I was asked to assess Billy as part of the programme 'Born Naughty?' to see what might be causing his bad behaviour at home and more recently at nursery. He had already been seen by the Paediatrician Dr Ravi Jayaram who had made some important observations.
Billy aged 3 years, along with his Mum and Grandmother came to a children's centre which was local to me but was a good 3 hours drive from their home. I played with him a for a short time and then screened his spoken language skills. I was looking for: his attention level, listening ability, auditory memory, understanding level (information carrying words), vocabulary, verbal reasoning and expressive language. I was also looking for his social communication/pragmatic skills which includes three major communication
skills:
Using language for different purposes, such as
§ greeting (e.g. hello, goodbye)
§ informing (e.g. I'm going home)
§ demanding (e.g. Take me home)
§ promising (e.g. I'm going to take you home)
§ requesting (e.g. I would like to go home, please)
Following rules for conversations and storytelling, such as
§ taking turns in conversation
§ introducing topics of conversation
§ staying on topic
§ starting conversations appropriately
§ finishing conversations e.g. not walking away
mid-sentence
§ how to use and read verbal and nonverbal signals
§ how close to stand to someone when speaking
§ how to use facial expressions and eye contact
It also includes Modifying language according to the needs of a listener or situation (for older children but Billy is too young for this), such as
§ giving background information to an unfamiliar listener
§ speaking differently in a classroom than on a playground
He coped really well with the assessment and scored highly on everything. I'd also put out a variety toys to see what the level of his play was like. His pretend play was amazing: he used lego as soup, made Batman and Robin from square shapes and pretended with imaginary toys too.
His family were concerned that he might have Autism as his uncle has a diagnosis of ASD. They were worried that his behaviour was due to this. However, if we look at the older way of looking at ASD: i.e. the triad of impairment of language ability, social communication and flexibility, Billy scores so highly as to void any suggestion of ASD, this, together with Ravi's observations, meant I did not therefore do any formal ASD assessment. His mum is to be congratulated on a fantastic job done!
We needed to look for an different explanation of the behaviour and called in the wonderful Deb Sugden, sleep expert.
