Private Assessment of my daughter: still left with questions

Will try and keep this brief (but will no doubt fail):

My 8 year old daughter has cause me concern since she was about 15months old. By age 4 her language was severely delayed and disordered. I engaged a private SALT and worked intensively with SALT and saw extremely good results and a lot of language development (including better attention and eye contact). Fast forward to now and school are recognizing anxiety when under pressure, hypersensitive to noise and demanding silence in class (yeah right!) slow progress in literacy and numeracy (poor reading comprehension despite good decoding) poor attention, slow output (despite adequate fine motor skills and extremely neat handwriting but strangely with no spaces between the words) and failure to finish work. She now has an IEP, ear defenders, help with literacy, social skills classes, visual plans. At home we have had severe meltdowns and very difficult/extreme behaviour, phases of constant unhappiness, difficulties with social skills, apears very rude to us and has difficulties with the unwritten social rules around playdates etc. sensory issues (extreme aversion to 'scratchy materials' and never wears socks in the house). She can be very anxious when asked to do homework, and often this is impossible. She can also meltdown at seemingly nothing, losing control, shaking, bloodshot eyes, screaming at the top of her voice, often this seems irrational and happens despite being given clear instructions, choices and consequences. Her language was recently re-assessed by the same SALT and her structural grasp of language was found to be age-appropriate but understanding of non-literal language and conversational skills markedly different on 1st centile. SALT suggested Aspergers. Sick of waiting around for NHS (still waiting for ADOS) I decided to have a private assessment carried out. The assessor did ADOS/ADI-R and observed in school at lunchtime (anxious) and at after school club (repetitve overtures to other children, didn't recognize when others were not interested, just carried on talking and repeated over and over with other children). The outcome of the assessment was that my daughter has 'significant' impairments which affect her in each area of the diagnostic criteria on an 'everyday' level, yet are not severe enough for a diagnosis. He noted her lack of gesture, lack of acknowledgement and interest in him, inconsistent interpretation of non verbal language, mild sensory issues, rituals, inflexible thinking, difficulties with social rules and very literal interpretation of written language. Yet because they are not 'severe' she needs help as per Aspergers kids but does not merit a diagnosis.

I was very impressed with this man but I wish he could have come on holiday with us and seen how many insurmountable difficulties she encountered from hot sand to new environment to suddenly deciding to not take turns at something. She is 8 years old and has just started Y4. We just watched the end of Casualty and there was about to be a car accident so the channel got changed and my daughter complained, saying she liked watching 'the travel news'. Am I right to question this non-diagnosis?

Parents
  • My youngest daughter got her diagnosis aged 7, before she had her diagnosis, I told her that I believed she had autism anyway.  The reason for this was that she was becoming negative about herself and it broke my heart, I wanted her to know that it wasn't her fault (although I emphasised that it wasn't an excuse for bad behaviour!) that she became overwhelmed and had meltdowns.  I wanted her to know she wasn't a bad person as she told me she was and told me she should be dead.  When she had her assessment, the clinicians told me not to tell her about her diagnosis.  I told them I already had.  Their eyes widened and they looked at me as if I had made a boo-boo.

    As I have Asperger's myself, I know that not knowing why you are the way you are is far more detrimental than knowing you have a label.  It helps you make sense of it.

    Maybe you could talk to your daughter and say she has some traits of the condition, if you don't feel comfortable telling her she actually has it.  You could tell her it makes her special, and have lots of amazing qualities and gifts, but also some things are extra difficult for her and make her explode.

    My daughter has threatened to cut me and kill me many times, as well as herself (she's also 8yo), and a few times I've had to hide all the cutlery and scissors up high just in case.

    Don't let what some bumbling clinician has done affect your relationship with your daughter, follow your instincts on how to talk to her.  Be led by her by asking a couple of probing questions and gauge how much information she can handle.  She will have some awareness of being different and struggling with who she is at that age.

    I don't think you made a mistake sending the private report to the CDC, it's all information that helps form the larger picture.  Perhaps when you see them though, make it very clear that you feel he should have diagnosed her and she has all the hallmarks of Asperger's.   Really emphasis her history.  When I referred my children I typed up 20+ page life reports on them as evidence each.

    If things don't pan out at the CDC diagnosis-wise, you can still ask your GP for a 2nd opinion at another clinic.  So all will not be lost.  It will just be horribly stressful for you to go through.

    Don't lose heart, it is very difficult, meltdowns are a reaction to something.  Sometimes there is no specific trigger, just existential stress that needs releasing periodically.  Just ensure she has a time out space (bedroom or wherever) that she can retreat when she feels overhwhelmed, that is a calming place maybe with some sensory toys.  Explain to her that sending her to her bedroom is not wasting her time, as she can use that valuable time to feel better/calmer and also read, do homework or listen to some nice music.

Reply
  • My youngest daughter got her diagnosis aged 7, before she had her diagnosis, I told her that I believed she had autism anyway.  The reason for this was that she was becoming negative about herself and it broke my heart, I wanted her to know that it wasn't her fault (although I emphasised that it wasn't an excuse for bad behaviour!) that she became overwhelmed and had meltdowns.  I wanted her to know she wasn't a bad person as she told me she was and told me she should be dead.  When she had her assessment, the clinicians told me not to tell her about her diagnosis.  I told them I already had.  Their eyes widened and they looked at me as if I had made a boo-boo.

    As I have Asperger's myself, I know that not knowing why you are the way you are is far more detrimental than knowing you have a label.  It helps you make sense of it.

    Maybe you could talk to your daughter and say she has some traits of the condition, if you don't feel comfortable telling her she actually has it.  You could tell her it makes her special, and have lots of amazing qualities and gifts, but also some things are extra difficult for her and make her explode.

    My daughter has threatened to cut me and kill me many times, as well as herself (she's also 8yo), and a few times I've had to hide all the cutlery and scissors up high just in case.

    Don't let what some bumbling clinician has done affect your relationship with your daughter, follow your instincts on how to talk to her.  Be led by her by asking a couple of probing questions and gauge how much information she can handle.  She will have some awareness of being different and struggling with who she is at that age.

    I don't think you made a mistake sending the private report to the CDC, it's all information that helps form the larger picture.  Perhaps when you see them though, make it very clear that you feel he should have diagnosed her and she has all the hallmarks of Asperger's.   Really emphasis her history.  When I referred my children I typed up 20+ page life reports on them as evidence each.

    If things don't pan out at the CDC diagnosis-wise, you can still ask your GP for a 2nd opinion at another clinic.  So all will not be lost.  It will just be horribly stressful for you to go through.

    Don't lose heart, it is very difficult, meltdowns are a reaction to something.  Sometimes there is no specific trigger, just existential stress that needs releasing periodically.  Just ensure she has a time out space (bedroom or wherever) that she can retreat when she feels overhwhelmed, that is a calming place maybe with some sensory toys.  Explain to her that sending her to her bedroom is not wasting her time, as she can use that valuable time to feel better/calmer and also read, do homework or listen to some nice music.

Children
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