SALT report not supporting Stat Asses

[daniels-mum]

Good evening all,

 

I have had a setback today in Stat Assesment Request procedure, I have had the SALT report back and she has said that DS does not meet the YR 6 criteria for Statutory Assessment under E Band Communication and Interaction Funding. Does anyone know how much emphasis is placed on the SALT report. DS teacher is supporting my request and I have a great Community Paed but this has really thrown me. She has stated that DS has difficulties with reciprocal social interaction particularly with peers in unstructured times, and difficulties with processing auditory information.

 

This is further complicated by the fact this SALT works very closely with the Senior SALT who was part of the CAMHS team that saw DS and decided he did not meet criteria for a diagnosis of ASD/AS.

 

I have recently asked for a second opinion at another CAMHS within the city but the original CAMHS has asked me back to discuss my request for a second opinion. In essence it is the same SALT who sits on the diagnosis team within sons CAMHS and who also inputs into the STAT assesment procedure, albeit through a SALT who works under her.

 

Does all this make sense, im confusing myself now.

 

Sorry, just had to let of steam, im sure family are sick of me rambling on and on about it all, im just not having a good day and was really pleased with myself at weekend after sending all my views and reports off and this has upset me.

[wasuup]

Could you ask what criteria his needs do meet then? I don't know what to advise. <'>

 

 

This is the banding criteria for communication and interaction

band D for my LEA

 

Support to facilitate effective communication, interaction and curriculum access / personal development and to ensure understanding of instructions and tasks and to modify language through a specified programme for some of the day.

Support to develop attention and concentration skills for some of the day.

Frequent SLT advice or input from staff with relevant expertise.

Specific/targeted and visual strategies to enhance the communication environment throughout the day.

 

This is band E

 

Assistive or Alternative and Augmentative Communication (AAC) needed e.g. Makaton / PECs

Support to facilitate effective communication, interaction and curriculum access / personal development and to ensure understanding of instructions and tasks and to modify language through a specified programme for most of the day.

Support to develop attention and concentration skills for most of the day.

Frequent advice and occasional input from SLT or staff with relevant expertise to train school staff in Assistive Communication.

Specific/targeted and visual strategies to enhance the communication environment throughout the day.

 

 

Statutory Assessment Criteria for Children with Autistic Spectrum Disorders

 

Evidence of Intervention (all to be present)

1. Evidence that the school or early years provider has sought appropriate

advice from outside specialists and implemented any recommendations

made by such specialists.

2. Evidence that parents have been consulted about following a programme

of intervention with their child.

3. Evidence that a suitable intervention programme has been implemented

with the child by the Early Years Provider or school that the child attends

for at Least two terms.

4. Evidence that input from an educational psychologist and/or paediatrician

has been given to parents and the Early Years Provider or school, and

that this advice has been incorporated into the intervention with the child

for at Least one term.

Evidence of Response to Intervention and Level of Difficulty

5. Evidence that all three features of the ?triad of impairment? are present to

at Least some degree:

a. The child?s social functioning is impaired in one or more of the

following aspects of Social Interaction:

? Interaction with adults or children.

? Interaction in small groups of 2 or 3 as well as larger groups.

? The use of eye contact, facial expression, body posture and

gesture to regulate social interactions.

? To develop and maintain appropriate peer relationships.

b. The child?s communicative functioning is impaired in one or

more of the following areas of social communication:

? A significant delay in receptive and/or expressive language

skills, not accompanied by compensatory use of gesture or

mime.

? An not accompanied by compensatory use of gesture or

mime.

? An absence of language.

? Superficially perfect expressive language.

? Impaired comprehension of language including

misinterpretations of literal/implied meanings.

? A relative failure to sustain conversational interchange (at

available language skill level with reciprocal responsiveness.

? Stereotypical and repetitive use of language, and/or

idiosyncratic use of words or phrases.

? Use of pitch, stress, rate, rhythm and intonation of speech.

? Uses echolalia or delayed echolalia (i.e. repetition of phrases

out of context).

c. The child?s functioning is impaired in one or more of the

following areas of imagination:

? There is an impairment of flexible thinking, imagination and

adaptation to change. This varies from difficulties with

development of 'pretend play' in the early years to difficulty

with inferential/hypothetical/philosophical thinking in the later

years.

? In general, the child displays restrictive, repetitive anand

stereotypical patterns of behaviour, interests and activities.

These may be seen as:

! A preoccupation of stereotyped, restricted patterns of

interest.

! Specific attachment to unusual objects or all-absorbing

narrow interests.

! Apparently compulsive adherence to specific,

non-functional routines and rituals.

! Distress over small, non-functional changes in the

environment or normal daily routines.

6. Evidence that some of the following associated features are present:

a) Age of Onset

? Impaired development is evident before the age of three

years.

? Communicative phrases may be used by three years or

earlier.

? Self-help skills and a curiosity about the environment during

the first three years could be at a level consistent with normal

intellectual development.

Cognitive Ability

? Significant discrepancies between various facets of cognitive

functioning as measured by the National Curriculum tests and

standardised tests of cognitive ability.

? Islets of skill in certain areas, e.g. music, arithmetic, jigsaws,

assembling mechanical or electrical objects. This contrasts

with lack of skill in other areas.

? The unusual recall of routes, maps etc, without interpretation

or change.

c) Eye-contact and use of visual skills

? No eye contact or fleeting eye contact.

? Use of peripheral vision.

? Looking past people and objects.

? Fleeting eye contact.

d) Sensitivity to Stimuli

? Heightened sensory awareness to sound, light, taste, smell or

being touched.

? Indifference to pain or cold for example.

e) Motor Control

? eg excessive stereotypical behaviour such as hand flapping,

jumping, exaggerated facial responses or tip-toe walking;

unusual posture, uncoordinated large movements or tactile

defensiveness.

f) Motor Imitation

? Difficulty in copying skilled movements.

? Difficulty with left-right, back-front, up-down.

g) Physical Functioning - sleep, appetite, etc

? Erratic sleep patterns.

? Erratic eating and drinking patterns.

? Restricted diet.

? Unusual toilet habits.

h) Emotional Reactions

? Excessive or lack of reaction to everyday situations.

? Excessive fear of harmless objects or situations.

? Absence of fear or real danger.

? Laughing at others distress.

i) Behaviour Problems

? Socially immature and difficult behaviour.

? Screaming, temper tantrums, running away.

? Socially unacceptable habits.

7. Evidence that despite intervention as outlined in 1-4 above, the child?s

abilities have failed to improve in the areas identified in 5 and 6 above.

Evidence that Other Explanatory Factors have been Excluded

8. Evidence that the child does not have primary difficulties in another area

(eg Hearing Difficulties).

9. Evidence that the child does not have a significant delay in overall

cognitive development.

10. Evidence that the child is not displaying ?Elective Mutism?.

11. In the case of a child for who English is an additional language, evidence

that communication difficulties are apparent in their first language

[daniels-mum]

Thanks Wassup for the reply. I will have a good read through all that info.

He is currently on SA+ and has been for years now, he gets 6 units of funding and is supported about 75% of the time in class either individually or small groups. He is going up to High School in Sept and I really want to have things in place for then as they will be reviewing his funding not long after he starts, hence why I want to apply for a stat assessment and a statement, where the money comes from then is no concern of mine.

 

With regards to diagnosis or "non diagnosis" the criteria they used was ICD-10.

 

One of the things they said he missed was that he didnt have a significant delay in his speech before two years, but I have been reading up since and I am of the impression that there doesnt need to be a delay for a diagnosis of Aspergers (although I will stand corrected), and in fact it is one of the ICD-10 criteria that there isnt a delay.

 

The other thing was that they said that on occasions he interacted well with people with they wouldnt expect from a child with Aspergers, but in the report I have just got today she has said for the speech diagnosis "Difficulties with reciprocal social interaction particularly with peers in unstructured times, and difficulties with processing auditory information". I bet her boss will kill her for putting that in!!

 

The other things was they said he didnt have all encompassing interests, but he is 11 yrs old and sits in his room and writes lists from Thomas the Tank Engine when all th other kids are playing out, it is also well documented that he paces up and down the school playground at breaktimes and wont play with other children even if they ask. If thats not repetitive behaviour I dont know what is.

 

At the time of the non diagnosis I just accepted it, although I was devastated but I have since thought about things and looked at the ICD-10 criteria in more detail and he def meets it from my point of view. I am dreading going back next week, but am determined to see it out.

 

Thanks for taking the time to reply, I have had an awful evening and no one to talk to, its just whirring round my mind is the letter from the SALT.

 

I know its late but I think Im going to have to have drink!!

[wasuup]

Thanks Wassup for the reply. I will have a good read through all that info.

He is currently on SA+ and has been for years now, he gets 6 units of funding and is supported about 75% of the time in class either individually or small groups. He is going up to High School in Sept and I really want to have things in place for then as they will be reviewing his funding not long after he starts, hence why I want to apply for a stat assessment and a statement, where the money comes from then is no concern of mine.

 

With regards to diagnosis or "non diagnosis" the criteria they used was ICD-10.

 

One of the things they said he missed was that he didnt have a significant delay in his speech before two years, but I have been reading up since and I am of the impression that there doesnt need to be a delay for a diagnosis of Aspergers (although I will stand corrected), and in fact it is one of the ICD-10 criteria that there isnt a delay.

 

The other thing was that they said that on occasions he interacted well with people with they wouldnt expect from a child with Aspergers, but in the report I have just got today she has said for the speech diagnosis "Difficulties with reciprocal social interaction particularly with peers in unstructured times, and difficulties with processing auditory information". I bet her boss will kill her for putting that in!!

 

The other things was they said he didnt have all encompassing interests, but he is 11 yrs old and sits in his room and writes lists from Thomas the Tank Engine when all th other kids are playing out, it is also well documented that he paces up and down the school playground at breaktimes and wont play with other children even if they ask. If thats not repetitive behaviour I dont know what is.

 

At the time of the non diagnosis I just accepted it, although I was devastated but I have since thought about things and looked at the ICD-10 criteria in more detail and he def meets it from my point of view. I am dreading going back next week, but am determined to see it out.

 

Thanks for taking the time to reply, I have had an awful evening and no one to talk to, its just whirring round my mind is the letter from the SALT.

 

I know its late but I think Im going to have to have drink!!

 

 

I don't know the answers but it won't just depend on what the SALT says as everyones view including yours will be taken into account before a decision is reached and there are other areas to take into account not just communication and interaction part. <'>

[Sally44]

Get in touch with the National Austistic Society and speak with their educational advisors.

They are sending you in circles.

You don't have to agree with the SALT, and I doubt she has done very extensive assessments of your child to come to the conclusions she has got. If she has a diagnosis of an ASD she has language communication and social interaction difficulties. These needs have to be met. Unless the SALT is suggesting she is wrongly diagnosed??

What is her expressive and receptive speech like. Does she struggle to find the right words to say, does she use delayed echolalia, what is her auditory memory and auditory processing like, does she have problems with working memory, does she have Semantic Pragmatic Speech Disorder. What are her social skills and play skills like. Have they even been assessed? Does she have a Social Skills group or supports during playtime and dinnertime. Do they use something like Circle of Friends. Is the SALT even have a specialism in autistic spectrum disorders.

If you reply no to any of the above, she hasn't done a thorough job.

You can get private reports done. But make sure they are independent ie. don't work for the LEA or NHS, and make sure they have experience of Educational Tribunal work. Then watch the LEA run.

Private reports do not make things up. But they will do all the assessments you want and will give an unbiased report that will state what she needs to support her. LEA and NHS professionals work to their departmental budgets. There is a big difference. And once you have evidence of what your child needs it has to be provided BY LAW. If the LEA don't have the staff available they have to BUY IT IN from outside professionals - no one will tell you that.

So get in touch with the NAS to start with, and also your local Parent Partnership.

[Karen A]

Thanks Wassup for the reply. I will have a good read through all that info.

He is currently on SA+ and has been for years now, he gets 6 units of funding and is supported about 75% of the time in class either individually or small groups. He is going up to High School in Sept and I really want to have things in place for then as they will be reviewing his funding not long after he starts, hence why I want to apply for a stat assessment and a statement, where the money comes from then is no concern of mine.

 

With regards to diagnosis or "non diagnosis" the criteria they used was ICD-10.

 

One of the things they said he missed was that he didnt have a significant delay in his speech before two years, but I have been reading up since and I am of the impression that there doesnt need to be a delay for a diagnosis of Aspergers (although I will stand corrected), and in fact it is one of the ICD-10 criteria that there isnt a delay.

 

The other thing was that they said that on occasions he interacted well with people with they wouldnt expect from a child with Aspergers, but in the report I have just got today she has said for the speech diagnosis "Difficulties with reciprocal social interaction particularly with peers in unstructured times, and difficulties with processing auditory information". I bet her boss will kill her for putting that in!!

 

The other things was they said he didnt have all encompassing interests, but he is 11 yrs old and sits in his room and writes lists from Thomas the Tank Engine when all th other kids are playing out, it is also well documented that he paces up and down the school playground at breaktimes and wont play with other children even if they ask. If thats not repetitive behaviour I dont know what is.

 

At the time of the non diagnosis I just accepted it, although I was devastated but I have since thought about things and looked at the ICD-10 criteria in more detail and he def meets it from my point of view. I am dreading going back next week, but am determined to see it out.

 

Thanks for taking the time to reply, I have had an awful evening and no one to talk to, its just whirring round my mind is the letter from the SALT.

 

I know its late but I think Im going to have to have drink!!

 

Hi.The information re speech delay relates to high functioning autism.The diagnostic criteria for AS specifically state that the development of language is within normal development or advanced.Ben has extremely advanced spoken language and always has.So I agree with your understanding.It is worth checking that the SALT has specialist knowledge and training re ASD.Ben was seen weekly for 18 months re dysfluency [stammer ] between the age of 3 and 5.The SALT never raised any possibilty of ASD.Karen.

Edited March 26, 2009 by Karen A

[Sally44]

For a diagnosis of Aspergers language development is supposed to be typical. However, most children with Aspergers do have language and communication difficulties eg. literal interpretation, problems with semantics or pragmatics, auditory processing or auditory memory. Usually the expressive speech is average or advanced. Sometimes there are problems with receptive speech.

[Karen A]

For a diagnosis of Aspergers language development is supposed to be typical. However, most children with Aspergers do have language and communication difficulties eg. literal interpretation, problems with semantics or pragmatics, auditory processing or auditory memory. Usually the expressive speech is average or advanced. Sometimes there are problems with receptive speech.

 

Hi.Sorry I was not very clear.I should probably have said ''the development of spoken language'' rather than language.All children with Asperger have social communication difficulties. Karen

 

[daniels-mum]

Thanks for the replies I appreciate people taking the time to do so. I think I'm just having a bad week.

 

I am going back to CAMHS next week to discuss my request for second opinion. Luckily one of the other mums from school is going to go with me, she has been through it all with her son who has a statement and a diagnosis and she also is a parental supporter for Parent Partnership, I am really grateful that she is coming with me as I am not as knowledgeable but I know they wont get past her at all as she ace. I am daunted about going back though as I am seeing the same people who wouldnt diagnose son last time but it has to be done.

My son has actually regressed alot since they last saw him, both at home and in school and his teacher said if they come to see her a now she would give them a completely different picture to when they first visited him as she had only known him for a fortnight then. I have asked if I can take a copy of her views from the Statutory Assessment request with me to show them.

I am glad I am right about the ICD-10 criteria, I have been through it with a fine toothcomb and my son definately meets their Aspergers criteria so I want to raise this with them next week.

I have been looking into private reports, there is a guy near me who is approved by the NAS and has been seeing children and adults for years, so I will be keeping him in mind.

Its all so stressful at the moment, I have got a special delivery letter to collect from the sorting office in the morning as I wasnt in earlier when they brought it. I think it may be from the LA, I am going to pick it up at 7.30 in the morning when I take my youngest son to nursery but I just wish I could read it now!! I just hope and pray its good news, but im not holding out much hope.

 

Thanks again for the replies, it does help, I feel like there is no light at the moment, I just keep telling myself it will be so worth it if things work out x

[Sally44]

You are entitled to take any evidence you have that supports your case. Professionals' advice should be shared. Ask your son's teacher to put her concerns in writing. Send a letter to the SALT requesting her to put in writing what statutory assessments she has carried out on your child, what the results where, what the SALT believes the difficulties/needs are and how school should be meeting them. List how your child has regressed academically and socially (IEPs being SMART is very important, as it should record regression in ability ie. last IEP child recognised 20 high frequency words, now recognises 13.

Put in your letter that you have looked at ICD 10 and that your child meets the criteria for Aspergers. You can give examples of how you believe they fit the criteria. The other criteria is DSM IV - you can look at that too.

Put in the letter that you are not satisfied with their service and how your child is being supported in school and how they are continually regressing academically and socially and that you will be seeking legal advice. Then see what happens. Also get in touch with the National Autistic Society. Also refuse to sign any agreements that suggest you are happy with your child's provision at school.