visiting GP for a referral for assessment

Some further thoughts on the diagnosis.

Diagnosis is not a process of identifying ASD traits and then totting them up to come to a score. Diagnosis is about assessing communication and social skills. If a diagnosis is arrived at then it means that there are significant impairments in communication and social interaction skills. This is a matter of judgement but the process is backed up by standardised tests and questionnaires that try to measure where someone is on the autistic spectrum. If you score significantly highly enough and far enough away from 'normal' then the doctor will take this into account when amaking the assessment. The words "significant" mean that an opinion is necessary from an expert of some sort. Autism, like the mental disorders that you need to distinguish it from, is a hard thing to diagnose or to even identify by someone who is not an expert. General practitioners and many other health professionals will just not have come across it in enough detail to be able to have an opinion of their own.

Oh Dear!

Was the school paediatrician qualified to diagnose autism? This is normally done by specially trained psychologists or psychiatrists. A paediatrician will specialise in childhood conditions but may well nto be an expert in autism.

It does not sound as though a formal assessment has been made. This usually takes 2-3 hours of observation etc.

Unfortunately, I think you are no further forward in knowing whether or not your daughter as ASD. You may have to insist, very politely, that your GP refers you to a consultant who is qualified to diagnose or rule out your daughter's issues.

On the subject of diet, are you aware that soya products, particularly soya milk, are not always tolerated. Have you looked at the dietary advice at http://fedup.com.au/ ?

Again thank you so much for the help and advice previsouly given it was really helpful when talking to the GP etc. 

We have been to our GP who referred us to the school Paediatrician.  We have seen him a few times and finally convinced him that she does have ASD traits! 

We feel the traits are closer to Asperger's but we have been told that it is no longer assessed for it's all under the ASD umbrella, which we understand.

At the end of the meeting he said I agree she has ASD traits but doesn't meet the threshold for a diagnosis, he didn't say what the threshold is.  We only discussed probably about 20% of the behaviours/struggles that she copes with on a daily basis in the 20-30 minute appointment that we had.

Does anyone know if there is a national threshold or is it a local authority threshold?  Where would I find information on it?

We have been left wondering what to do next.  She is still struggling with school and daily life is a challenge.

Thanks

Elli

Sorry for not replying sooner.

We identified at an early age that she was intolerant to full cows milk and other diary products, especially chocolate.  She takes Pizotifen (she has been on this since the age of 6yrs) and has to have lactuose free milk.

Elli said:

She is already on medication to manage the stomach  cramps she suffers from which are brought on by certain food types and anxiety.

have you identified what these foods are? What medication does she take? I've got a particular interest as i have similar problems. The doctor advised antihistamines to deal with intolerance to a lot of fruits and veg. 

What the gp assesses primarily is insistance...keep at it. The line you need is: "I want you to refer my daughter to the local Autism diagnostic service." Repeat as required. Try not to be drawn into a discussion of your daughters' condition with the gp, as they cannot provide a diagnosis and lacking specialist training can misinterpret the information leading to them wanting to diagnose depression or anxiety disorder proceeding to medication... 

KaloJaro said:

Try reaching out to your daughters main teachers,

I really agree with KaloJaro's wording here and recommend that you do this by "reaching out" and trying to avoid confrontation and argument. My earlier question, about whether one of you also has the condition, was leading up to asking how good you can be, with a little thought and preparation, at negotiating for your child? As an Aspie, I have come to understand that I really wasn't any good at this, as an adult and parent, and I ended up alienating people all of the time (I still do on occasion!)

The problem with Aspergers, especially in girls, is that it truly is an invisble disability.

I got very good at faking being normal at school until one day I just snapped and my carefully constructed 'mask' fell apart to the point where I couldn't put it back together again. It really shocked/scared my teachers as I'd always been a good 'teachers pet' and they'd never noticed anything 'wrong'. So to suddenly see me completely in pieces really shook them up.

Of course the teachers I had little contact with didn't really understand, but they didn't need to. I had the help I needed, I had a reason to ask for a little help without feeling weak/unjustified, and my confidence grew. I started wearing my mask less and less, and my teachers were shocked to find I had a personality beyond 'quiet, knows the answers'.

Try reaching out to your daughters main teachers, as they're the ones she'll interact with. The Headteacher can be an idiot but ultimately in day to day life they'll have little interaction with your daughter so its not worth worrying over. If you can get your daughters main teacher/s to understand, then that's all that matters. Once I was able to bond with the teachers I saw daily, I started to do a lot better overall, as I felt safe enough to tell them what I was honestly feeling. The head of SEN at high school did a terrible job, but I never had to actually interact with her and all the TA's were wonderful.

Often, teachers will happily adapt to help students, especially if they're behaved in lesson. After discovering I learned best by drawing/doodling alongside notes in lesson, my english teacher would let me draw in the margins of all the mock exams, then give me a blank sheet of paper to take into the genuine exam so I wouldn't give in to anxiety and overdo the answers. Because of this small adjustment, I was able to actually enjoy the subject, not just tolerate it for good marks (as I used to believe that if I didn't get good marks, my future would be over).

My mum is brilliant and has gone on the warpath for me many times over the years, even moreso since my diagnosis, and what she's taught me is to try and pick and choose my fights. If you can't convince the Headteacher, focus on the teachers. Or vice versa. If the GP's don't take you seriously, then you have the right to ask if they have the qualifications to assess your daughter. If they don't have a degree in mental health, it is your -right- to demand for an assessment. Now, when you do get referred, it can take months to get seen, then months to get an official assessment. Its a long process, but again, it's worth it. Just keep doing what you're doing :)

Do you, or your husband, think one of you is on the spectrum? The condition is normally/often/frequently inherited.

Hi, it may be worth completing one of the online autism tests to show your GP

Thank you Kalo Jaro your post is really helpful in how to present the information to our GP. They have mentioned medication in the past and we have said no, we don't feel that would help at all.

We have found that in school the new head teacher thinks she knows but just insults our intelligence and what we know about our daughter.  She has little quality of life because she doesn't enjoy anything, unless horses are involved.

Thank you again for your help!! 

Hi, your best chances of getting a referal lie with a list of just how the symptoms affect your daughters day to day life, and not just inflence her, genuinely harm her, either emotionally or physcially. Many GPs are not experts in mental health, and seem loathe to refer people when they can perscribe medication to treat the symptoms, not the cause.

With referals, its hit and miss. Some GP's are on the ball and will refer you immediately for assessment. Others? Nothing short of being suicidal will make them put you down for a referal, so you have to be confident in yourself when you say you believe your daughter has Aspergers Syndrome and -needs- an assessment to live to the best of her abilities. You must must must highlight how her quality of life is suffering from a lack of diagnosis.

Deliver a compelling arguement by showing you know your stuff, don't let them give her any behavioural medication and 'see how she goes'. This is a delay tactic and often leads to more blocks down the road for when she will inevitably require a diagnosis (i.e. 'Oh shes on this medication, shes been fine on it for a while, its not urgent, keep on with the medicine and see how it goes'). Not to mention the damage behavioural medication actually does to your brain when given out by someone who isn't a mental health specialist....

Also be wary of resistance within the school, there are often teachers or staff who think they know what Autism is, because of the manner female Aspies present themselves at school, some staff will often feel they 'know best' and that she 'doesn't really have Aspergers', as they're usually only trained to handle those further down on the Autistic spectrum. Its stressful, annoying, and an uphill battle... but once you get there your daughters quality of life will almost certainly improve, after my diagnosis (again, as I'm female I had to deal with the many judgements of 'she doesn't have it') my life changed for the better, even though I was in my late teens. My little cousin was diagnosed when he was about 10 as well, also with autism, and since then he's gone on to do exceptionally well in school and made tons of friends.

Best of luck

We don't feel she needs treatment as in medication, but feel she isn't getting the correct support in education she really struggles with school. 

She is already on medication to manage the stomach  cramps she suffers from which are brought on by certain food types and anxiety.

hi & welcome!

Can I ask if your daughter has a problem(s) that needs treatment?