Today was Moose’s appointment with the developmental pediatrician. It was not at all what I was expecting. First of all, I was under the impression that in addition to the doctor, there would be a variety of therapists like at our home visit. No, just the doctor. That’s OK I guess–no duplication of efforts there. Anyway, I thought there would be more play based observation, which there wasn’t. Really, most of the appointment involved her asking me questions from a screening tool, and then recording my answers to get a diagnosis. I didn’t entirely trust this tool–there were times I felt like she didn’t understand my answers, and other times when I felt like she was trying to prompt to answer what she felt was accurate. I hope it all came out the way it should have.
She had already been over the reports from the three therapists who had observed him, so she had an idea going in what she was looking for, I guess. She also observed Moose, but there wasn’t a whole lot for him to do–we were in a typical doctor’s examination room. Not too exciting for a not quite three year old. She also did a brief physical exam at the end of the appointment–not sure what the point of that was, but she seemed satisfied.
Anyway, after going over the screening tool, she gave Moose the diagnosis of mild autism. She said that with therapy, in the future the diagnosis might be “downgraded” to PDD, but for now, it is what it is. Her recommendation is that we send him to the preschool program through the special ed branch of our school district, and, while she wasn’t sure if they even offer it, she thought full day would be best. I have several problems with that, beginning with the fact that he isn’t even three yet, and still needs a good long nap, but whatever. I have to call the district, and they’ll tell me if they even offer full day for someone his age, which they very well may not…we’ll just have to see.
Here’s what bothered me about all this, aside from the diagnosis itself, which has me quite down. First of all, she was a half hour late for our appointment. First appointment of the morning, you don’t expect that, but she got stuck in traffic or something…didn’t really get us off on the right foot, and she wasn’t even apologetic, which I didn’t appreciate. Her manner was a bit brusque, too, which wasn’t helpful to me, as I was upset, but this appointment wasn’t about me, so I can get over that. I didn’t like her basing her observations of Moose on only what she saw of him in an exam room for an hour, though. There was nothing for him to do, and all she could do was point out him opening and closing the doors on the cabinet. Yes, a repetitive behavior that can be a red flag, but he doesn’t stuff stuff like that to that extent at home, or in other environments where there is something else to do. He was bored, plain and simple. She also pointed out how he didn’t want to come to her and interact. Again, I get that that can be a red flag, but that’s not how he usually is with people. From the first day the therapists came into our home, he has been sitting in their laps, playing with them, and being generally sociable. And he didn’t know them from Adam, although he is getting to know them now. Isn’t it possible that he just didn’t like her? I didn’t really; why should he?
And the other thing that gets me is that all three therapists that observed him reassured me that they didn’t think he was exhibiting traits of autism, that it wasn’t something I should be worrying about. All three of them saw him on different days, in different moods, and yet they all told me this, without knowing the others had said it. How can they all be wrong? I know that they’re not doctors like the woman we saw today–they’re “just” therapists. But this is their specialty, and I don’t think they’d just tell me what I want to hear, so what’s up with that?
I don’t know. I really wasn’t expecting this diagnosis going in. In my gut, I thought she’d say PDD, which is on the autism spectrum, but I certainly wasn’t prepared for a full-blown autism diagnosis. It’s good that it’s mild, and I guess I have no choice but to put him in the preschool, for at least part of the time, and do all of the therapies that are being recommended. But I really don’t think she got a good sample of what his normal, daily behavior is, and I really wish there was some kind of option for a second opinion or something. I suppose that I sound like I’m in denial; maybe I am. But if he’s going to be labeled with something this serious, I’d like a little more reassurance that it’s an accurate label. I find this whole thing very troublesome.