Where to seek help (SN section)
, Jun 20 2017 01:04 AM
6 replies to this topic
Posted 20 June 2017 - 01:04 AM
Just after some advice regarding DS2 (just turned 4). Both his teacher and school/community nurse have raised the possibility of a "processing disorder." To be honest, I wasn't entirely sure what a processing disorder entailed and after some internet research on both auditory and sensory PDs, I'm not sure either quite fits him. His issue appears to be using his knowledge to formulate an answer to a question. In some instances, I think the knowledge is simply lacking, ie when asking him about an unfamiliar topic - he has no idea. Other times I don't think he understands what the question is asking (comprehension).
- First questions: where do I go to rule out (or in) a processing disorder? Is 4 too young to diagnose? What help can I give him and where to go for guidance?
Other issues which have been raised, none of which is severe in isolation, but putting them together forms a picture of who he is...:
- Speech is delayed - he has improved in spades since starting school (3-day per week) in Feb, but still noticeably behind his peers. Seeing a SP once a fortnight. Hearing was impaired until 2.5 though.
- Low-ish core strength - slouches a fair bit when sitting on the mat at school and feels the need to lie down often. Seeing Pead OT weekly.
- Fine motor skills - he is OK at manipulation (eg lego, puzzles etc.) but struggles with pencil/writing skills. Also addressed in OT sessions.
- Very sensitive to loud sounds (eg hand dryer in public toilets, extractor fans etc). I did attribute this to him having glue ear until 2.5 years. Hearing is now fine. (Sight also fine).
- Fussy, fussy eater. He will eat a variety of textures though, from yoghurt to apples, however won't eat marshmallows or soft lollies (which you would think most kids would like.)
- Very interested in objects, gadgets and how things work. Seems to be a clever kid - can recognise numbers to 20 easily (forwards and backwards), all letters, starting to learn sounds of letters and a few words. No concerns cognitively.
- Socially he gets on well and communicates (as best he can) with us and peers. Likes to interact with other kids and takes turns.
Anyway, I feel like I am rambling, but wondering whether I need someone to help me see whether there might be something bigger at play. I'm not particularly worried by any one symptom, but sometimes when considered together it feels like a lot. Where do I go? Any other insights? - Thanks for your help.
Posted 20 June 2017 - 04:39 AM
You need to go to your GP with the list above and a letter from pre-school about their observations.
I'd be asking for a referral to a developmental pediatrician for assessment.
Most of those things could be nothing much other than delayed start to clear hearing however there are also a few unrelated things which are red flags for autism.
But that's what the developmental paediatrician will review. They have a lot of experience in what's normal for age and the nuances of different conditions - if any.
There tends to be a long waitlist so you are wise to get your name down now, and then you can always cancel if things resolve in their own.
Posted 20 June 2017 - 09:12 AM
I think the Dev Paed is that person. To look at all of the pieces of the puzzle and see it together they mean something more. And I suppose then provide advice for the therapists, teachers and you to provide the help that will have the best 'bang for your buck'.
Posted 20 June 2017 - 09:20 AM
Just on top of what has already been mentioned, if you feel there is is an issue with language comprehension and instruction following, then have him assessed for Central Auditory Processing Disorder. This can only be done from age 7 through an audiologist. We went through Australian Hearing. The appointment is not bulk billed. We hesitated for that reason. But when we bit the bullet and decided to spend the money, it answered all of our questions.
Posted 20 June 2017 - 10:49 AM
I would also say see your GP about a referral for an appointment with a developmental pead. They are the ones who specialise in this sort of stuff, and would have a clearer idea on what could be causing the issue. There are some red flags there.
Some processing disorders like central auditory processing disorder will not be assessed for until a child is older, as there are factors within a the development that need to be taken into account.
Around language I am assuming the speechie has done a receptive language assessment? Some of the issues around communicating you have mentioned do sound similar to what my children have been through. One has a mild receptive (and expressive) language delay, but it was hard to realise because when he didn't know a term or piece of language he could sometimes pick it up due to the context it was put in. He also struggles with multiple step instructions due to executive functioning issues (we are currently working on 3 step instructions). My other child was similar, his speech issues actually relate to his adhd diagnosis. Once he started medication for ADHD almost all of his speech issues cleared up (which was good because speech therapy was doing nothing as they couldn't get him to stay still or focus...)
Regarding sensory processing disorder, this is usually diagnosed by OT, with possible input by a dev. pead. And it doesn't always necessarily mean that it is every sense that is causing an issue. it could just be 2-3. Has your OT had you complete a sensory profile for your child?
The only other one I would mention is when they say processing issues, there is also a possibility it could be something to do with working memory or visual processing. Working memory is basically the memory you use while doing activities, a simple example would be being able to remember a word sounded out on one page while reading a book, when you see it on the next. My younger child will sound it out, until he has seen and sounded it out for a minimum of 12 times (makes learning to read, really really really slow). Visual processing is something that changes as kids grow, T has this mildly and it also effects how he reads. he often flips words, reads words from right to left rather then the other way. So what and that will be confused when to you and me they look completely different... but to him they look very similar because he goes from right to left.
Posted 20 June 2017 - 10:58 AM
He actually sounds very much like my high functioning asd son. He gets along with other kids but does have unusual interests.
See's OT as he struggles to write. Weekly speech therapy. His language is pretty good now he's 5 but can get blocked when it's a new topic.
I think a dev paed would be a good idea as they can see whole picture
Posted 20 June 2017 - 11:48 AM
I would get a referral to a dev paed. He sounds a lot like my son with ASD and lower muscle tone (except my son is non verbal.)
DS was diagnosed when he was three and a half (we also did hearing tests and blood/urine tests to rule out Fragile X syndrome and extra/missing chromosomes.)
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