Update following Area Inclusion Officer visit to Pre-school for DD (2.10)

[lou031205]

I just thought I would update all of you that kindly gave me so much support and advice:

The AIO visited at said the following:

-DD has poor concentration - accesses all activities, but not for long enough. So tends to flit. (I see this from the fact she comes home with 6 paintings, all with one stripe of the brush on them!)

-DD runs off a lot, and goes to the bathroom to play with taps etc.

-DD can't sit for story time for any length of time, and will run off to the doors, saying 'no' if asked to return, and finds it hilarious if the teacher comes to get her. She treats it all like a game.

• DD does not tend to play with other children. She tends to wander around on her own.

• In contrast, when there is a game in the structured time which involves interacting with another child, she thoroughly enjoys it and has a big beam on her face.

-DD's speech is not a concern, and is coming along well.

-DD puts most things in her mouth.

-The AIO does not feel DD is being 'naughty', but is unable to comprehend what is expected of her.

She initially suggested interventions and review after Christmas with a possible view to paed referral if no improvement (she felt DD is immature), but I raised home concerns, and asked if there was possibly some sort of Sensory Processing Disorder going on, because:

-DD will not wear clothes in bed, and only dresses if I tell her to. Otherwise she will stay naked all day.

-She will never admit to being cold, even if she is blue, and insists on having no covers on in bed, so just naked on a sheet, and a ceiling fan on in the room.

-She constantly climbs on to tables, other dangerous places, like the edge of the sofa arm, and says "DD faaalllll". She has no comprehension of possible danger or fear.

-She does not walk home from pre-school like other children, she roly-polys or flops down on the floor laughing that she 'fell over'. Or runs.

-She puts everything in her mouth.

-She has no comprehension of unacceptable things. For example she will do a poo on her potty, then tip it on the floor, saying "Poo fell over". No punishment changes her behaviour.

-She seems to have no understanding of 'naughtiness' other than when Mummy tells her off, she must have been naughty, so must sit on the naughty step.

-She melts down very fast and unpredictably.

-She has an obsession with the Tweenies.

-She has to really hurt herself to express pain.

-She has always had to explore things in great detail, i.e where exactly does the strap on the highchair fix into the frame. How do the straps fit together, etc.

-She will try to undo the screws on her toys using a pencil, etc.

-She has to try and peel stickers off of toys.

So, on reflection, the AIO agreed that she sounded more 'quirky' at home and coupled with her observations, she feels a Paed referral is necessary and she is going to take DD's report to their next meeting of the SN assessment group (consisting of Paeds, OT, SALT, etc) on the 24th October.

She feels DD definitely needs 1:1, and not just for freeplay but for the whole session. She seems to think that there is no problem funding this. I mentioned that she will increase to 5 days in January, and again she says funding is not a problem.

Interventions for her IEP include:

-Sand timer for activities to encourage increased attention.

-Small group language lessons, 10 mins each day, to encourage attentiveness and listening skills.

-Turn-taking games to encourage interaction with other children. Teachers to encourage children to join DD in playing the game.

-1:1 for all sessions.

-Introduction of a smaller story time with 2-3 other children for DD, with occasional encouragement to join bigger group.

-Ignoring DD if she runs off as long as she is safe, to prevent reinforcement of behaviour from negative attention.

Suggestions for home:

-Motivational box for tactile items she can explore IF I think she nees it out - either in times of being highly wired, or if she has been particularly good.

-NO NAUGHTY STEP - she doesn't get it, and it is just a game. Distraction only.

-Ping pong balls in a jar - if she earns 5 in a morning, she gets to do something messy/tactile, i.e. gloop, playing with bubbles in a sink. Or something like a story, trip to the park. A small treat. Same for afternoon.

-Use Makaton sign when asking her to sit down. Have started this and it is like I have hypnotised her!

-Use stop rather than No, so that she doesn't see it as an opportunity to 'fight' me.

Sorry this is so long, but does anyone have any thoughts? I was quite pleased at the outcome

Hi lou,

I would seek to ensure that you see a Developmental paed rather than just a general or community paediatrician. I would also look into getting a referral from your GP now with regards to the paed rather than after Christmas (those waiting lists are miles long as it is).

I would also look into applying for a Statement of Special Needs for your DD asap from the Local Education Authority; this is a legally binding document that will give her extra support (particularly useful too for when she is in school). You do not either need a diagnosis or nursery's permission to apply for such a document; infact this is better off coming from you anyway.

HTH

Attila

What are your concerns? To me she seems like a normal toddler. I'm very impressed you have gotten so much from them, when and why was she referred?

Thanks Attila, apparently the paed is from a group who gather together to discuss children that are educationally of concern, so I gather it will be a paed with an interest in development. The meeting in which DD will be discussed is on 24th October, and I think then she will be fed into the system.

Not sure about a statement at this stage, esp as they seem so keen to provide her with assistance.

AmIWhatAndWhy - The pre-school raised concerns which I outlined on this thread I had just thought she was extremely hard work, and that I was a bad mum.

It was the pre-school that referred her to the AIO on 11-09-08, and she visited yesterday.

It is a bit hard to explain on paper, but everyone who knows her has nodded when I said the pre-school think she may have a special need.

Hi Lou

I am glad your DD has been flagged up for extra assessment. I think personally your DD needs more assessment from the developmental Peadiatrician.

I mention the Statement for the following reasons. It is fab nursery will provide this level of 1 to 1 support now but you have to think longer term too. Your DD won't get this extra level of support in school given at nursery unless there is a Statement in place.

Yes, in the long term you may be right, Attila. I suppose I am being cautious because the AIO would only have pegged her as 'immature' if it wasn't for the things I pointed out. So until seen by the paed, I won't know if my suspicions are correct about there being more than a little immaturity going on.

bump

I read the first few lines and thought she sounded similar to my NT dd who is a couple of months younger. The rest of it reminded me much more of my ds2 (AS) who has sensory issues, especially the dislike of clothing and an inability to feel the cold. I would go for a referral too.

Thank you so much!!!

Tclanger, it is so weird, I was just going to hijack another thread you are on because I wanted your opinion, as you were so helpful when I asked about 2.9 year olds.

I am just so glad I was brave enough to mention the possibility of a SPD to the Area Inclusion Officer. She had pegged DD as 'immature', although she didn't indicate what time frame she feels DD lags by. But when I told her of all our experiences of DD at home, which all seem very sensory to me, she changed her mind and felt a referral was needed sooner.

She says there is a panel that meets once a term, and referrals for this term have to be in by Friday. So she will get discussed at panel on the 24th October. Apparently there is a paed, OT, AIO, SALT etc that meet.

The bag that you talk of sounds a lot like the 'Motivational box' that the AIO was telling me about. She is going to give me a list of things to put in it, like rubix cube, squashy ball, nik naks of all sorts.

I am just so glad I am not mad. I just thought I was a bad mum. I am having a bit of an emotional low, tbh.

It is just so draining having to tell people, and them saying 'yeah I thought something was up'. WELL WHY DIDN'T YOU SAY SOMETHING WHEN I WAS STRUGGLING AND TELLING YOU I THOUGHT I WAS A BAD MUM WHO COULDN'T CONTROL HER DAUGHTER?

I had to tell the church toddler church today, that pre-school is going to be providing 1:1 and they think there is probably a SN of some sort. The leader of the session said that he had kind of guessed, and they had been allocating one worker just to DD for months He also said that he loved DD and he thought she was amazing and funny . It helped alot.

I will, of course

I can't thank you enough for all your input. It is so good to know that we are not alone, and that this isn't the end of the road for DD. She is so adorable and has amazing character. I just don't want her written off because of her behaviour.

I do have another question, if that is all right? The AIO said to abandon the naughty step and just distract. Earlier, DD was frustrated because she decided she wanted coffee, and we obviously didn't want to provide her with some at 2.10 years old! She got very cross, and frustrated. She was screaming and shouting, and when we ignored that, she came over and hit me several times (not hard, just out of frustration). When I ignored this, she went on to bite her hand hard. I waited till she was 'touchable', and pulled her onto my knee and told her how much we loved her, and talked to her about how cross she was, and asked her questions like "did mummy make you cross", etc. She was able to tell me that she was cross and sad.

Did I do the right thing? Hitting me is totally unacceptable, yet I don't know how to handle it in the light of this new information. Previously it would have earned a spot on the naughty step. But this has been vetoed. What would you suggest?

Just a quick update - DD went to pre-school on Monday, and when I went to pick her up they said that her 1:1 has started, even though they don't yet have the funding through, and they had seen a huge difference even in that one session!

Apparently their inclusion co-ordinator (one of the pre-school workers) (B)is using her 1:1 for all behaviour/ development stuff, such as free play etc during the earlier part of the session, and her key worker (A) is using her 1:1 for the educational side, working towards her early years key skills.

They said that until now if there was more than one child at a table, DD would just watch what was happening, and wouldn't join in. But yesterday with B's encouragement, she actually joined in with 3 other children!

A said that she had started simple counting with DD, as she knows the pattern of numbers (so 1 comes before 2 before 3), but she wanted to start giving her the concept of quantities in counting. I asked DD whether she did counting with A, and she said "one, two, three bears".

They were really pleased with her, and said that although funding isn't through yet, and they haven't had the report with DD's IEP yet, they just wanted to crack on with what they do know they need to do, and can do.

I am so pleased! We are laminating our lounge floor this week (it is half done) so that we can do messy play as rewards for good behaviour.

Still a bit of an emotional rollercoaster, realising that DD may have significant issues ahead (why else would the pre-school ask for free play 1:1, and the AIO suggest full 1:1 instead?), and seeing her behaviours in a new light. It almost seems easier to have thought she was particularly naughty, rather than developmentally behind. Now I know different, I am having to adjust to the new world I am entering.

She is, and has always been, a little ray of sunshine. So lovely, so caring, so independent, so quirky. I suppose it is just making the most of the empowering quirks, and minimising the effect of the limiting quirks on her little life.