Experts at odds: father fears financial fallout

WANGANUI father Jody Lawrence is afraid he may lose access to services to help his son, after a locum paediatrician removed an existing diagnosis of autism because she did not want to label a three-year-old.
Mr Lawrence's son, Shaun, was diagnosed with an "Asperger Effect" by a visiting paediatrician at Wanganui Hospital last July a diagnosis that had given the 28-year-old dad access to respite care and a variety of special education services for Shaun.
However, at a follow-up appointment for the child's epilepsy in March, another locum paediatrician had removed this diagnosis, telling Mr Lawrence that, although his son showed "autistic effects", she would not call him autistic, as a three-year-old should not be labelled.
Since then two service providers have contacted him to say Shaun's diagnosis hads been changed and this could mean he would no longer access funding or services such as respite care when they came up for review later this year.
Without an autism diagnosis, Shaun would also lose access to the Early Bird Programme, which aimed to help parents deal with their autistic children's social communication and behaviour problems, and Mr Lawrence feared he would be bumped down the waiting list to see a behavioural psychologist.
"I don't think (a diagnosis of autism) would affect him at all, I think it would help him. They call it a label; I call it a diagnosis," Mr Lawrence said.
While Sommerville Centre family support co-ordinator Sandy MacMillan told the Wanganui Chronicle that the diagnosis of a disability such as "mild global development delay" meant the family could still access services like respite care, Mr Lawrence said he had been told this was not the case as it was "mild" and it would still not help him access behavioural services.
Mr Lawrence moved to Wanganui from Auckland last year, after he was awarded full custody of his son.
Although the head-banging and temper tantrums meant he knew something was wrong with Shaun before the diagnosis, he had not known whether it was autism or the effects of physical abuse by a family member.
At three-and-a-half, Shaun was still in nappies, could not talk, was increasingly frustrated and aggressive towards others and weighed more than 20kg.
His GP had referred him to the hospital for assessment for possible autistic or Aspergers traits in July last year. Last Friday Mr Lawrence hand-delivered a letter of complaint to Wanganui Hospital, requesting that Shaun be reassessed by a senior doctor, after his June 13 letter could not be found.
"Due to this doctor refusing to keep this diagnosis due to her belief three-year-olds should not be labelled, I will lose my funding in areas that will help my son&
"My son has major speech and developmental problems and his behaviour is becoming more dangerous to himself and others," the letter says.
"He is now causing serious self-harm and has become very violent towards me and other adults, including day care works and special ed workers I need this help now."
The hospital which asked the Wanganui Chronicle for the opportunity to speak with Mr Lawrence before this article was published gave him an appointment with head paediatrician David Montgomery the same day as he delivered the complaint.
At the appointment, Dr Montgomery told him the locum who rediagnosed Shaun had been a general paediatrician, and that he would assess Shaun himself in two weeks.
Shaun would then have to see an autism specialist in August, as it was difficult for a general paediatrician to diagnosis autism unless the symptoms were very obvious, Mr Lawrence was told.
However, Mr Lawrence, who suffers from arthritis to the spine and cannot work, was still angry about the changed diagnosis, which he had not seen a copy of until Friday.
This was the second complaint he had made last August he had laid another one with the hospital and the Health and Disability Commissioner after the first locum paediatrician told him he should put Shaun in a home because he was a single father.
"(He) told me men can't handle stress and men can't raise kids on their own because of stress, let alone special needs kids."
He was told his complaint would not be investigated as the doctor had left the country.
On Friday, Whanganui District Health Board chief executive Memo Musa confirmed the customer relations officer had received the complaint from Mr Lawrence on Friday, but said the hospital had not received one before that.
He would not comment further on a clinical matter, he said.
Meanwhile, Autism NZ chief executive Maree Whitworth said that while there was debate about diagnosing children under five, it was possible to diagnose an autistic spectrum disorder without defining the kind of autism too closely.
"It's not a label; it's actually a diagnosis. You wouldn't go to the parent of a child with cancer saying you were not going to label him," she said.
Health Ministry Child and Youth Health chief adviser Pat Tuohy said there was "reliable" international evidence that showed autism spectrum disorder diagnoses could be made with confidence between two and three years old, but this was not necessarily the case with Aspergers Syndrome.