Just been emailed OT report

[claw3]

Ive just received my long awaited OT report. I have been waiting since December 2008 for it.

In order to comply this report, she went into school once and observed him during playtime and lunchtime recently, after not seeing him since December 2008 (and me making an official complaint to the NHS about her)

Now i have been 'negotiating' with school to put some help into place for ds and some parts of her report are well, damning and i would like your advice.

For example since starting school in January 2009 ds has never eaten any of his packed lunch or if he does he will eat literally one mouthful of his sandwich. OT report states based on her observation 'ds is a full and willing participant and has been seen to eat his dinner within his designated table'

She states she has attended 'multi disciplinary meetingS at school. She attended ONE meeting and it was not 'multi' the only outside agency there was her. She attended this meeting as ds had been extremely distressed and confused in school and was claiming that lots of children were 'hitting' him and they were not (she hasnt mentioned this) she covers this by saying 'playtime has in the past caused ds some difficulties in social interactions. Then goes on to say 'ds was observed playing happily with other children'.

Now for the really damning bit 'Particularly work has been undertaken in conjunction with his school around the school day and particularly toileting and break times. The school have worked very hard with ds to ensure that he is fully supported and all strategies suggested are being undertaken.

For example

1. A concrete set of pictures on a key ring such as a ?toilet- for I need to go?.
2. I need assistance as I?ve soiled self.
3. I need time out from the playgrounds etc.

The school have basically handed ds 3 cards, which he doesnt use. He gets no other support or help other than that.

Grumpy, sorry got involved with trying to get my head around which part of the OT report to pull apart first, so didnt check back here.

Thats terrible they want to offer you nothing, but then tell you are not doing it 'right' and the SEN officer slagging you off, i should be shocked, but im not. Im sure the school phone ahead to warn everyone im a nutter, strange how they phoned CAMHS the day before our interview and had a 'chat' with the therapist we were due to see!

You are further down the road than me, so i cant add anything helpful as we havent been there yet, but i can totally sympathise with you.

Im off now as ds is here, just wanted you to know you have my support, i think they have acted in a pretty shitty way too.

Grumpy, I'm so sorry you had to go through that.. It is challenging enough to have endless rounds of meetings with professionals in which you have to tread a fine line between getting them onside but sticking to your guns, but to have them turn on you in your home is pretty unforgivable.

I hope you're feeling a bit better about it but it is hard to be undermined like this when your only concern is your child.

Claw - if it is any comfort, DS is getting better about eating and I did exactly as you have. Not forcing or pushing food on him. Bit by bit he has improved and I understand these things do get easier with age.

Actually we're on a rare night out with our earlybird chums so will be lots of wine and mutual moaning. And granny is staying over so maybe even get a lie in

Grumpy and Claw, and I hope things improve.

Starlight if I am ever up your way I willtake you up on that. I don't doubt its a good thing but here allthey push is TEACCH, which i think is better than nowt but not enough IYSWIM.

On a night out with carnival tomorrow

That's good grumpy - nice that you made some mates there too

Starlight Itrust thepeople who doABA to pick somethuing good for their child- I amnot negative about itpersonally, it was just never an option for us being the bunch we are.

We did bibic for a while but X3 it was just too much. Our lives are asd therapy though LOL, allroutine / managed social interaction etc. I would start my own therapy scheme but the ABA peeps nicked my name for their website

Grumpy, the swines, the absolute swines.

Do you know that the RCSLT (Royal College of Speech and Language Therapy) accepts ABA as a valid and evidence based treatment? (Your SALTs probably don't know this but I do.)

It is laid out in a planning and commissioning document for services for ASD, fresh off the press.I'll link to it-it's freely available to anyone.

Very poorly written and referenced and makes use of old evidence but IT IS THERE.

Print it off, read it (not hard to read) and next time they come out with their ill informed bile, wave it in their faces and say

'How odd that you are refuting endorsements and recommendations made by your governing body.'

Then, watch their jaws drop.
The trick always is to use their own weapons against them.

Here you go my darling. Take a deep breath, read it then get out there again.

XX

You're dead right about TEACHH, Star.

That's an interesting document Moondog.

How does it fit with the apparently common practice of SALTs recognising social communication difficulties as part of the ASD diagnostic assessment and then discharging because schools have a toolkit and untrained TAs to deal with it?

I'd genuinely like your opinion on that if you have a moment

I can't comment on that as an official stance as have no knowledge (beyond anecdotal) of how prevalent it is. My personal view is that SALTs are not the best people to work exclusively with children with ASD in the early stages, particulalry very challenging kids. This is because SALTs have no theoretical training in behaviour management and arranging reinforcing contingencies for children who don't (at least initially) find social communication (ie communication for the sake of it, rather than that designed to get them something) reinforcing.

Behaviour analysts do, because thier background is in the science of behaviour which is rule governed. SALTs are needed at a later stage when behaviour under more control and children more amenable to co-operation.

SALTs are great-they have a rigorous training and know a lot about communication. Their remit and caseloads are so wide though and peopel with ASD are a completely different kettle of fish to any other communication disorder.

Assistants and 'toolkits'???? Noone ever reads or acts on those silly little boxes full of papers. As i say repeatedly, it doesn't matter what the peopel at the top say.Unless the person supporting the child on a day to day basis has a good training and support system, it is quite often a waste of time and (research suggests) even damaging.

If you are interested in this stuff and growing acknowledgemnt of it as an enormous problem, I'd recommend reading the very readable Bercow Report and Lamb Inquiry, both of which slam the present state of affairs and make concrete recommendations which are' happily, being put into place also.

The Treehouse school website has some good press relaeases commenting on this stuff too.

Thanks. My son has no behaviour management problems. He is nearly 7 and a very good little boy at school who has trouble communicating his needs - trouble with the social communication side of things. he doesn't need a behvioural intervention before he is supported.

It worries me that a SALT is capable of commenting on this, as an 'expert' as part of a multi-disciplinary team as indicated in the document you provided a link to, but will not get involved in monitoring a social communication intervention.

Bercow's report comments on social communication as well as language skills being crucial to education, yet it is all lef to poorly qualified TAs.

This is not a dig at you. I was just hoping for information on whether this type of intervention i.e. assisting a child with ASD in developing communication skills was seen as an appropriate part of a SALTs mandate

I'm not taking it as a dig at me, don't worry. It's a valid discussion point.

It sums up something else I am unhappy with about the present SALT model.What is the purpose of pointing out problems and areas of need unless you are going to address them?

Assessment without follow up evidence based intervention strikes me as morally wrong.

Social communication is very much part of a SALT's remit.If they tell you it isn't, ask to see the policy which states that with the reason why.

Thanks Moondog. Is it something the Head of SALT should address? My son was discharged in October and has had about 4 sessions at school with a TA since. The more I have looked into it, the more annoyed I get. Especially, after going to see Carol Gray and Michelle Garcia Winner and seeing the type of work which can be done.

Much appreciated!!

My advice to antone with an issue is to cut through the middle men (or women) and deal with the manager direct. I'd recommend writing things down and keeping records.

I don't know what the exact issue is with yuor ds so can't advice more than that, other than to say that if you are unhappy take it to the people who are paid to deal with this stuff.

Does your ds have a statement? Also important to get SALT quantified and specified in that.

Did you go to Bournemouth to see them?I would have loved to have gone.Carol Grey is fantastic.

Thanks. I know as a professional, you can't comment on specific cases beyond yoour knowledge. DS is heading for an Asperger's dx but has been discharged without justification after needs were identified.

I understand from school this is a normal practice and it just annoyed me!!

Carol Gray rocked - inspirational!

Sorry about hi-jack claw!!

Debs, no worries, not a hi-jack at all, glad that people are talking and sharing info.

Peachy, i thought by giving him less to eat, it would solve the problem of him getting anxious about being last. I asked him yesterday, so did you manage to finish your lunch today?. No he was still the last one! Why because the teacher told him he had to finish his drink, they just dont get it. And with a report like that from OT saying they doing all that they can, they never will!

Im glad to hear that food issue can get better in time and there is hope.

Now this morning i have received hard copy OT report in the post and can see who copies have been sent to.

I am currently in the process of pulling the OT report to pieces, should i copy in all the poeple that the report has been sent to, just in case they refuse to withdraw it?

Thanks Moondog, and sorry Claw about double hijack. I don't think the SALT does actually disagree that much with what we are doing, the Manager and our supervisor had a good chat whilst my SALT was giving me both barrels and actually they aren't that far apart. Its more our SALT's personal terror of going to tribunal (shes a bit meek and easily frightened)l that she allowed to colour her attitude to us, DS therapy etc as though if she jumps on the LA bandwagon they will let her off the hook. She's already said positive things about DS progress with ABA so she can't take that back. Just was shocking how the word of one SEN officer that we were unreasonable parents can change the attitude of everyone. Like they forget to use their own judgment. Of course makes us nervous that we are now going to encounter this confrontational attitude now everywhere we go and DS is just getting even more lost and neglected in the process. Just felt a bit battered and bruised but we will come back out fighting. Made me realise I definitely want to get someone else to do the advocacy at tribunal who's less emotional!

That's a good idea Grumpy.However focussed you are, he is still your child and being a mother is very different to doing this for a job.

You need to focus on facts, not feelings.Remember that.
If you can demonstrate positive outcomes from the intervention used (by taking baselinie measurement and plotting progress) then there really is no argument.Remember-they are more scared of tirbunals than you are.Many people I know who have been, say the process is a wonderful relief.

I use the Motivaider a lot. Really useful in meetings where you need constant reminders not to get emotional and recriminatory but stick to the facts.