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 ************ *************
If you are suffering from chronic pain due to injury or an orthopedic disorder, scheduling consultation with an orthopedic specialist is necessary.
In order to get most of your appointment, you must know what to expect from the first meet with an orthopedic. In this article, Kim Von Martin has listed some things to expect during the first orthopedic clinic appointment.
Actually, seeing an orthopedic surgeon for the first time can feel like a traumatic situation.
However, if the expectations are known, the appointment runs smooth, inquiries are replied and strategies are made.