Who can diagnose?

[Athena]

DD has a "working/informal" diagnosis of ASD, nothing in writing, we have only been told verbally by the Educational Psychologist.

 

The paediatrician has not diagnosed ASD, the report mentions social communication/interaction problems and learning difficulties.

 

The OT has diagnosed Sensory Processing Disorder and Developmental Coordination Disorder, and has told us verbally that DD does appear to be somewhere on the Spectrum.

 

We have applied for statutory assessment for a Statement. The LEA have telephoned me to say that they will only accept a diagnosis of ASD from a Paediatrician, not an Educational Psychologist.

 

We were going to get an independent Ed Psych report, but would we be wasting our time and money if the LEA have told us that only a Paediatrician can diagnose?

 

Is this information correct?

[baddad]

I don't think it's strictly correct, but different authorities have different 'rules' depending on the expertise available in the surrounding area. With my own LA/LEA it's pretty much a joint thing with the paediatrician/ed psych and a highly regarded S&LT team, but if they didn't agree with each other the paediatrician has more sway.

 

Most LEA's view external evidence from private consultations with a degree of cynicism, and while that's a real catch-22 for parents struggling against the system I tend to agree with them because while the percentages may be an unknown there are undoubtedly some 'Doctor Robert's' out there.

 

The OT's vague observation is probably worthless and possibly inappropriate in terms of her professional status. I think DCD is the new term for dyspraxia, and if that is the case dyspraxia and ASD's share many, many common features.

 

Equally, why has the the Ed Psych only made a 'verbal' working diagnosis? Why does her written report not accurately reflect her professional opinion? Has that opinion been exchanged with the paediatrician, other than informally via a third party (i.e. yourself). Was the ed psych's opinion offered as 'casual observation', or did it arise from specific consultation regarding your son?

 

It's quite common (perfectly natural in fact) for people to display some behaviours that are labelled 'autistic'; the difficulty is where that sliding scale moves from 'normal' features to a significant impairment in daily living. If there's also a learning delay in the mix and something like dyspraxia it gets even harder to work out exactly what's going on.

 

Hardest of all, though, is the differing opinions (or rather, interpretations - the criteria for dx is there, but each diagnostician has a completely different take on what that criteria means in real terms) on what does constitute an ASD and the postcode lottery it engenders. I have no doubts that we're now in a position where autism is being overdiagnosed, but am equally certain that in other locations diagnosticians are guilty of 'fence-sitting'.

 

Looking at your situation I would guess the best line to pursue is to get your paediatrician and ed-psych communicating - perhaps invite both to your DD's next review or try to arrange an interim review if necessary. Ask both to put their diagnosis in writing, and then refer back to those documents to highlight the questions you want to direct at the other one (i.e. if the paed has written something that contradicts what the ed-psych said (or vise versa), ask for an explanation.

 

The reality, from the LEA's point of view, is that the only evidence of diagnosis (and they have to base decisions on evidence) does not indicate ASD. Until they have evidence (from a source they consider reliable - see above) of ASD they can't put it into a statement and can't use it in any assessment of provision... Having said that, not having a dx of ASD is not actually a reason for refusing a statement - the MLD diagnosis and DCD diagnosis your son does have would probably be evidence enough if the effects and needs are reported in the 'right' way (which is another issue in itself - the SEN is based on need, not diagnosis, so even if you do get an ASD dx it won't make any difference if the statement request doesn't define a level of need that cannot be met by (i.e.,) school action plus or the provision available from the school's regular 'additional needs' budget).

 

Hope that's helpful

 

L&P

 

BD

[Sally44]

I think it would be helpful to speak with the National Autistic Society, and also find out from your own LEA who they want the diagnosis to come from.

The NAS should be able to tell you about the centres in your area that diagnose ASDs.

The professionals you have already seen regarding your son should also know who diagnosises in your area.

As there is a signfiicant number of those with an ASD throughout the UK there are usually multi disciplinary teams working in every LEA area who have experience of diagnosing an ASD.

In my case school referred my son to the SALT and EP. The SALT referred us onto a 'communication clinic', which was based at our local childrens hospital and we saw the Clinical Paediatrician and Clinical Psychologist twice over a period of 6 months and they gave the diagnosis.

I think EPs can diagnose for learning disorders such as dyslexia.

SALT assess and diagnose for language difficulties/disorders and also for Social Communication disorders or skills.

If I were you I would speak with your LEA Educational Psychologist and ask them who the Developmental/Clinical Paediatrician is that diagnoses ASDs in your area and how you get a referal to them.

I would also want full assessments carried out by a Speech and Language Therapist who has experience of speech disorders and ASDs. Both ASD and Aspergers have difficulties with language and social interaction. That is a major part of the diagnosis. You need their input to find out what needs your child has in that area for those needs to be met and those recommendations included in a Statement. Without a formal diagnosis and also a report from a SALT you are missing alot of information regarding your child's needs. Just because a child is speaking does not mean they have no language or social interaction difficulties. If they are assessed and have absolutely no difficulties in these areas then a diagnosis of an ASD is unlikely.

[Sally44]

Also without a diagnosis and a SALT report the LEA may say that there is not enough evidence of your child's difficulties or that the school has not had the opportunity to attempt to meet those needs. My son's school referred him to the SALT. I presume your school can do that too if they have concerns. If they don't have concerns why is that. Is it because they don't recognise his difficulties or is it because he doesn't appear to have any?

[Goody]

Hi all,

 

Here in Japan, it is hardly difficult to find the professionals on AS, PDD, LD and those related fields. Please take a look at my profile.

I think professionals (doctors) will diagnose but it isn't curable. We Aspie should know about ourselves what kind of functional problems we have. I know about myself more than doctors and professionals.

 

 

 

This is just FYI,

 

 

Goody,

Edited June 16, 2009 by Goody