Multi-disciplanary Diagnosis Clinic - what is involved?

[notfromaroundhere]

Hi all,

I've not posted on Mumsnet before so please forgive me for barging in.

My DS1, who is soon to be 3, is being referred to a "multi-disciplinary diagnostic clinic".

He was intially referred to SALT when he was about 22 months due to concerns over his lack of language and social communication.

He has actually come on leaps and bounds so I was quite blind-sided when the SALT rang to say that she wanted him referred to the clinic and I didn't actually take much of the information in! I think she mentioned Occupational Therapy but I can't be sure.

Have any of your DC gone through this process?

Many thanks

Hello and welcome. At DS's clinic, there was a senior SALT, a paediatrician and educational psychologist. They were all in the same room with use for about 1 hour. There wasn't an OT, but it is a relevant professional (to look at sensory issues), so there may be at your DS's clinic.

The paediatrician asked lots of questions about PG, DS birth and development and general behaviour.

SALT observed him playing with a selection of pretend play type toys, chatted to him a bit, asked a few questions

Ed psych did a few non-verbal intelligence tests- copying patterns of blocks, and choosing similar pictures.

After 1 hour they bogged off and conferred, and came up with diagnosis (or in DS's case lack of!) and future plan of action. Written report came a few weeks later.

Outcome with DS was - they thought he probably didn't have ASD, but wanted to keep an eye on his language and social communication problems, so speech therapist was to monitor this.

I can exactly mirror what TC says. We had a meeting with an Ed Psych, SALT and a paediatrician when DS was two and a half. DS wouldn't perform any of their non-verbal intelligence tests (which is why it's so hard to get an idea of IQ in children with autism!) so they relied very heavily on what they could observe from his behaviour and the history they took from us. They talked on their own for 15 minutes or so while we waited, and then called us in. They said "We do think that DS has ASD - actually, to be completely clear, he has autism..."

And then they gave us some leafets for the NAS and off we went.

It was about a six month wait for us between the referral for the meeting and the meeting itself, and I found that far more stressful than the diagnosis itself. I think we were actually relieved by that stage, although, like you, I was completely shocked when our SALT suggested it.

Good luck!

Our experience was similar to TC'S but ours was an assessment for a morning each week for 5 weeks followed by a feedback session.

Each week there 3 children & parents in a large playroom with a playgroup type session.
There were also a SALT, OT, Physio, Clinical Psych, Paediatrician, Playworker. Over the weeks each of the professionals spent time with the children on a one to one & also watching how they interacted with each other. They also set up a snack time & formal activities to see how they coped & reacted.
There was also a side room were we went for more formal structured assessment without distraction.

it sounds a bit full on but it was very thorough & ds2 wasn't aware he was being assessed & he was given Biscuits!!
It was all set up to be fun for the children, the only one anxious was me!

It was a very good process o go through it will either settle any concerns you ahve or enable you to get any additional support for your ds.

ask SALT what the usual wait time is at it varies hugely from area to area - DS had to wait 13 sodding months. hopefully your area is less overworked. children with receptive language delays can struggle with the supposed non-verbal intelligence tests, so the results can be biased and look worse than they really are.

Thanks for all your replies.

I need to get either a GP or the community Paediatrician to request the referral so I've got a doctors appointment next week. Could get one sooner but that would be with the GP who grabbed DS1 and told him off so I'd rather wait.

I have been putting off the community paediatrician appointment as the last one was just diasterous - they wanted me to leave DS1 in the waiting room with a receptionist "keeping an eye on him". (he was 2 at the time). It went downhill from there!

The SALT we have been seeing actually works in the diagnostic clinic so I am hoping our wait won't be too long as we are technically on the "right" list although this purely by her changing jobs and keeping us on.

Thanks again for all your help, much appreciated

My DS (3, AS) had a whale of a time at his assessment clinic sessions - they had a snacktime which made a big difference. Ours had a parents' group with a chap that just chatted with us and answered questions, it was really great.
Our last paed appt was pretty disastrous as it was in a dull consulting room with medical equipment he couldn't touch and no toys. DS just howled to be let out and she abandoned the tests she wanted to do. Next time I'll ask if we can do it in the waiting room where there is a playhouse and toys - I'm quite happy to forgo lack of privacy to avoid another totally unnecessary meltdown.

Oops, forgo privacy that is, not the lack of it LOL.

our experience was a lot like anon's but a few more children. It was almost like a mother and toddler group from ds1's point of view, he loved it. We did 5 x 2 hour sessions.

I've never had a problem with paed appointments netiher, thankfully. I think most do have toys and things available.

The only thing was though, that although ds had assessments from 4 or 5 different professionals at the multi disciplinary he still had to have seperate referals for proper assessments by SALT, physio and OT which also lasted up to 90 mins each. It can all add up to a lot of appointments!

Its reassuring to hear that your DC coped well with the assessment; my DS1 will tolerate the SALT doing tests for so long and then get fed up and refuse to comply any further.

Did any of you take your other DC with you? I have a DS2 (14 month climbing, room destroying demon) so I would normally try and arrange someone to look after him but the SALT felt it may be beneficical for the Paediatrician to see how DS1 interacts with DS2...

I wouldn't bother - as it's going to be stressful enough as it is going through the assessment procedure without you having to worry about toddler behaviour. What you could do is try and get some video footage of them interacting if the paed feels that he would benefit from seeing it in the flesh rather than just from your description.

Our experiences have been fairly similar to the ones mentioned so far.

OT - Toys and puzzles were set out to see what each ds did with them. I also had to go through a questionnaire with the OT about the things that ds liked and the things that ds avoided, eg noise, light, spinning etc.

SALT - More toys and puzzles. She also looked at books with each ds and asked them questions to see how much they could understand (very little).

Child Psych - Teamed up with the SALT and watched the same activities and interaction. I think she also tested things like colour-matching and being able to copy patterns.

Physio - Equipment set out to assess ds' ability to walk, balance, climb, throw, catch etc.

At the end there was a big meeting where everyone presented their findings and the Paed gave their dx.

The only time I took a younger sibling with me was for ds1's intial appointment with the Paed. I think it would have been too stressful and distracting to have taken them to actual assessments.

Ive never had a choice about taking the dts with me to appointments. Witht he multidisciplinary it was ok, becuase it was a huge playgroup type setting, and I played with the dts while ds1 interacted with the asessors.

With the 1:1 assessments, I went in chatted to the assessor and then left ds1 with them while I waited outside with the dts.

It would be ideal not to have to take siblings, but it is doable with them. I think you describing interaction between them should be adequate really.

ds1 has very poor concentration levels, but I think most professionals know how to deal with it. If he wouldn't comply they'd switch tactics then maybe try again later.

good luck with it all.