The Autistic Assessment Process

Since Reuben's preliminary diagnosis in May of autistic spectrum disorder we have been seen by various other professionals - specialist health visitor, educational psychologist and we are seeing speech and language next week. They all observe Reuben in different settings and write a report based on their observations. In September we will meet again with the paediatrician, ed psych, hv, speech and language, portage worker and the special needs coordinator from Reuben's nursery. Then the paediatrician will discuss all their reports and make a full diagnosis which will enable all the people who work with him to all know the steps that are going to be put in place for him. The educational psychologist observed Reuben for 2 hours at nursery last week and then came to meet me and we talked for another 2 hours about her role and how she can help him, especially in the pre-school year. She said that although she saw no interaction from Reuben with the other children in her time there, she saw glimmers of potential for future interaction which was positive, and that he has a flair for certain things which are above the level expected of a child his age, like the counting and numbers.
I think it will be quite a trying time for him over the summer, Reuben does not like change, being out of  routine and things not happening when they should. He instinctively knows that on a wednesday he has a portage worker who comes to the house and he waits for her at the door; if  she is ill he is inconsolable for the rest of the day, unable to understand why things are different to the norm, so this summer of Esther being home, no school run, no portage worker, less nursery, a holiday (!) and Daddy being home for a few weeks will really test him and us! I think he may be spending more time than usual in his 'safety zone'.
Unfortunately Reuben's spinal cast has a fault, a big crack appeared at the front the day after he was in hospital and it is turning into a big caved-in area on his chest. The hospital are aware of it and once it spreads to the sides, which is looking likely, we have to go back for it to be strengthened enough to last until the next change in September. It's fine for now, not ideal but should be ok for the meantime - if it spreads any further it compromises the effectiveness of the jacket so it's not doing it's job so we'll wait and see what happens. Because the casting process is such a big ordeal under anaesthetic and traction, the hospital are reluctant to take them off and re-do them unless it is completely necessary, it's not the same as a broken bone cast and they have to weigh up what is best, and usually it is to keep it on as long as possible, adjusting as necessary.
Reuben now attends nursery 2 full days a week, and loves it, he is getting used to the routine and the order of the day, choosing for himself to do more and more things and explore more. He enjoys the company of the adults who work with him and comes home singing parts of new songs he has learned, occasionally I have to ask them  what he is singing as sometimes it's just a phrase he will repeat or a tune but we get there!
Here are a few photos :o) Here is Reuben enjoying the morning sun outside in his pyjamas! He loves to be outside!

 Reuben works hard with his portage worker matching and sorting

 Reuben outside looking at the flowers!

 Picnic at Worden Park :o)