried to get to know lots of the professionals that are on that forum and also make sure I meet with anyone that comes into school. e.g. the person from asd school outreach or speech therapists. TC you are doing a fantastic job. I am always encouraged by the posts you put up and how much you know. Your little lad is one lucky pup - keep going!

what did yours have then Spacegirl - was it an OT instead of SALT? Mine had ed psych, paed and SALT. Thank you for your kind words btw. What is the early years forum btw? Is it just something in your area, and is a forum where parents can contribute/go to meetings?

Mine had a paed and psych. The next one included our lovely psycholgist cause I asked him to come cause the psych had been really dismissive and patronising and I didn't want to deal with it again. Outcome of second joint clinic is that he has been referred to autism team because they are more able to advise on complex cases and his autistic behaviour etc. I think that involves a salt, paed, ot and psych with social communication specialism. This team is not very well funded and have no admin so I don't know when we will get an appointment - soon I hope!

I am in South Wales. The early years forum meets once every month or so and is a combination of health and education proffesionals. They discuss each child (under 6)and what their needs are. The transition worker filled out the forms when he changed nursery. Each proffessional and the school have to file a report. I think statements go before them too - ours was refused as he is not causing them any behaviour problems in nursery at the moment. It also has his paed, special needs health visitor and the area senco etc. My special needs health visitor is fab. She has referred us to so many things e.g. OT and camhs and filled out our dla etc. Sorry to ramble - obviously we are still in limbo land and I am muddling along trying my best but feeling like I am getting it wrong.

Thanks for the info. We have an equivalent up here - it's the Pre-School Panel. From what I can gather DS's case is not going to be referred to them. As DS doesn't have any behaviour problems at nursery, noone is interested in getting him any 1-1 time etc.....
DS was referred to the Neighbour Early Years Service, but they have done very little (sent someone out to do obs twice at his private nursery) but that is all. We don't have SN HVs at all in my city .

Sounds like this is a very frustrating process for you too Spacegirl, I hope you manage to get the autism team appointment. DS has allegedely been referred to the SALT Early Intervention team but have heard naff all.

Has your ds had develomental tests because that was one area that highlighted his areas of weaknesses. Also we applied for statementing that failed but also meant that they have a duty of care to ensure that he is doing ok.

For my ds they are saying that reception and year 1 will be the big test to see if he can cope re: 1 - 1. It's just that you want to head off the problems before they become too big isn't it. Been speaking to the senco recently too as my ds1 has some special needs too. His nursery think he is lovely which doesn't help him get help. It is awful that am wishing is behaviour there to be like it as at home.

That sucks re: special needs health visitors. Mine is brilliant - not trying to rub it in but she is based in the childrens centre so she can knows everyone and can chase stuff up. Because there are so many people involved it is very useful.

DS has had some basic developmental tests done by HV, then cognitive tests at the joint clinic - on basis of those and what I reported to them, conclusion was it's just speech/social skills that are delayed. I have noone to chase anything up - have to do it all myself - but then only SALT is really ongoing, ed psych isn't going to be involved further as DS did OK on the cognitive tests, paed is likely to review in 6 months as that seems to be usual procedure according to school, but the joint clinic report didn't even say there would be a paed review. I tried asking DS school how they felt he would deal with year 1, (he starts reception in Sept), but they just feel it's impossible to predict that far ahead, OK that's a point, but it would be nice to get support in BEFORE things go tits up.

what do they mean just speech and social skills that is crap! It is fundamental to school life. Could you have a chat to the school senco? I can't believe you have got to do everything yourself and don't have anyone fighting your ds corner. I am relating to you big time on the before it goes tits up. Cause I am not stupid and I can see the chasm between my ds and his peers. One time before the ball got rolling I chased up an appointment with the paed. I phoned and phoned till I spoke to him direct. It worked!

I've not really dealt with the senco, only the head of nursery (she's very clued up as to local services and or lack thereof and familiar with kids with language problems). am waiting for private SALT report as to what she recommends re:nursery - she has been in and is very happy with how they are dealing with DS from language point of view.

sorry that was a bit of an incoherent reply - thinking aloud. once I have private SALT report and recommendations, and a "way forward", I'll see whether I need to speak to school senco, or whether nursery head will just implement it as is. and yes - I fully agree with you on the importance of speech/social skills etc - language is so fundamental to many of life's activities - the thinking at joint clinic seemed to be that hopefully as DS speech improves, the social skills will follow automatically.