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Paediatrician doesn't agree!


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Feeling I need some advice regarding a child at my setting, he joined us last Sept and from beginning KP shared with me she had concerns about his general development and having observed him and also carried out the 2-year development check, feel this little boy has a global development delay in all the prime areas.

Initially, bearing in mind the 'softly softly' approach, going down the speech and language checklist with mum asked if okay for me to refer for speech and language assessment. In November, at the review meeting, working in partnership with child's HV, suggested mum go to GP and share our concerns (mum feels that he has made some improvement since starting with us, but think she feels we are 'pushing' for referral and has gone along with it). Was pleased that GP agreed to refer and paediatrician appointment was (for once) very soon (usually takes 3-4 months). Mum returned from appt in December and said 'doctor had no concerns about her child, was developing 'normally', this was confirmed in a letter to the HV.

Now feeling somewhat 'undermined'...not sure if that's the right word, but it is obvious to us that this child has a development delay of about year or more in all prime areas and just for the life of me can't understand why the paed didn't feel the same way!

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i would speak to your area senco and put your point forward. Do you have a connection with the assessment centre? and write everything down so that when the parents come to you in 6 months in a panic you have all the details to hand.

 

You can of course set an iep up for him to 'help'him develop which would still give you a road into helping Mum and the child and agree a course of action. Has she seen where he is on any developmental chart (or dm statements) so that you can make comparisons?

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Guest lillybeth

Unfortunately other than record the information there is little you can do. I had a similar situation with a little boy who I thought had cerebral palsy, consultant said he had foot drop. Dr retired new one took over and after a scan the child has been diagnosed with cerebral palsy. Also you do not know if the parents underplayed the situation when they saw the consultant.It is so hard but as finleysmaid said record his development and show the parents.

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Did the paediatrician not ask for a report from yourselves on this child? Not exactly fulfilling the multi-agency working style that we are meant to adopt if not! But then it also depends on the paediatrician I find. Some listen to what school / settings say while others completely ignore you. I had a child in F2 who clearly was on the autistic spectrum, he went to a paediatrician who stated that if school were aware he had difficulties and were manangin those then that was enough. He was in Year 3 when he finally received a diagnosis. It is so frustrating when you are in this situation, especially if the parents aren't seeing what you are seeing. At least if they are recognising he is having difficulties they can be the strongest catalyst in getting things sorted.

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thanks for your replies, yes i gave parent a copy of 2 yr dev check to take to GP and IEPs in place. Also have invited SEN support from LA to review meeting and to observe + ed psy so will be lot of profs around at meeting! its just that this makes me question my prof opinion but know child better than a 'snap shot' appt by paed in clinic!

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I have been told today that a child, whom mum and I suspect is on the autistic spectrum,and whom we have been badgering peoplesuch as ed psych, SLT etc for 6 months has eventually been referred to a paediatrician. He has the 4 page report I wrote which clearly outlined the childs strengths and areas of concern, an ECAT monitoring form and copies of the last 2 IEPS and what does he ask for? For a health visitor who has never seen the child or been in contact with the family to visit and do a developmental check on him before he will proceed! unbelieveable

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Same problems in my area. A special needs service that doesn't recongnise aspergers as a problem. They just think that we cannot manage children's behaviour.

 

The problem is that the person that takes the children to the paediatrician and answers all the questions is normally in denial (yes the parent). There is normally 2 or 3 adults in the room with the child. Perfect all that attention! Now if they came to observe them against their peers in the nursery, there may be a different outcome.

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Feedback from review meeting today.....parent shared with me that when the paediatrician assessed her child, all that he did was look at his physical development and said he was discharging him because her child was within his age/stage of development! The Early years consultant from LA came in to observe following meeting and she feels that there are obvious signs that he may be on the autistic spectrum. We will continue to support him through IEPs and monitor his progress, and will refer again if necessary, when have built up a bigger picture, maybe trying too hard, into 5th gear before going through 3rd/4th gear (find myself doing that more and more these days....not sure what is going on but seem to get more children joining with additional needs, and been in early years for 15 years now!

Think my setting is getting a bit of a reputation with local community paediatricians for referring children...must think not them again :rolleyes:, it is just from experience you get to know what to look out for and remember 5 or 6 years ago another child who 'slipped through the net' and didn't refer and has since had a diagnosis of ASD and when he was with us had concerns but didn't act on them.

Edited by meridian
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I have been told today that a child, whom mum and I suspect is on the autistic spectrum,and whom we have been badgering peoplesuch as ed psych, SLT etc for 6 months has eventually been referred to a paediatrician. He has the 4 page report I wrote which clearly outlined the childs strengths and areas of concern, an ECAT monitoring form and copies of the last 2 IEPS and what does he ask for? For a health visitor who has never seen the child or been in contact with the family to visit and do a developmental check on him before he will proceed! unbelieveable

It is the 'overburdened' health visitors who are struggling to cope with the number of children and despite the 'promise' of more health visitors as part of the new healthy child programme, in fact in our area HVs are handing in their notice because of the huge responsibility of their job. Max321 - think it is about time that some paediatricians recognise that early years staff KNOW their children and should respect their views...bet you feel very undermined by this!

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