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So annoyed- 2yr old check


klc106
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Hi all

Firstly, I would like to apologise in advance to any health visitors on here, I am not against them at all!

One of little ones, who has been attending our setting since January, turned 2 at the end of June this year. We have not yet done her 2yr old progress check due to the summer holidays. We do know that she has difficulty pronouncing some letters due to an accident just before xmas, knocking her front tooth up into her gum and the dentist told us it would affect her speech whilst it works its way back down. We completed her tracker in June and she was in 16-26 (s) or 22-36 for everything! This little one is a loving, clever and confident little girl.

She had an appointment today for her 2yr old check with the health visitor. I had a phone call from mum afterwards and she was in tears. Her health visitor has said she would like to refer the little girl for speech therapy and also make a referral due to her behaviour difficulties! Myself and my deputy are totally annoyed at this, as we have known this little one for 9mths now and have also been out with her outside of the setting during the summer (I am good friends with mum). The health visitor told mum that her daughter is the highest scoring child she has ever seen (with lowest being the 'best') and that pre-school should be moving her on more!

Having spoke to mum, the little girl was asked to complete an inset puzzle (we have observed this on numerous occasions) and she did and named all the different pictures, she was then asked to do it again and said "no" so was marked down as not being able to concentrate. She was then asked to draw a circle (she drew a line) which admittedly she does not yet know what a circle is! She was also asked to identify an octagon from a group of shapes which she couldn't do. She was also asked to thread buttons onto string which she does find tricky.

The health visitor asked mum if the child would run out into a road if not stopped, mum answered "yes". She was then asked is the child clingy and she replied "no not really, unless in new situations or new places". The health visitor said this contributes to her behaviour issues! The health visitor said she is passing on her concerns and mum will get a phone about what happens next and they will probably visit our setting to observe the child. She also said, it is evident from the child's behaviour, that mum pays a lot more attention to her older child and her baby than this child!

Sorry for rambling on but I don't know how to support this family. Myself and my deputy feel like we are incompetent in our job, but then we have got observations to show this is all ridiculous! I know she hasn't got any difficulties other than speech as mentioned before. Mum is beside herself with worry that she will be in trouble.

ANY advice please :(

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Yes I agree with Sunnyday, get the check done and show how well you know this child and what they are capable of doing. It must be an impossible!e task for health visitors to try and assess a chi!d in the short appointment times that they have. Could you, with parental permission contact the health visitor and speak to her about your findings?. We are meant to all be working together (supposedly) and your knowledge of this child is invaluable. Good luck.

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Well crumbs. That's a great way for the HV to build a relationship with the parents isn't it.

I would like to see sight of the red book, then wait for them to make contact with you.

In the mean time get your own 2yr check done.

If she has been with you 9 months you should have a good awareness of her strengths and any areas of intervention if needed.

Then you can discuss this with them when they visit, with parents permission of course.:)

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Thanks all for the quick replies. Mum is keen for me to speak to them and we will be getting the 2yr old check done asap. The senior health visitor is ringing mum early next week to tell her the plan of action and I have told her to ask if they would possibly visit the child at pre-school. This health visitor isn't working tomorrow so I am not able to contact her.

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I would get her two year check done of course, but you do have evidence anyway by the sound of it.

I would give your area SEN team a call and chat to them, they can advise you if there is anything else you can do at this point. Maybe your setting SEN could give the Health Visitor a call and talk to them to find out for sure what was said and how, this may help both of you possibly.

I would also reassure mum that she will not be in trouble, I cant see how, she accommodated the health visitor and has kept in touch with you over how this little one is getting on so not sure how she could be.

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Mum is a really worrier at the best of times, I have reassured her she won't be in trouble. I also sent an email to our area senco asking for a visit (she prefers us to email) so we can discuss how we can handle the situation.

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I would suggest mum tell the senior health visitor she is not happy with the check and ask if a health visitor can visit your setting to see the child in a familiar environment so that you can share the knowledge of this child and also how best you can both support her. (keep the health visitors on side of course!!)

I wonder if this is a less experienced health visitor who is going by the book rather than exprience.

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How wierd....one of our mums came in to collect her 2 year old this pm and said nearly the same thing re her health visitor....little boy is just 2...was asked to thread some beads etc...and that she HV, wants to refer him to a speech therapist !!!!!!!!!!!!!!!!!!!!!!!!...We were all gobsmacked....he is brother to an unbelievably clever big sister who started school today....so he will now be on his own and we all think he will blossom from now on....but I am of the mind that perhaps money is talking...HV refers.....Speech Therapist gets to keep her job ??....what do you all think ?? Our Mum was absolutely taken aback......and we advised her not to refer and to wait awhile..see how he goes....

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Oh dear what a horrid situation, we too come across this often however more than 50% of the time (I base this on my experience only) the transcript of what you get from parents differs greatly from the HV point of view as a parent can go into panic mode (as I think most of us would when it comes to our children) We now follow up immediately any 2 yr checks by HV where a parent feels anything was said that was not in line with 'normal' development - this helps us work with the parent by both HV and us singing from same Hymn sheet so to speak. I would suggest also to go ahead with speech therapy Referal as they like to see the child early and once on the system they will get reviewed regularly so even if there is no issue at least it puts mums mind (and yours) at rest. Again I base this on what our LA speech and Lang system is like so if may be different for you.

If mum has got it all right then as said above I would encourage mum to raise her concerns over the visit or express mums feelings to them on her behalf as it sounds like an awful visit.

 

Hope it all works out well :)

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Agree with all the above about getting the check done etc. In our area, Speech Therapy appointments take so long to come through that I tell all new parents if they are ever offered a check - accept it. The child will get an assessment eventually something like 16 weeks wait here and they will be told pretty quick if there is nothing to worrry about.

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Difficult but I'm just gonna say it, the check should have been done, if she was 2 in June

When did you break for holidays? End of July ?

 

The positive from this is that she has been referred fro the SALT, no easy thing these days (well in our area)

 

The HV only saw her for a little while, you know her really well, so can reassure her that from your point of view

You feel her daughters development is on track apart from her speech

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Difficult but I'm just gonna say it, the check should have been done, if she was 2 in June

When did you break for holidays? End of July ?

 

 

The check should be done between the child's second and third birthday. We do ours at around 2 1/2 as children move into our Toddler Room at two, so it gives staff a chance to get to know them before doing the check.

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Why 'should' it have been done? We have until they are 3 to do the progress check. She turned 2 on 24th june and we finished 10th July. I would rather do it this term than try and fit it in between all the other end of term things that had to be done! The health visitor rang and booked her appointment in the holidays so we couldn't do it before her visit.

 

I cant see how we can work with a health visitor to support a parent when we disagree with everything that was said! There was other things but I just outlined what happened. I dont feel this child needs speech therapy, she can speak clearly, just has a lisp on some words due her tooth. Our area senco advised us that you shouldn't refer for SALT until a child is at least 3.

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Difficult but I'm just gonna say it, the check should have been done, if she was 2 in June.

The check should be done any time between 2 and 3 years, so just before the child's third birthday would be fine. However, if the parent wants if for the HV check at an early date, then it should be done at that time.

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Perhaps you could ask the Hv for the assessment sheet (not for this child just the one they use) the questions she asked are certainly not the ones suggested in our area (maybe suggest you would like it so that you can link it with yours!!! ;) )

We tend not to get any salt referrals before 3 as the system is this are appears to be in meltdown!

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Mum didnt know about the health visitor check until the beginning of August and we were on holiday. Mum didn't asknfor our check as she thought the same as us, that the child is perfectly fine with no issues.

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I think ths 2 yr progress check wasn't to well thought out from the start, I get the reasoning behind it but the timescales never work out for us.......they either come in already having attended their HV check, so when we do ours does the HV really want it, or they're not in long enough to make sound judgements before they have HV one, or they come in as 3 yr olds already so never have one anyway :/

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Our area Senco says the same, they don't want children referred until three unless there is a major issue (we have a child who had an operation on their mouth so they are under the speech therapist) and our speech therapist also says they are only really concerned with three year olds who have very little language as they have numerous referrals that are unnecessary. We are the same as someone else mentioned, we do their progress check around 2 1/2 to tie in with them moving up rooms. Thankfully our main HV here is actually very helpful and will liaise with us first if she thinks there may be a problem to get our point of view x

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I understand what your saying, but surely if the child is with you and you know her well as she had been with you 6 months, and your HV do 2 year checks that's the best time to do it.

I understand the check is between 2-3 yrs but if a child is with us from 2 , once they have settled and has built a relationship with key person we would do the check then not wait until 3 yrs. We usually complete them after term 1 unless for whatever reason they have not been attending reg.

 

In our area checks are done just prior to 2 years and most have them before they come to pre-school

 

sorry probably preaching a bit here, not meaning to offend.

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......and we advised her not to refer and to wait awhile..see how he goes....

I'm not sure this is good advice.

 

I have been told by more than one SALT that they would prefer to see lots of children whose difficulties are mild and will resolve themselves if it means they catch the ones who need support earlier. There are limited opportunities to help some children so it is important that they are seen as early as possible.

 

klc, I wonder what evidence she thinks she has that the mother concerned gives her other two children more attention. That's a rather sweeping judgement! If the mother's reporting really is accurate, this HV sounds like she has made a lot of assumptions based on not a lot of knowledge or experience.

 

I would encourage the mother to go along with the SALT referral for her peace of mind, make sure your two year check is done ASAP and be prepared to have a frank conversation about your observations of the child with lots of evidence when the HV comes in to see you.

 

If the mother is a friend of yours, would it be a good idea for the HV interactions to be handled by a different member of staff?

 

 

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I am only writing it on here as my deputy isn't on the forum, she is the child's key person and she is dealing with the issue.

Suer- I never said we will wait until the child is nearly 3 to do the check, we will be doing them this half term (we have another child who is 2 weeks older than this child too). I was just saying that will visits from teachers, transition forms, end of term trip and parties I don't feel that they should have been done before the summer.

Thanks for all the advice

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We don't take children until they are two and a half and I like to get the checks completed within their first term. So the children would all have had their HV checks. I have never thought to ask the parents about these (woops) But when would the health visitor ever see our check? I presume the next time the child routinely sees the HV would be for the school vaccinations. Not sure these two year checks were that well thought our with regard to working together.

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As far as 'when' doing the 2 year check is the right time, i think its important to remember that children attend all our settings for different lengths of time. For example we only have some children for one session a week (not ideal..) whereas of course some are in all day nurseries.

It would be impossible for us to make an informed judgement on a 2 year old after just a few weeks of one 3 hour session so we tend to wait until we feel we know the child before we do the check.

In our area of Kent we are advised to wait '2 terms' before any referrals are made - unless there is an obvious emergency.

Of course we still monitor, collect evidence and use our own strategies to support in the mean time,

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Would you do one for a child who started this week, turns 3 next week, has had HV check and no probs (according to mum) and who is only with us 3 hours a week

It will probably take until he is 4 before we truly 'know & understand' him

have been told we must!

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Look at how much confusion there still is over these checks 2 years in, not only when and if we do them, but we have to do 3 copies and I'm sure I've read others do 2......we all flag any concerns without having it recorded on this even when the HV check has already shown no concerns.

 

I have children joining at just gone 2 that are already attending SALT sessions, and I have already received 'traffic light' sheets for them.......think we are very fortunate with our S&L unit.

 

Going back to first post ....I have sent 4 year olds off to school that would find it difficult picking out the octogon. Maybe they need more realistic tests or do some SMART training :/

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