The Health Visitor Assessment

It was just last week I was sat here at this very computer and writing a post that was making my blood boil. Its' a post that I put off publishing, you see it was a post docuenting how I let down I felt by my health visitor following on from Leo's 2 and a half year check. It's a post that I have now posted alongside this one.. Because the contrast of feelings that I have felt change within this time frame are something that I never anticipated.

My health visitor turned my opinion of her completely upside down and she re-gained my trust once again, and in this moment right now... I am so thankful to her.

They say everything happens for a reason, and I have to say I am inclined to agree with them. It has been almost a year since I have had any form of contact from my health visitor despite multiple attempts of phoning her, leaving voicemail's in the hope that I could just speak to any member of their team and follow up THEIR concerns for my little man. No one ever returned my calls and not even a whisper was heard from them, until Granny was at the doctors earlier this week and just by chance ran into our health visitor.

Granny told our health visitor the struggles we have faced in the last year, some of which I haven't even posted on this here blog... Nursery reports putting Leo's speech and development 20 months below where he should be. Concerns over his general being in the social environment and hints and nudges that there may be something else underlying. Of course in my heart of hearts I had my own opinion, and I didn't share the same concerns as the nursery, and at this moment in time, the same concerns the health visitor had potentially shared back in January.

It turns out that our health visitor has been off on sick leave for a substantial amount of time, she hasn't been around. That doesn't excuse why another member of the team couldn't have responded to my calls and my messages. But it does explain the radio silence and lack of action that has been on the air waves...

The outcome from this chance meeting with the health visitor (who was now back at work full time) was that she felt awful for the last year. She had been told how let down I felt, basically how I had felt in the post I had written here. She juggled her schedule around and the very next day I spoke to her on the phone. We arranged a meeting for today (Monday 15th December 14) and she arrived at the house ready to make a referral based on everything that I had told her.

I wanted this referral. I really wanted it. I wanted to be put in front of a professional and be provided with answers that I felt were long over due. Was it just a speech delay? Or was it something more? Had I been walking around with my head in the sand all this time? Or was my gut instinct the right one?

 Leo and I had been sat on the sofa in silence before the health visitors arrival, I didn't want him engrossed in the television or tootling around the lounge with his favourite trains, I wanted him to to show his full attention so that the health visitor could get a real idea of his character and personality. The health visitor arrived armed with her suitcase, and a number of the objects and puzzles that I had watched Leo complete on his 2 and a half year assessment.

 I handed the health visitor the latest nursery report, and the report I had been handed by the lady from a local agency who had come in to observe Leo. She thanked me for these forms, and then told me that she wouldn't be looking at them until she had completed her assessment which I thought was a grand idea. 

For a little while she just sat and observed us, listened to Leo and I talking among ourselves and watched Leo as he played a magnetic fishing game. Leo wasn't phased by her presence in the room, and just carried on chatting away with me as he always would, and this pleased me greatly as it meant that she could hear first hand just how much his speech had come along. She could hear that he could hold a conversation.  

The health visitor had brought a copy of the first assessment that she had conducted back in January, and it was decided that we would focus on the parts of the form that she had labelled with a 'Q' for query. 

Leo was still happily playing his fishing game, but was easily persuaded to demonstrate his drawing skills. We found out the array of colourful crayons and asked him to find the red one, after he had done that and produced some beautiful markings we asked him to find a number of different colours in turn, and that's exactly what he did. The health visitor was pleased with his drawing, pen holding and colour knowledge which pleased me in turn.

As the assessment went on our health visitor surprised me. She told me she had absolutely no concerns. No concerns over his speech, she even went on to say that he was a right little chatter box and wasn't even really behind on that front any more. She told me that she wasn't going to be referring him because there was absolutely no need, and that the Pediatrician would laugh at her for putting Leo forward when he was quite obviously developing and happy.

Then she opened up the reports I had handed her, the one from the outside source that had come into nursery read that Leo didn't give eye contact. That he had poor facial expressions and was ultimately very behind. Her response? Well she pretty much said that they must have seen a different child that day, because the little boy she had just witnessed was switched on and alert.

Then she read the nursery report and was astounded at where they were placing Leo in his developments. In some areas they have Leo 20 months behind, and that is on the most recent report that I received this month. I have just accepted this as fact, everything following the 2 and half year check in January I have just accepted. The concerns, the worries, the urgency... It just seemed to be the path we were on and Leo was behind. Until today when the health visitor told me that Leo was perfectly normal. 

The health visitor told me that Leo is not behind at all, he is catching up and is actually operating in the capacity of a 4 and a half to 5 year old. She said that if the nursery are grading these reports as they are then there is something wrong, either Leo isn't as happy at the school as we think he is, he's shy, or the staff need further training. She made me promise that I wouldn't worry, that she is certain that he is just a normal 3 year old boy who is going to excel at school, he's just getting there in his own time.

Hearing all of this, all of this positivity from the lady who had first expressed her concerns 11 months ago was astounding. I was beaming from ear to ear. She was completely agreeing with me on every front, and my instinct had been the right one. I hadn't been walking around with my head stuck in the sand, I had been listening to my intuition, and it was the right one.

I had been so set on getting Leo the referral I didn't once for a second think that the health visitor was going to come in and go against everything that had initially been said, and against the reports of the nursery, and actually see Leo as I see him everyday.

It's been 11 months since Leo's 2 and a half year check, so much has happened in that time frame. He has grown and developed and done so much growing up. Yes I feel like someone on the health visitor team could have provided the courtesy of calling back and picking up our case, but ultimately Leo was fine just like I knew he would be. And in the end our health visitor came through and helped us.

For that I am very grateful.

Frustration

This post was written on the 2nd December 2014, and in that time frame from then until publishing a few developments have been made. You can read about our positive experience with our health visitor right here. But for now, this is how I was feeling until these developments were made..

A year ago in January Leo had his 2 and a half year check. It was here that concerns were expressed over his development, particularly in his speech. I left his appointment far from impressed with the way I had been spoken to, but I left with the next steps of what I had to do in order to help Leo. The health visitor had told us that she wanted to see Leo again in two months’ time, she wanted him to repeat the assessment and if she still wasn’t happy then she would refer him onto speech therapy and we would go from there.

The health visitor was supposed to book Leo in for an eye appointment as soon as possible as she had also expressed concerns over a potential squint. The two months came and went with no word from our health visitor and no word of any appointment to get Leo’s eye checked out. I called and called the office where she worked trying to get in touch with her, when that failed I left her a voice mail asking about the eye appointment and also asked her to call me back so that we could arrange the assessment appointment. There was no call back, and absolutely no contact from my health visitor after that. She finally got around to making the eye appointment judging by the fact a week later a letter landed through the door, but I’m sure that’s only because I jogged her memory after she had let us fall through the cracks.

Still she had expressed some real concerns over Leo, she had taken one chilled out Mother and turned her into an emotional wreck. She had insinuated that there was more wrong with Leo, but of course couldn’t go into any details about it. She was that concerned that she just completely forgot about us, and in the long run she has let me and more importantly, she has let Leo down. The way she spoke to us about Leo back in January was worrying and completely negative. When I go over that appointment in my head I don’t re-call anything positive being said at all. But the point is she has taken those concerns and not followed up on any of them, she has left a child who would have benefited from a speech therapy referral 11 months ago drop completely through the net.

Ultimately She hasn’t done her job and she hasn’t supported us through any of this, and the respect I once had for her has diminished. I am actually angry at the way we have been treated by her, or not treated as the case may be. I left that appointment and did everything she advised, maybe if she had held up her end of the arrangement things wouldn't have taken this long to sort out. Maybe the positive improvements I can see in Leo today could have been exceeded further.

Leo has come on so much in the past 11 months, but our health visitor doesn’t know this. Leo could have come on even further had she pulled her finger out and actually done what she was supposed to be doing. I have been lucky in the fact that nursery have been on hand to help, and eventually they referred Leo for speech therapy back in June, a whole 5 months after it could have been originally placed.

Now speech therapy is happening, and they are nice enough people and I am glad that they are on board to help Leo and I, but even they are flakey. They book appointments and then forget they have booked them, they double book them, they book them and forget to tell you they have been made, they turn up late, and don’t really seem to know whether they are coming or going. It was just the other week that I rushed from work in my lunch break to be at an appointment that the speech therapist had forgotten to cancel with me, wasting my time, and wasting Leo’s time when she refused to see us.

We have had outside people from the local children’s centre come in to observe Leo at nursery, and nursery passed back the positive feedback that they didn't think anything was wrong and the observation had been fine. Only for me to then receive a report that read completely differently, it spurred me into calling the doctors and booking into see our GP to try and gain a pediatrician referral. It than transpired that this report was actually a rather old report and that the latest observation was absolutely fine.  I sometimes feel like I am banging my head against a brick wall, one person is telling me that Leo is really behind, another tells me he’s absolutely fine and the spectrum of normal at this age is so varied, and then there are people feeding me old information.

I feel like I have had to jump through hoops to even get to this point, I welcome any help with open arms, but the people who are in a position to help don’t seem to be very forthcoming. The appointment I am sitting with Leo on Friday (Friday 5th December 14) is ultimately me pushing to get Leo in front of a pediatrician. If there is something underlying (which I don’t think there is aside from speech delay) then it will have taken a year or over for someone to actually see us. Now I can’t help feeling really frustrated about that fact, because if there is an additional aspect of needs that hasn't been catered for, that’s an entire year of support that has not been there. Everyone who has seen Leo, I have had to fight to put him there. Surely it shouldn't be so hard to seek an opinion and guidance to help a child? To help my child!

I will go along Friday and see what is said, but I am certain the only issue is speech delay. Everyone is so quick to label a child these days, and speech delay or no speech delay, that boy of mine is happy and never without a smile for long.

The One Where We Go For An Eye Test

Back in January I told you all about Leo’s Two and half year check. It was an experience that I really didn't enjoy and came away feeling incredibly rubbish about. Our health visitor turned the entire appointment into a complete song and dance, she insisted on seeing Leo two months later so that she could follow up and check on his progress.

During the appointment she decided that Leo had a squint and was going to be booking a separate appointment for him, that would come through a few weeks later. She wanted to get Leo seen as soon as possible so that treatment could commence if needed, she didn't want him waiting around if he did have one. We got to the end of March and I still had not received the promised appointment through and there had been complete radio silence from our health visitor.

I tried to call her myself on numerous occasions and finally left her a voice mail asking her to give me a call back. I wanted to discuss Leo and get the follow up that she had advised, and also get Leo’s appointment for his eye sorted just to air on the side of caution.

I never did get a call back from our health visitor, and this has gone on to annoy me further. However the date I left the voice mail obviously spurred her into finally booking Leo’s eye exam, even though she still didn't call me back. A week later I received a letter from the surgery with a date to take Leo in, and ironically the letter was dated 27^th March 2014, the day I called and left the message.

I can’t help feeling really let down by our health visitor, what if Leo had actually had a squint? What if she had prolonged the necessary treatment? What if Leo had been a child who had other problems? What if he was being abused? Would she still have been so slack?

On Wednesday 23^rd March I took Leo along to have his eyes examined. We walked into the room and Leo instantly spied a Thomas train. We took our seats and the lady we were visiting got Leo to co-operate with her tests. She shone a little light in his eyes and got him to follow it with his eyes. She used toys to get his attention and was really fantastic with him.

The doctor asked me what I thought, and I personally knew that Leo did not have a squint, but not being a professional I wanted to make sure that my gut feeling was right. My thoughts were confirmed seconds later and she agreed that Leo’s eyes were perfectly fine.

The appointment lasted no longer than 10 minutes, we were in and out. Leo had been fantastic and I was really pleased with the doctor that we had seen.

The health visitor still hasn't followed up with us, she hasn't contacted us to arrange for Leo to come in as promised. The appointment that she wanted to schedule with us was for Leo to come back in and repeat his check-up. Then if she still wasn't happy, she was going to refer Leo for speech therapy. Since January Leo has come on in leaps and bounds, and I want her to see this. I do think he would benefit from speech therapy, and I want her to pull her finger out and do what she promised.

The health visitor has booked us in for a hearing test on Wednesday 7^th May, this is something I personally asked for during the check up in January. I wanted to rule out Glue Ear and make sure he was hearing everything as he should. The health visitor told me that this would happen if he was referred, and that it wouldn't be happening now. But all of a sudden we have an appointment through… I am pleased just to get it checked and ticked off, as Leo can quite obviously hear everything but it’s just nice to confirm.

As for our health visitor, I have lost a lot of faith in her. She hasn't followed through with her promises, she hasn't communicated with us and she hasn't been efficient. From now on I will be doing everything through nursery. They will be doing their own check with him in the next few months. I feel they are in a better position to tell me what he will benefit from as they know him and see him in a setting he is familiar and comfortable in.

We will be getting Leo’s hearing checked and my gut instinct is telling me that he will fly through it. My personal opinion is that Leo has just been slower in talking than other kids his age, and as expected, he is getting there in his own time.