9 months ago

Example of letter written after first appointment

appropriate for age

appropriate for age delayed for age need further assessment This is the area that I am most concerned about. It is hard to get M’s attention and he was happy to play by himself for a lot of the session. His eye-contact with me was best when he liked an activity (for example bubbles). There were times that he engaged well with me for a few seconds at a time. For example, when I was talking to you, he opened up the lego-door and peeped through to get a response from me. When he liked that response, he tried it again a few times. He said “nose” and pointed to the tissues to let you know that he wanted to wipe his nose. When I was blowing bubbles and I waited, he said “more bubbles”. Therefore there are times when he uses words/phrases communicatively. However, overall, from what I observed and what you told me, he doesn’t use words and phrases to communicate socially as much as I would expect. What else? During the session M’s behaviour wasn’t challenging or disruptive. However, you said that it is very hard to get his cooperation a lot of the time. You said that it is like there is a “barrier inside him” and that he won’t compromise if he decides he doesn’t want to do something. You said that he is “resistant to being taught” and learns best from a screen (for example nursery rhymes, colours) rather than a person. You also talked about M’s dislike of some food-textures and that it is difficult for you to predict what he will and will not eat. Sometimes he rejects a food that he happily ate before. Before he eats any food, he presses it against his lips or nose first. I noticed him do this with biscuits you gave him during the session. In summary: M is 3 years old. His receptive and expressive language are delayed. This means that he isn’t understanding or saying as much as I would expect for his age. I am more concerned with his social communication in that it is hard to get his attention and he doesn’t use his words and phrases as communicatively as I would expect.

You also expressed some concerns about his behaviour and some sensory issues (food-textures). You asked if M might have autism spectrum disorder (ASD). I have noticed that he seems to have social communication difficulties but I can’t say if that is because he has ASD or not. However, I do think that it will be useful to make a referral to the Early Intervention Team for further assessment. I will discuss that with you at our next appointment. What happens next? 1. I talked to you about a group that we run for parents of children who have difficulties with social communication. This group is made up of 5 sessions in total. There will be 3 sessions for parents only and 2 sessions for just you and M. The parent sessions will be held on the following dates: ************************************************************* The other 2 sessions for videoing will be arranged separately with you. You will get a letter about this group in the next few weeks so you can respond to that letter when you get it. I hope that I have correctly written everything that you told me. If you have any questions feel free to contact me. Yours sincerely, Senior Speech and Language Therapist ************ *************

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