The New Case - Showcase April

in #health6 months ago

The start of another day, and a new child turns up with their apprehensive parents to see my wife. My wife is an Occupational Therapist specialising in children with educational issues and Autism spectrum disorders and we work from home.

This child came on a personal recommendation from another parent which is always the nicest way to get new cases and is how we get all out kids.

"Oh, you look so kind," said Finn's Mum upon meeting my wife. I wondered what she was expecting, and smiled to myself as I further wondered if she will maintain her opinion in the future as I am sure at some point she will be sat downstairs listening to her child's cries and screams of frustration or tantrum. Maybe both!

Finn is 8 years old and his worried parents called last week because he had been held back at school due to his inability to read or write in Thai. Often that first conversation is fraught as although parents often see slight differences in their children as they are growing up, they refuse to believe there is a problem and continue on in the hope, or expectation that their kids will level out as they age. In our sad experience, this never happens and if the child has issues that are noticeable by parents then it is an issue that needs addressing as early as possible, although he has seen a Doctor previously and simply been diagnosed as ADHD and given drugs.

Two problems here.

Firstly, drugs. Whilst there are occasions when drugs are useful to supplement a course of treatment to address a specific issue, they are completely over prescribed by the medical profession as there is little in the way of free therapy here. Despite the wife being extremely 'cheap', regular therapy is a financial struggle for many. For my wife, upon seeing a kid for the first time, it is much easier to make an assessment when the child isn't on drugs as the drugs may be masking some very relevant issue that might be very important in making a diagnosis.

Secondly. Parents lie. A lot! Parents are often unwilling to accept serious issues with their kids, which is understandable I guess. They often play down problems and this is especially so in Thailand where 'face' is everything. It is often left to my wife to use her training and experience to get to the bottom of the real issues facing a kid with problems. Finn's parents haven't mentioned drugs, despite being asked and were very vague when asked about his trips to the Doctor.
He has come to us because school have held him back and he cannot read or write in Thai........

So it's an assessment morning for Finn.

Upon arriving and seeing me, Finn immediately spoke to me in English and said 'good morning'.
"He likes English so much", said his Mum, doing what many parents do by over-emphasizing the positives. Kids, as well as parents, often learn to push their positives to try and mask their problems. It's a very successful diversion technique; except when they try it with the wife!

"Hi Finn, I'm Nathen". I held out my hand for him to shake, as my wife likes me to do and his arm wobbled as his hand went out to meet mine and he gripped firmly. Way too firmly.

First check on motor skills, both gross and fine.

Next check, walking up the stairs. And as already expected, it was right leg, step, right leg step and not left-right-left-right as a child within the threshold of 'normal' would be walking. How I dislike the word 'normal'.

Another excellent and quick technique to check on fine motor skills is using scissors. To use scissors requires quite a specialist combination of muscles and fine motor skills. It's another great pointer to possible issues.

And so we continued. Jumping, puzzles, crafts, dancing and singing, with Finn all the time chatting away perfectly happily in his native Thai, constantly punctuated with many English words. Neither of his parents speak any English.

Upon chatting to Finn's parents afterwards with my wife discussing with them what she thought, there were many nods of agreement and the truth begins to come out as parents begin to understand that there can be no secrets from the wife, diagnosing the real issues is what she does, and does so well. Parents sometimes use the assessment as a test of my to check what she says corresponds to what they may have been told before by either a Doctor or another therapist.

From Mum, we had a few tears. Then the guilt. Then the hope and determination as she and my wife went through the schedules to fit him in for a couple of hours a week and discussed a program.

The money we spend on tissues!

Finn is most definitely on 'the spectrum'. He is probably of above average intelligence and his future is bright.

Hang on. Autistic ? Above average intelligence ?

Intelligence is not a factor in Autism. Autistic kids can have low or high IQs as any other person can have. It is a common misconception that Autism, learning difficulties and low IQ are all linked. They are not. They are all completely different issues.

Finn will be back on Thursday at 5.30pm, and we are now sat waiting for Tartar, an amazing, bi-lingual 6-year-old who, despite being small for her age is an incredible swimmer and has a propensity for punching her classmates in the face and swearing at her teachers both in Thai and English.

Behaviour issues. Work in progress

Any questions about any of the issues in this piece, please ask away in comments and I will relate them to the boss and reply as soon as I can.

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Thanks for dropping by. Your Upvotes and Resteems are gratefully received but your comments and engagement are truly appreciated. Let's keep up the debate. Thank you

@nathen007

Life's not all about the hustle. It's all about the humanity

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