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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19309
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am wondering if someone could provide me with some advice

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I am wondering if someone could provide me with some advice please? My son is 17.5 months old and I strongly suspect he is autistic and I have an appointment booked with a NHS paediatrician in June 2014! In the meantime, he has weekly contact with his father. He has never bonded with him (but has with a few other people - albeit - everything is on my sons terms!). His father suffers from social phobia, severe anxiety, OCD, chronic depression, is a 'recovering alcoholic' and frequently requires sleeping tablets. He has also in the last 3 months been signed off from work due to the anxiety. He is sadly unapproachable and highly unpredicable with some anger management issues. He gets easily confused, making false accusations and only seeing what he wants to see and hear. He has on a number of occassions said that (from 11 weeks old) our son has spoken to him. I have raised this with a solicitor and he is now denying this. He has had intensive therapy in the past and been referred 5 times for counselling in the last 10 years but never goes to counselling. He has crossed roads without looking whilst pushing my son in his pram but claimed he was listening for cars! He is on supported contact at a centre but my I VERY VERY concerned about the emotional and indeed physical impact he is/will have on my son. It takes my son at least 2 days to settle back to his normal self after contact only for it to start all over again a few months later. He hasn't seen his father for 3 weeks, due to his father cancelling, and my son has remained settled with no head banging the last 2 weeks!! I am certain this is having a impact on my son, particularly as there is a suspicion he may have special needs. Please can you provide any advice or assistance?!?!?!
It will help if you could provide some further information:
Has his primary doctor noticed any developmental issues?
Has he had any assessments done during the first day after contact with his father?

Customer: replied 4 years ago.

The Health Visitor has been to see my son and referred him. Unfortunately, no assessments have been done during the first day after contact. I don't know who can help me with this as unfortunately I don't have the funds to get private assessments done.

Thank you for the additional information.

I'm not sure how to overcome the financial issues, but from a medical perspective, the approach that is most likely to be helpful would be to perform an assessment on the day after contact with his father. Ideally, this should be done by the same person that is already familiar with your son by seeing him on a good day, so that the extent of deterioration can be compared to baseline.

This could be done by his primary care doctor. A primary care doctor is not a specialist in care of developmentally delayed or special needs children, but they can usually perform an adequate assessment to document altered behavior and deterioration in function.

A proper medical assessment at the time of greatest problems would be important to help provide proper care for your son, but also may help address how to manage the ongoing contact with the father. If there is documentation of significant deterioration in function, then the primary care doctor may be able to accelerate the assessment. Your solicitor also may be able to use any documented changes in behavior and functioning that arise after contact with the father to either require that the father seek appropriate counseling or care or limit the contact with the father. Courts are generally loathe to restrict contact with either parent, but the court also typically has the primary interest in the health and well being of the child, so objective documentation of a deterioration in behavior would usually need to be considered strongly by the court.

Therefore, from a medical perspective, the next step would be to perform an assessment when there is deterioration in behavior after contact with his father. Since it is taking so long to get in with a specialist, the initial assessment can be done by his primary care doctor.

If I can provide any further information, please let me know.

Customer: replied 4 years ago.

Thank you. I will try and arrange this. Contacts are on a Saturday, so difficult to get someone over the weekend, but will speak to the HV & GP again.

Would his fathers diagnosed conditions not be considered a concern when dealing with such a young child?

They might be considered, particularly if the conditions are more severe, but there would be greater concern if there is independent documentation of an adverse effect on the child.

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