If your child has been referred for an Autism assessment it can be a daunting prospect. It is difficult to know what professionals are looking for and what it all means. It is usually because there concerns about their ability to interact and communicate.
Why has my child been referred for an Autism Assessment?
Let me be straight with you, usually a child is assessed because there concerns about certain areas of their development. A speech and language therapist will refer if they are worried about your child’s ability to interact and communicate with others or because their play skills might be different from other children of the same age. An SLT might also refer if your child is showing some atypical or difficult behaviours.
Who will be at the Autism Assessment?
Autism assessment will involve a child development team – two or more professionals which could be made up of, a paediatrician, a speech and language therapist, a psychologist, an occupational therapist, or a physiotherapist. Although it can seem like there are a lot of people involved, it is good to gather the opinions of as many professionals as possible. They will all be looking at the results from slightly different viewpoints and will challenge each other’s thought processes to come to a more robust outcome.
What will happen during the Autism Assessment?
During your assessment, the child development team will ask you lots of questions and will be observing your child’s behaviour. in order to make a diagnosis of Autism – your child must show difficulties in all three of these areas.
- This could be in their understanding of words, following instructions and interpreting other people’s gestures. communication can also relate to your child’s expressive language; the types of sentences they are using and the ay their speech sounds.
- This means how your child responds to others, their interest in interacting with the people around them and the purpose of their interactions. Professionals will also be observing ‘how’ the interaction is taking place and will be looking at behaviours such as eye contact and communicative gestures.
Rigid or inflexible thinking
- This means how they are playing and using their imagination – often children with autism with demonstrating repetitive or stereotyped play. They might prefer to follow certain patterns or rituals, or have overfocused or unusual interests.
A person with autism can have more difficulties in one particular area, but all three will form part of the diagnosis. Most children with Autism also have some issues with sensory integration, their senses constantly sending them confusing messages. Children often have challenges with sleeping and can be highly selective in their choice of food.
Remember, whatever the outcome, it will not change who your child is. They are still your baby, with the same likes, dislikes, smiles and cries. If your child has been given a diagnosis and you are confused about next steps, contact the National Autistic Society for more information and support.
You’ve waited a long time for a speech and language assessment and now you are here, you’re not sure whats going on! Your child is having great fun, but what has this got to do with their speech and language skills?
Here’s the deal. Evidence tells us that Speech and Language assessment for children in the early years should always be embedded in play. But that’s not all, when a child is engaged in play, they are more likely to relax. they are less likely to feel like they are being tested and are more likely to demonstrate their language skills as they would at home.
Let me be a bit more specific, in an assessment a therapist is looking at several areas of your child’s development these are:
- Attention and listening
- Understanding of language
- Speaking and Talking
- Speech sounds
- Social skills
So, here’s what is in store for you: The speech therapist will have a range of toys available to your child targeted at different developmental levels. The toys your child engages with will give them information about the child’s cognitive ability, their attention and their play skills.
The therapist will be looking at what your child understands by asking your child to follow instructions, things like pass the ‘plate to mummy’. If your child can follow this it shows the therapist they are able to follow instructions at a 2 word level (they need to understand plate and mummy). But, remember, it is all hidden in the play.
Not only that, the therapist will also be recording anything your child says as well as commenting on their non-verbal communication.
Non-verbal communication is anything your child does to convey meaning without using real words, take a look at this video. These twins aren’t using any words but there is so much communication going on: shared eye contact, gestures, vocal intonation, body language and facial expression. That is what your therapist is looking for during the assessment.
Remember, A good therapist should be able to tell you what they are doing and why during the assessment so don’t worry, it’s ok to ask :)
The Health Visitor has told you not to worry, that she might be a little bit behind but she will catch up in a few months. So you wait…and wait but you still feel like her language is not developing as quickly as other children. Her speech is not as clear as others at nursery and she is not progressing as fast as her older sister.
Sound at all familiar? If the answer is yes, there are a couple of things I would recommend you try to fast track a referral to a Speech Therapist
Get a hearing test.
If your child cannot hear it – then they won’t be able to say it. Nearly 80% of children under the age of 8 will suffer with glue ear which can affect their hearing and access to speech sounds. It is always worth getting this checked out before doing anything else.
Get your facts straight.
The more you know about child development, the more you will understand about your child’s difficulties. Often, the more you find out about your child’s delay, the less concerns you will have.
But don’t take my word for it, take a look at the Talking Point website and the Cochlear’s Integrated Scales of Development to get an idea of where your child is up to. It may surprise you, what is ‘typical’ for a child at 2 years.
Let me explain, if you go to your GP and say, her speech doesn’t sound like the others at nursery this doesn’t give the doctor enough information about what’s going on and whether to refer to a Speech therapist or not.
if you say:
She isn’t using any functional words to request and she is playing on her own agenda or
She seems to be replacing all of her initial consonants with a ‘t’ or a ‘d’
This gives the Doctor much more information to go on. And a more specific reason to give you a referral to a Speech therapist.
Think about it, if you are vague about what the problem actually is, it’s difficult for the health visitor or doctor to know what you are concerned about.
Vitally important, last and final point:
Be the expert.
You may have a ‘gut feeling’ but you will get a lot further into the referral process if you have facts and examples to show to your Health visitor, GP and paediatrician to back-up your concerns.
Demonstrate your child’s knowledge and skills and track their progress on this ‘talking point chart’
Have videos demonstrating behaviour in situations other than the GPs office. Show the Doctor what they are like at home; in a crowd or at nursery.
Gather as much information as you can from nursery staff or their childminder. Ask them to write a note or short letter to support your concerns.
It is a shame we have to go to such lengths as parents to get an NHS referral to Speech and Language Therapy. But, honestly, it is worth doing if you are concerned.
If you don’t want to wait, you can call me at Mable or sign up for a free consultation when we Launch in October – I will be happy to talk things through and advise on assessment and therapy options.
For all of you trying to get a referral to a Speech Therapist I hope this is useful! – Let me know how it goes
We’ve seen it all! crying, laughing, whinging, hitting, pinching, squealing – Children can make it quite clear how they are feeling by their actions…. and noises!
The good news is, as children begin to pick up new words they can communicate about things that upset or fascinate them and so learn new ways of regulating their behaviour.
Too often, the vocabulary we teach our children to describe feelings is often restricted by what we think will be easier for them to learn.
So what does this mean? – It means we limit their vocabulary to usually happy and sad – these two words are very powerful, but simply not diverse enough to cover all the emotions and feelings our children are experiencing.
More importantly, if we limit what words our children are learning, we limit their ability to describe their life and environments. Wouldn’t it be nice if our children had a couple more words to describe how they’re feeling?
So how do I get started?
Help her to understand her emotions by giving her the feeling names
Encourage her to talk about how her mood – for example, ‘we are going to pizza express with Amy later, you look like you are excited!’
By giving her a label for how she is feeling she makes a connection between the word she hears and the emotion.
This starts to build up her vocabulary which will allow her to talk about feelings in the future.
Give her lots of opportunities to identify feelings in herself and others
You might say ‘you hurt your knee but you didn’t cry, because you are very brave!’
Or you might point out a situation they would remember ‘ Do you think mummy was brave when she hurt her toe this morning?’
The best way to teach appropriate ways to react to things is be modelling good behaviour ourselves.
Your child learns from your behaviour. They see your facial expressions and body language when you get angry, or frustrated.
‘When daddy gets angry he will sometimes leave the room, take a deep breath and come back when he feels calm’ This provides them with a strategy to use when they feel the same way. It also supports their understanding of recognising emotions in others.
Don’t restrict her vocabulary – the early years are the best time to teach new words. Here’s some inspiration:
- Words: confused, brave, curious, disappointed, generous, friendly, jealous, bored, surprised, proud, calm, shy,
- Phrases: I think, I feel, I wonder, I want
Resources to help
This website has a huge amount of resources including an excellent book list covering lots of different emotion words and feelings
Centre on the Social and Emotional Foundations for Early Learning (CSEFEL)
You’re already running late, it’s time to get to nursery and she is glued to CBeebies. Without a thought, you reach for the remote – flick the off button and you enter….
But, don’t lose your rag, just remember these 3 top tips for keeping it together ….when she is losing it!
As you may have noticed, some children do not have the words to talk about how they are feeling, instead they will act out these emotions in very physical, and sometimes inappropriate ways:
“When my two year old gets really angry she will throw toys around the room or bump her head on the floor– I’m always worried she will hurt herself” – Carly, Macclesfield
In this situation there are 3 key things you can do to stay sane during toddler tantrums.
1. Stay Safe
Two year olds are unable to hit their heads with enough force to actually hurt themselves, unless it is against a sharp surface. Make sure your child is safe, but don’t fuss. You could try putting a pillow under their head or moving them to a carpeted area of the house.
If possible, ignore the behaviour. As your child learns they are not getting what they want from exhibiting anger in a physical way, they are more likely to stop
You may choose to leave a favourite toy or blanket with them – so they can use it to soothe themselves. Keep an eye on your child but indulging the behaviour, or getting angry and frustrated yourself will make it worse.
2. Stay calm
it is difficult not to become, frustrated upset or angry when your child is behaving in this way. But you must try and keep a cool head.
Here’s how: go into another room, take a deep breath through your nose (count to 8). Let the breath go slowly through your mouth. Do this at 3 times while concentrating on creating a space between your head and your shoulders.
Feel calmer? return to the situation with a level head, make sure she is safe and then acknowledge her emotions.
3. Acknowledge how she feels
It is so important that you acknowledge her feelings. If the toddler tantrums are started by you turning off the TV. Say, ‘I know you are angry, it’s ok to feel angry but we need to turn off Peppa because we are going to nursery’.
- Here, you have acknowledged her emotions – I know you are angry
- Provided her with a label for her emotion ‘angry’
- Used repetition to reinforce word and concept learning – said angry more than once
- Given her a reason: ‘because we need to go to nursery’ if you explain why you have done this in a reasonable way she will develop her understanding of how others around her are thinking and feeling.
A final thought? – Children are less likely to have a tantrum and act out in a physical way when we teach them how to tell us how they feel.
1. Stick to routines
Take the needless guesswork out of meals and bedtimes. Let everyone relax into the predictable flow of a healthy and secure life. children feel more secure when they have boundaries and are able to predict what is going to happen next. Of course there will be changes to routine, but explain why the changes are happening and that things will go back to normal tomorrow so your little ones know what to expect.
2. Don’t be afraid to ask for help
Don’t struggle needlessly, people offer to help because they really want to be there for you. Take time everyday for yourself and connect with the things that matter to you as an individual. Check out stress less for more ideas. Happy Mums are not afraid to ask…and Very Happy Mums just say, “Please.”
3. Get out and about
Fresh air, sunlight, and nature are believed to be critical mood enhancers for women, pack up the push chair and get out in the park. take some time with your baby and check out what is around your area. It doesn’t have to be for hours on end. ten minutes will make all the difference and lift your mood for the day.
4. You have heard it before….that’s because it works!
hitting the gym can feel a bit self indulgent with little ones around. but keeping fit and healthy is so important for your mental health. Exercise will also support your stamina and help you get a better night’s sleep. call in a favour, get to a zumba class and sweat it out.
5. Reduce distractions
switch off the radio, the TV and put your phone away. These artificial distractions throughout the day are stress inducing and reduce your ability to switch your attention from one task to the next. They also affect the amount of time you are able to concentrate on things. When you can, get some peace, reduce the stimulation, switch it off and connect with what is going on around you.
6. Give more attention.
And less of everything else. Devote ten minutes a day to giving undistracted attention to your children. Not in activities driven by your agenda, but according to their terms. Undivided attention is the most concrete expression of love you can give. see our special time post for more ideas
7. Say sorry
The best way to teach your little ones is by example. Be the first to apologise and instantly restore household harmony. By your doing it, your children will learn humility, empathy and forgiveness.
8. Get some rest
I know right? are we kidding! In the first months..years of a baby’s life mums can wear sleep deprivation like a badge of honour. but the sooner you get your eight hours back the more joyful you will really feel.
9. Give your body what it needs to stay alert, to exercise and to support your babies.
Go for sugar free muesli or bran flakes or porridge for brekkie and try to eat as much fruit and veg as you can throughout the day….if you aim for 10 pieces instead of 5 you will find it doesn’t give you much room to eat anything else
10. Plan some time with your mates
You need something to look forward to on the horizon to stay positive throughout the day. Whether it’s book club, a joint gym sesh, or a night on the tiles make sure you have something in your diary that is going to keep you pumped.
The best support you can give your child is a stress free, happy parent – it is not selfish to make time for yourself. so go on, call a friend, make a plan, call in a favour, it’s time to get back to being you.