You might have (briefly) seen me on the Chanel 4 programme 'Born Naughty?' I was involved with Honey, a 9 year old girl who was having lots of behaviour issues.
I saw her for the first time at the Children's Centre in a small Staffordshire Village, which is within the local library. I planned for her to get there at lunchtime, while it was closed, just in case we had any problems. I knew that she wasn't in school and could be difficult to manage.
Dr Ravi Jayaram, the Paediatrician and Dr Dawn Harper, GP, had already seen her at this point and had felt I was the relevant 'expert' for the job. My remit was to assess her language and communication skills and to see where that lead me including taking part in an ASD assessment .
It took a while to get Honey into the room (#understatementoftheyear), with her Mum being the brunt of her feelings. When she agreed, she said that cameras couldn't come in. I started the session with photographs of all the activities we were going to do and asked her to put them in the order she wanted to do them in. This gave her a sense of control.
I screened her language using an ipad app and various informal activities. I'd got a bubble wand as one of the activities both as a motivator and as a reward in the middle of the tasks. Unfortunately it was raining extremely hard but a promise is a promise so we went outside to do this.
I think she felt sorry for me then as we were both soaking wet through so she agreed for the cameras to come in. I carried on looking at her expressive language using a narrative exercise. She joined in the activities but was very anxious. This was exacerbated when I asked her to re-tell the story: a palpable wave of fear emanated from her. To diffuse down the situation, I stepped into help. She completed all the required tasks.
After the first session, I knew we had a child who was very anxious with difficulties with receptive and expressive language and social communication but not enough information by any means!
We decided to capitalise on her love of animals and go to Nature and Nurture Therapy Centre at Sunshine Barn, in Ashbourne, for the next session. This is run by Frances Weston a counsellor with experience of many types of childhood issue including ASD and anxiety. I also took along Charlotte Williams, an autism therapist so they could both help in my assessment of Honey's needs. I like to work with others when doing an ASD assessment, not just a clinical psychologist and paediatrician but others with potentially different viewpoints if possible, so all factors are covered/considered. A diagnosis of ASD is a label for a lifetime so the NICE guidelines are essential as a minimum.
WOW!! What a difference. She was greeted by Tilly the therapy dog and came in quite happily. She spent some time familiarising herself with the other animals: Bertie and Beatrice the sheep, the ducks, the chickens etc and was fully co-operative for the entire afternoon.
I was able to complete a formal language assessment and various other tasks for an ASD assessment. Then later, while I interviewed her mum, Honey played with Frances and Charlotte and of course Tilly. This was quite unusual as Honey doesn't normally let her mum out of her sight in new situations.
Honey's mum has a really good understanding of Honey's difficulties. She lives with them everyday after all, so we were able to get a really good profile of Honey's strengths and weaknesses.
It was a very productive full afternoon and it was fantastic to have both Frances' and Charlotte's expert observations. We were able to report back our findings to the paediatrician. The findings from both sessions confirmed that Honey was on the autistic continuum. Her profile however,was not typical, rather it fitted the criteria for Pathological demand avoidance PDA).
As you saw in the programme, if you watched it, the positives of having a diagnosis are tied up with people's understanding of her behaviour. If we view it as 'panic attacks' its easier to stay calm and cope. The Elizabeth Newson Centre was also able to offer some different parenting tips. However, a note of caution: a diagnosis doesn't take away the extreme difficulties of Honey and her family. The diagnosis is only the beginning. They still have to live with this and do their best to get through each day. I have the utmost respect for them and hope I'd do half as good a job in that situation!
We'll look more about PDA next time.
For more information about Sunshine Barn please go to http://www.natureandnurture-cic.org/