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Doctors and health visitors


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Good evening

 

Just after your thoughts on a matter.

 

Over my many years as a practitioner and SENco I have referred many children for various reasons.

 

However I find every now and again the parent goes to their GP and whilst there comments that we've mentioned 'little Jonny may need some additional support' only to find the DR/ health vistor undermine us and reply with something like 'they're very young and seem fine to me....., nothing to worry about, no point come back when he's 5' etc.

 

I'm finding it really hard to not say anything to them - they see the child for 5 mins listen to parents and say no the Pre school is wrong.

 

It makes us loom stupid and leaves the child unsupported. Eventually ending up in school asking why we didn't notice there was a need!

 

Your thoughts please

 

:/

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i absolutely agree. we are expected to pick up issues with any of prime areas asap, and do so to prevent it from impacting on child's development in all areas. we have referred 8 of our 22 children already - 1 for psed/speech, 1 for physical, and rest for speech/speech and understanding. am dreading parents coming back and saying they are fine x

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I have some sympathy for your thoughts - last year we picked cerebral palsy in a 3 year old - HV hadn't thought there was anything wrong, the year before we also picked up dyspraxia - again HV hadn't thought anything wrong. This we excelled ourselves - child started in September last year as a three year old with no known issues apart from having had an operation on larynx and chronic constipation. Child known to 10 different health specialists - they all managed to miss the global developmental delay - this child now has a backyearing statement which we fought long and hard for with the parents - along with the usual referalls for SALT (about six so far this year) I am beginning to fee a bit like a very underpaid medic :D

 

As you say sometimes the medics don't really spend enough time with the children to really see what some of the problems are but they are very quick to dismiss our concerns.

 

I hasten to add this is not all medics - we often get children referred to us from our local hospital Child Development Centre as they recognise that we have quite a bit of experience with children with complex additional needs - nice to be shown a bit of professional respect.

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I have a BIG warning about this...keep going! if you think there is a big problem speak to the HV direct or ask the parents to go back again (and record) we now write letters to doctors as well to back up what we think and why. The reason for this is that a few years ago we had a little boy that we were worried about...over a period of a few months he did not improve and we kept sending him back on the 3rd attempt the doctor took it further (after LOTS of persuasion) he was diagnosed with Duchenne muscular dystrophy ... a life limiting condition. It was really important he got early intervension. I have been much more on the ball since then and don't accept no for an answer...doctors can be wrong!

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My problem is the parent is listening to the dr this time,thinks that they'll 'wait and see' wasting precious time.

 

I find it really frustrating - the child goes to Sch in sept and has little to no language. One word and a lot of gesturing is how he communicates.

 

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The 'wait and see' or 'watchful waiting' approach is a recognised method of putting off assessment in some authorities. It is a way of weeding out those who will recover and catch up at the expense of those who need intervention ASAP.

 

If you are really concerned about a child please keep complaining.

 

I kept sending a child to the GP and even wrote to his consultant to express my concern about his hearing loss. The audiologist put his lack of response down to stubbornness!!!!

 

He now has significant permanent hearing loss which could have been completely prevented with earlier intervention.

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Other strategies you can use are - with the parent's permission - invited the HV into the setting to come and see a child causing concern in a group of age similar peers - sometimes that gives them the wakeup call they need. If that fails (again with parental permission) ask someone from your LA SEN team to visit for a second opinion (if your LA has one). Sometimes they can get balls rolling that we can't. As others have said also document everything to ensure that you cover yourself.

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If this is mainly a SALT problem what would be your normal referral process. In this area we have a drop in centre where parents can take children for an informal assessment (they often help in diagnosing other conditions too ;) ) ...different areas have different services to difficult to know what is available to you....ring your advisor and alert them to the problem, they should be able to advise!

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Hello again

 

Thank you fr yor replies ;)

 

We've had the LA inclusion officer in who assessed the child and met with mum/dad. We had previously sent to drop in, who were not as helpful as we'd hoped and said they'd see him again in 6 months (jan) however I have called to attempt to get the appointment brought forward but the salt are reluctant as the parents always have an excuse as to why the child is not speaking as expected for his age/stage.

 

Mum speaks manderian and dad only English - however child speaks a maximum of 30 English words, 20 manderian but mainly a very high pitched screach, which he uses alongside dragging you to what he wants.

 

The other children tend to ignore him.

 

The LA inclusion officer told mum and dad that being multi lingistic was not an excuse for the lack of use of either language - mum and dad comment maybe we expect to much..........

 

I'm perplexed at the fact we're told to flag children early and get them help, yet the ppl we refer to seem to fob off our referrals due to lack of time, knowledge, funds meaning school thens flags them and everything takes longer.

 

I'm so frustrated :/

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i SOOOO know where you are coming from. We see the children daily then the 'specialists' see them once and say everything is a-ok. I think all you can do is plod on with this one and support the child as best you can. As to the original moan about the doctors...i guess the same answer is true...just keep plodding on, try and build a relationship with the HV's and just keep going. ;)

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I share your frustration - we have two at the moment who HVs think are fine but we are convinced have additional needs. One has thankfully moved and the new HV is listening to us. The local preschool SEN service is over stretched and rather alarmingly seems to be washing its hands of these two - similar children have had extra support and one to one funding in the past. I can almost hear the sigh when I ring the health visitors and tell them who's calling :/

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