He responded to your short sentences by looking at you or saying a word. He often showed his pleasure in something by tensing up his body and/or flapping his arms. He didn’t make a lot of eye-contact with me but did sometimes respond if I made a comment by looking at me briefly or by coming over to me. He was able to play by himself while we talked, sometimes bringing things over to you to show you. He loved playing with the lego and talked to himself while he played with it. He also liked cutting up the wooden vegetables. Once I heard him say ‘again’ when he wanted you to blow more bubbles. Otherwise the single words that he used were to name things, for example toys that he was playing with or pictures on the wall. What did I notice during my visit to the preschool? When I observed L in the preschool he mostly played by himself, playing with the other children only when they had something that he wanted. Once he sat down on the ground opposite anther boy who was playing with a ball and he stayed there for 2-3 minutes looking at the boy and smiling. L’s teacher said that was the first time she had seen L do that. During the time I was there, L didn’t pay much attention to what his teacher said to him but when he liked something he was happy to take part. For example he didn’t join in with the group singing at first but then once the circle had been formed, he got a chair, joined the circle and sat down. He was very enthusiastic about the nursery rhymes, showing this enthusiasm by tensing his body, flapping his hands up and down and lifting his feet off the ground. Once or twice he tried to do the actions of a nursery rhyme. His teacher told me that L never eats in preschool. He has a dislike of certain textures and doesn’t like drinking from a beaker either. Getting support from other professionals After my visit to the preschool I suggested making a referral to the occupational therapist in primary care to investigate the possibility that L has a sensory processing disorder because of the way he tenses his body at times and because of his dislike of certain food-textures. You agreed to this after discussing it with each other and with your extended family. A couple of weeks after that, you contacted me about the possibility of a referral for a team assessment, rather than just an occupational therapy assessment because of your concerns that Roxy has “mild ASD”.
We discussed that and we agreed that there are concerns that warrant a referral to the Early Intervention Team. You expressed some of these concerns and some are things I have observed. They are as follows: L’s language delay His reduced eye-contact His delay in potty training His reluctance to stop drinking from a bottle and to feed himself His preference for food with a smooth texture, without lumps His body-tensing and arm-flapping when he is excited or happy What is better? Although you have concerns about L, you are also noticing consistent progress. He is what you talked to me about: L is using more words He used to scream a lot in public places and when you left him in his preschool – that has stopped in recent weeks. He used to get very upset leaving my clinic room because he wanted to take toys with him – you feel that you are managing that much better and now although he still gets upset, he doesn’t scream He has very recently tried food that was a bit lumpy What happens next? You filled in the application form for the Early Intervention Team (E.I.T.). I will send them that form as well as a copy of this letter. The Early Intervention Team will then contact you when an appointment becomes available. If you have any questions about this letter or if you want to clarify anything in it, you can let me know. Yours sincerely, Senior Speech and Language Therapist ********* ******.*********@******* c.c. Senior Speech and Language Therapist, Early Intervention Team