Have doctor's appointment with DS1 (age 7) this afternoon. Please help me ask the right questions

[whatdayisit]

I have had some concerns about my DS for a while, but most other people tell me I am worrying about nothing, that he's just a bit different and that's a good thing. I agree with that wholeheartedly, but there's just something about him that makes him seems a bit out of kilter. I wrote to the Gp setting out my concerns and he has asked us to go in to see him.

The concerns are:

-Poor co-ordination e.g can't do buttons, v. messy eater, can't ride bike.
-Finds writing/drawing very difficult, but is very good reader.
-Strong need for routine and dislike of the unexpected
-Popular socially and gets along with all other children, but has no real friends. i.e always has someone to play with, but a different person everyday.
-Dribbles a lot.
-Makes loud, seemingly uncontrollable screeching noises.
-Dislikes affection.

However, the school have never raised any concern other than to complain about his attention levels and say that his lack of progress in writing is surprising, as he's such a good reader.

We have no behavioural problems and he sleeps and eats well, is a happy child and throws himself into everything he does. Despite his lack of success in some areas, he is a confident boy.

Hopefully, the Dr will have the letter in front of him, as I wanted to avoid having to spell out all DS's "shortcomings" in front of him. Can anyone tell me what I should expect and what I should ask?

If he does have a problem, it is likely that it is mild (he functions Ok on a daily basis) is there any benefit to getting a diagnosis and therefore labelling/medicalising him for something that just makes him a bit different?

I imagine the doctor will really want to talk to your ds rather than you so much as he already knows your concerns. He would also maybe want him to do some physical tasks (skipping, walking, plus hand/eye coordination)
You could ask your boy to wait outside if there is something else you want to add at the end.

How is he at following instructions, short term memory or organisation?. These are things that weren't so much of a problem at school when my ds was 7 but from about 9 they were. Perhaps you could also mention things which you think may become a problem in the future.

good luck...hope it goes well

Thank you both.

Tclanger - what do you mean by literal interpretation of language? He doesn't "get" jokes. Loves slapstick, to the point of becoming hysterical at times, but doesn't get why did the chicken... type jokes. He doesn't have any speech problems, in fact I'm told he's among the most articulate in his class, but he was late to talk. Didn't have any words at all at his 2nd birthday.

Trout, he can do as he's told when he's listening and if it suits him. His memory is excellent and he has amazing attention to detail and recall of the smallest details, but somehow this sometimes seems part of the "problem" It's not quite "normal" iyswim.

I've actually just had a really nice phone conversation with the GP and he's going to send on my letter and refer us to the local pediatric specialist unit. He said he thought my letter explained it as well as he could and agreed that we don't want to discuss DS's difficulties in front of him. So now I just need to worry about what will happen when the referral comes through!

That really sounds like my ds but without the dribbling or screeching...google dyspraxia and see if that fits. Bear in mind none of the sen kids are exactly the same in everything. They all exist on different parts of the spectrum.

It really does sound like dyspraxia to me, but the gp won't/can't diagnose it properly, you need to book an appointment with an OT, the sooner the better as the not being able to keep up with the class in writing starts getting them very frustrated and they fall behind in all their subjects..

Ask about current waiting times for a paed referral and then therapy (such as OT). tbh by the time you get that far the issues will either have resolved themselves or become evident at school. Don't assume going through this process will get you a diagnosis - ds is 10 and we don't have one but he has some similar traits and gets OT.

Thanks Microwave. GP & I discussed dyspraxia and aspergers, which apparently can go together. Yes it's the writing that worries me most, as he's clearly very bright, but you would never know it to see his written work, against his classmates and I fear that, as he gets older, the written work he produces will be used to "judge" his ability more and more.

Has a diagnosis been able to help your Ds with his writing? The school are not overly concerned - have certainly never suggested he should be referred. Laziness or genuinely don't think there's anything to worry about? I sometimes think the schools are only interested in providing SEN help for disruptive children.

why are you gong through a paed? can you just book an OT direct as they are the best ones to advise. I think the waiting list if you try to get an appointment with an nhs OT referred through a paed is a long, long time. Can you afford a private OT session just to get a diagnosis? (over £100)? far quicker as LIZ says.

oops x-post

My ds handwriting is very poor, I pity the poor teacher that has to read it, and that coupled with poor concentration, messy eating etc screamed Dyspraxia. We have been seeing an OT for 1 yesr since he was 6 and it has definitely helped his confidence which was quite low. At least he understands its not his fault and he's quite bright. His ball coordination is also bad, he is left out of all the footie games that go on in the playground. Important for a boy

I can't understand why his teachers aren't concerned, are they not very hot on picking up SEN kids?

Very hard to find a private OT; a developmental paediatrician can be useful in such circumstances.

OT is likely not to use the word "dyspraxia" as some do not like labelling children. A lot of children thus slip through the net.

This may give some answer to Microwaveonly's last question posted:-

As the subjects of dyspraxia and dyslexia are not taught (or even discussed at any great length) at teacher training college, many teachers fail to recognise the condition when it is presented to them dismissing such children as "lazy". They need to be told that on average there is one such child in every class!!. Infact the whole SEN topic is brushed over very quickly.

I have been very pleased with the school generally - despite DS's difficulties they have helped him to become a very confident and happy child.

The school does have a good reputation for SEN, but we are in an area where there is a high % of SN and I do think that sometimes the more disruptive, ADHD? type problems are given higher priority, as they affect more than just the child in question. Also, DS is by no means struggling at school, although his writing is not as good as his reading, so it could just be that they really don't have any concerns.

That sounds pretty familiar. ds is defined as having a functional need for OT rather than medical and gets low priority as a result since resources are limited and he is at an independent school which seems to be out of their remit. We fund his one to one lessons at school but that could be provided in a state school.

LIZ how many one to one lessons does your ds have ? how old is he? I wonder if they might be useful for my ds but assume they are expensive.

It is about half an hour once a week one lunch time, around £30 per hour. Has helped with handwriting and spelling specifically. Also using a writing slope has helped relieve some of the stresses and fatigue of writing. He's also had 2 OT sessions so far this year which gave us some pointers to pass to school.