189 Visa - Medical tests for children with development delays

[Ronkite]

Hello,

We have recently submitted our Skilled Independent Visa (subclass 189) application. It was only during our medical examinations we have realised that the development delays/signs of autism in children would be a deal breaker for obtaining a PR visa. My kid (3 years and 4 months) had shown some signs of autism when he was 2.5 years old and has been attending an early intervention program ever since. He also attends a regular play school here in our city.

He was non-verbal just 10 months ago, but his speech has significantly improved in the last few months. He now speaks more than 300-400 words (eg: fruits, vegetables, colours, animals, vehicles, planets, action words, weeks, months etc..) and uses 3-4 word sentences like "I want water please", "open the door", "cover me with a blanket", "I see a phone" etc.. and asks for assistance using sentences like "help me". He can also count numbers up to 50 and trace alphabets among other things. He also started reading 3-letter words without much assistance.

He has been potty trained for over two weeks now and is generally doing well with his needs. We believe he is doing reasonably well in both his schools as we receive positive feedback from his teachers.

As part of his medical examination earlier this week, we have provided the details of his speech delay and his current pre-school program (early intervention) information to the Doctor. Since there was no formal diagnosis of ASD, and considering his recent improvements we didn't mention anything about his earlier signs of autism. Since my kid showed a lack of interest/attentiveness in this session(and also didn't answer couple of questions), the Doctor suggested that he may have to refer his case back to the Australian Immigration department. He basically suggested that the DoHA may ask for additional details from his school about his attention deficit. I now see the following message from Immiaccount.

"A Medical Officer has determined that additional health information is required to determine whether this person meets the health requirement for the visa subclass specified". 

Does this mean further medical tests will be conducted? And what tests do they generally conduct to determine my child's condition. I believe they may probably do some psychological evaluation to determine if he is on the spectrum, but not sure how this really works. We have only observed few of these highlighted symptoms in our child recently, and wondering if this would put him on the spectrum and make him ineligible for this Visa.

Quote

Signs of ASD in pre-school children

Spoken language

• delayed speech development (for example, speaking less than 50 different words by the age of two), or not speaking at all
• frequent repetition of set words and phrases [sometimes]
• speech that sounds very monotonous or flat
• preferring to communicate using single words, despite being able to speak in sentences

Responding to others

• not responding to their name being called, despite having normal hearing [sometimes]
• rejecting cuddles initiated by a parent or carer (although they may initiate cuddles themselves)
• reacting unusually negatively when asked to do something by someone else

Interacting with others

• not being aware of other people’s personal space, or being unusually intolerant of people entering their own personal space
• little interest in interacting with other people, including children of a similar age
• not enjoying situations that most children of their age like, such as birthday parties
• preferring to play alone, rather than asking others to play with them [sometimes]
• rarely using gestures or facial expressions when communicating
• avoiding eye contact

Behaviour

• having repetitive movements, such as flapping their hands, rocking back and forth, or flicking their fingers
• playing with toys in a repetitive and unimaginative way, such as lining blocks up in order of size or colour, rather than using them to build something
• preferring to have a familiar routine and getting very upset if there are changes to this routine
• having a strong like or dislike of certain foods based on the texture or colour of the food as much as the taste
• unusual sensory interests – for example, children with ASD may sniff toys, objects or people inappropriately 

Please advice if we should seek professional help (George Lombard or Peter Bollard) for this case right away, or wait a bit longer to see the results from further medical tests (if any)? Apologies for the long post, but would really appreciate any valuable inputs from forum members.

 

[Quoll]

They may ask you to get the psychometric assessments done. The fact that he is in an early intervention program usually raises some flags and they may assume that he's already had a cognitive assessment and ask you to provide the results of that. They would usually ask for a paediatric diagnosis, cognitive assessment, adaptive behaviour, speech /language assessment, possibly an OT assessment. You can probably find a clinical paediatric psychologist who could do that.

Bottom line though, yes, I would be seeking advice from one of the specialists in medical issues. The catch 22 is that if a child is needy enough to be eligible for support in education they are not likely to get a visa and if they get a visa they're likely to not get support in school.

[Ronkite]

6 hours ago, Quoll said:

They may ask you to get the psychometric assessments done. The fact that he is in an early intervention program usually raises some flags and they may assume that he's already had a cognitive assessment and ask you to provide the results of that. They would usually ask for a paediatric diagnosis, cognitive assessment, adaptive behaviour, speech /language assessment, possibly an OT assessment. You can probably find a clinical paediatric psychologist who could do that.

Bottom line though, yes, I would be seeking advice from one of the specialists in medical issues. The catch 22 is that if a child is needy enough to be eligible for support in education they are not likely to get a visa and if they get a visa they're likely to not get support in school.

Thanks Quoll. But hypothetically, if these tests concluded my child's case to be eligible for a visa, would they impose any restrictions on seeking educational support in future (i.e. via private schools or speech therapy sessions, if needed).

Also, if the immigration department facilitates these tests and the results are shared with them directly, what additional help would the migration agents usually provide?

[Quoll]

Each state has slightly different eligibility requirements for disability support in schools and immigration will consider assessments (they don't arrange them, they generally ask you to provide them) and make their judgments based on whether the child then meets the eligibility criteria for support. As special Ed support tends to be quite expensive, it's easy for the child to meet the threshold of cost to the Aus tax payer and therefore have a visa declined.  If they do give you a visa then expect little to nothing by way of government support but of course there is nothing stopping you from accessing therapies if you pay for them and if you can find a private school which would enrol him then of course you can pay the fees. If a child is likely to be eligible for the NDIS they're likely to fail. 

All the migration agents can do is look at the assessments and tell you what they think the immigration response to your visa application is likely to be and whether you're going to waste your time and money. It's usually better, when there is a known medical issue to consult the agents before applying for the visa but running the situation past them will give you a better perspective of what your chances are. They'll probably be able to tell you exactly what assessment battery is required.

Edited September 26, 2018 by Quoll

[Ronkite]

1 hour ago, Quoll said:

Each state has slightly different eligibility requirements for disability support in schools and immigration will consider assessments (they don't arrange them, they generally ask you to provide them) and make their judgments based on whether the child then meets the eligibility criteria for support. As special Ed support tends to be quite expensive, it's easy for the child to meet the threshold of cost to the Aus tax payer and therefore have a visa declined.  If they do give you a visa then expect little to nothing by way of government support but of course there is nothing stopping you from accessing therapies if you pay for them and if you can find a private school which would enrol him then of course you can pay the fees. If a child is likely to be eligible for the NDIS they're likely to fail. 

All the migration agents can do is look at the assessments and tell you what they think the immigration response to your visa application is likely to be and whether you're going to waste your time and money. It's usually better, when there is a known medical issue to consult the agents before applying for the visa but running the situation past them will give you a better perspective of what your chances are. They'll probably be able to tell you exactly what assessment battery is required.

Many thanks Quoll. It was a mistake to not do a proper research about the impact of developmental delays/autism on our immigration application. We had no clue about this until we walked into complete our medicals last week, and never thought this would become such an issue. Since we don't use any government support in our current country of residence, we never really thought about this while applying.

We will complete further medical assessments for my child and see how this goes. Thanks for your detailed reply, this is really useful information.

[KazBaker]

15 hours ago, Ronkite said:

Many thanks Quoll. It was a mistake to not do a proper research about the impact of developmental delays/autism on our immigration application. We had no clue about this until we walked into complete our medicals last week, and never thought this would become such an issue. Since we don't use any government support in our current country of residence, we never really thought about this while applying.

We will complete further medical assessments for my child and see how this goes. Thanks for your detailed reply, this is really useful information.

Hi Ronkite,

I received your message. I understand the situation currently you have matching with my sitution and i come out with a good result and surely you will have a positive outcome too. 

I read through your son’s condition considering the transformation is amazing. It suggests us that he is in process in developing. Thats a good sign. 

Now where do you guys live? Are you currently living in Australia?

let me tell you my process step by step below:

1. We had done our medical examinations (3 ppl) and during the son’s test the doctor discussed with us what my son’s lacking right now such as toilet trained, lack of full sentence but in words etc. she also said exactly what your doctor said to us that a commonwealth medical officer (MOC) will contact me about the assessment. Which reflect on immi account Health assessment section( further assessment required)

2. I received a letter from MOC about my son’s further assessment to be done by any psycologist in melboure. BVMS wants a report from the clinical psycologist about my son’s cognitive developmental. Later i went to our GP and she gave us a reference letter, with this letter you can see any specialist, so i booked a clinical psycologist near my home.

3. At the initial assessment, we described our situation with the psycologist about my son’s cognitive developmental issue. We talk about our son and bit family background and history. And after that he told my us to come at 2nd appointment because an interview is to be conducted with my wife

4. 2nd day, the psycologist were asking a many questions to my wife mainly what significant happend during pregnancy and any complex condition exist? questions were asked by the doctor to know the history and background, culture, etc.

5. 3 rd day the doctor had playing session with my son and he had gone through the toys, color, some instruction made to know how my son inreracts in a situation. What i understand was that he literally checked how my son’s life skill and social skill are applied.

6. He also contacted to kindergarten teacher about my son’ behaviour during the class or sesion. And also contact to GP.

In his report he wrote by assessing through all the situations that my son has receptive and delivery disorder which means language delay and Medical officer was determined that he meets the medical examination.

So you don’t need any medical examination again any of you. But you need a report from a psycologist his openion about your son’s current condition. I understand how hard it is for parents been through this situation. I couldn’t sleep many nights. It was our mistakes though as i did not pay enough attention to our son. We need to talk to him specially mom needs to talk most of the time or keep him interacts with other so that he will develop his life skills and social skills which help him developing. Since then i put him in child care for longer hours so that he can learn by spending time with other kids and educator. Now my son starts talking and i can’t stop him. 

If you recognise that your son might have only speech delay theb be sure you are going to do well and nothing to worry about visa outcome. Apart from speech delay if he is reported with other issue like Autism ss you mention. Here you have still an option. If it cost within $8000 per year for next 5 years=$40000. It is ok. Immigration don’t want to loose Australian tax payer’s money and it is a burden on tax payer.

Hope this info will help track your path to over come the situation.

All the best

 

[Ronkite]

3 hours ago, KazBaker said:

Hi Ronkite,

I received your message. I understand the situation currently you have matching with my sitution and i come out with a good result and surely you will have a positive outcome too. 

I read through your son’s condition considering the transformation is amazing. It suggests us that he is in process in developing. Thats a good sign. 

Now where do you guys live? Are you currently living in Australia?

let me tell you my process step by step below:

1. We had done our medical examinations (3 ppl) and during the son’s test the doctor discussed with us what my son’s lacking right now such as toilet trained, lack of full sentence but in words etc. she also said exactly what your doctor said to us that a commonwealth medical officer (MOC) will contact me about the assessment. Which reflect on immi account Health assessment section( further assessment required)

2. I received a letter from MOC about my son’s further assessment to be done by any psycologist in melboure. BVMS wants a report from the clinical psycologist about my son’s cognitive developmental. Later i went to our GP and she gave us a reference letter, with this letter you can see any specialist, so i booked a clinical psycologist near my home.

3. At the initial assessment, we described our situation with the psycologist about my son’s cognitive developmental issue. We talk about our son and bit family background and history. And after that he told my us to come at 2nd appointment because an interview is to be conducted with my wife

4. 2nd day, the psycologist were asking a many questions to my wife mainly what significant happend during pregnancy and any complex condition exist? questions were asked by the doctor to know the history and background, culture, etc.

5. 3 rd day the doctor had playing session with my son and he had gone through the toys, color, some instruction made to know how my son inreracts in a situation. What i understand was that he literally checked how my son’s life skill and social skill are applied.

6. He also contacted to kindergarten teacher about my son’ behaviour during the class or sesion. And also contact to GP.

In his report he wrote by assessing through all the situations that my son has receptive and delivery disorder which means language delay and Medical officer was determined that he meets the medical examination.

So you don’t need any medical examination again any of you. But you need a report from a psycologist his openion about your son’s current condition. I understand how hard it is for parents been through this situation. I couldn’t sleep many nights. It was our mistakes though as i did not pay enough attention to our son. We need to talk to him specially mom needs to talk most of the time or keep him interacts with other so that he will develop his life skills and social skills which help him developing. Since then i put him in child care for longer hours so that he can learn by spending time with other kids and educator. Now my son starts talking and i can’t stop him. 

If you recognise that your son might have only speech delay theb be sure you are going to do well and nothing to worry about visa outcome. Apart from speech delay if he is reported with other issue like Autism ss you mention. Here you have still an option. If it cost within $8000 per year for next 5 years=$40000. It is ok. Immigration don’t want to loose Australian tax payer’s money and it is a burden on tax payer.

Hope this info will help track your path to over come the situation.

All the best

 

Thanks a lot KazBaker for your prompt reply and for explaining this in much detail. We currently live in Singapore, and have completed our medicals here (3 of us).

I have contacted my child's Early Intervention Program school, and they have suggested either of the following two options.

1. Go for a full psychological assessment - which will be conducted by a clinical psychologist or an educational psychologist. Psychologist may use ADORS for assessment and will produce a full report to determine the diagnosis.
2. Visit a doctor to assess his medical condition to chart his developmental milestones. And then, get one of the speech therapists to assess my child for his Speech delay. This is because the panel clinic doctor has suspected a speech delay.

They will also issue a letter from school mentioning his EIP progress, which will detail his progress and his cognitive abilities. We also intend to get another letter from his pre-school to detail how his social interaction is in the school setting. We will probably go ahead with Option 1 and hope for a postive outcome from the assessment.

Our child had amazing progress in the last year, so we hope his diagnosis doesn't point to any adverse conditions. In any case, we have decided to not worry too much about the Visa process/grant but rather focus more on how we could help our child get much better.

Thanks for sharing your personal experience, it's really great to hear about your child's progress. We are quite hopeful that we will see similar progress in my child's speech in the coming months.

 

[KazBaker]

55 minutes ago, Ronkite said:

Thanks a lot KazBaker for your prompt reply and for explaining this in much detail. We currently live in Singapore, and have completed our medicals here (3 of us).

I have contacted my child's Early Intervention Program school, and they have suggested either of the following two options.

1. Go for a full psychological assessment - which will be conducted by a clinical psychologist or an educational psychologist. Psychologist may use ADORS for assessment and will produce a full report to determine the diagnosis.
2. Visit a doctor to assess his medical condition to chart his developmental milestones. And then, get one of the speech therapists to assess my child for his Speech delay. This is because the panel clinic doctor has suspected a speech delay.

They will also issue a letter from school mentioning his EIP progress, which will detail his progress and his cognitive abilities. We also intend to get another letter from his pre-school to detail how his social interaction is in the school setting. We will probably go ahead with Option 1 and hope for a postive outcome from the assessment.

Our child had amazing progress in the last year, so we hope his diagnosis doesn't point to any adverse conditions. In any case, we have decided to not worry too much about the Visa process/grant but rather focus more on how we could help our child get much better.

Thanks for sharing your personal experience, it's really great to hear about your child's progress. We are quite hopeful that we will see similar progress in my child's speech in the coming months.

 

That sounds great !

Yes go to clinical psycologist, they have their case study including all the aspect a child cognitive developmental status. He will be able to issue a report on developmental status. Once you get the report just forward to MOC. Job done !

Hopefully your son will be ok

[Ronkite]

15 minutes ago, KazBaker said:

That sounds great !

Yes go to clinical psycologist, they have their case study including all the aspect a child cognitive developmental status. He will be able to issue a report on developmental status. Once you get the report just forward to MOC. Job done !

Hopefully your son will be ok

Thank you 

[Noop]

Hi what is the status of your application ?

Visa granted ?

[H12R]

Hi Ronkite

Can u please tell what was the final outcome of additional medical requirement done for ur son? Did they grant him the medical clearance and vise?

[H12R]

On 26/09/2018 at 12:52, Ronkite said:

Many thanks Quoll. It was a mistake to not do a proper research about the impact of developmental delays/autism on our immigration application. We had no clue about this until we walked into complete our medicals last week, and never thought this would become such an issue. Since we don't use any government support in our current country of residence, we never really thought about this while applying.

We will complete further medical assessments for my child and see how this goes. Thanks for your detailed reply, this is really useful information.

Hi Ronkite!

 

Can you please tell what was the final outcome of ur case as i am facing a similar situation too. My child has been asked for additional medical checkup. I will be really grateful & looking forward for your reply.

[H12R]

On 27/09/2018 at 10:30, KazBaker said:

That sounds great !

Yes go to clinical psycologist, they have their case study including all the aspect a child cognitive developmental status. He will be able to issue a report on developmental status. Once you get the report just forward to MOC. Job done !

Hopefully your son will be ok

Hi KazBaker,

I am having similar issue. I have been asked to undertake additional medical requirments for my 3 yrs old daughter. She has delayed speech, speaks 50 to 80 words and is familiar with all alphabets and numerics till 20 to which she not only recognizes but also pronounces. The Bupa medical has sent me an email stating that we need to undergo additional health assessment of my daughter in a panel of peadratition or psychologist.

Can you please guide me what should i do to get them convinced as delayed speech exists in our family. 

As of now, i am afraid

1. What if they declare her not meeting the medical standards?

2. What should i do? Take up case as my visa class is 189?

Or

3. Render a statutory declaration that we would undertake her expenses ourselves?

4. how much chances are there that the CO would give us a health waiver on 189? 

You advice would be great in this matter.

[Quoll]

55 minutes ago, H12R said:

Hi KazBaker,

I am having similar issue. I have been asked to undertake additional medical requirments for my 3 yrs old daughter. She has delayed speech, speaks 50 to 80 words and is familiar with all alphabets and numerics till 20 to which she not only recognizes but also pronounces. The Bupa medical has sent me an email stating that we need to undergo additional health assessment of my daughter in a panel of peadratition or psychologist.

Can you please guide me what should i do to get them convinced as delayed speech exists in our family. 

As of now, i am afraid

1. What if they declare her not meeting the medical standards?

2. What should i do? Take up case as my visa class is 189?

Or

3. Render a statutory declaration that we would undertake her expenses ourselves?

4. how much chances are there that the CO would give us a health waiver on 189? 

You advice would be great in this matter.

Get a full cognitive/speech assessment. Nobody can tell you what they may decide until she has been assessed. It’s unlikely they would be interested in any assertion that you would cover all her costs because circumstances change and you could end up not being able to fund all the interventions required or may just change your mind. Once a kid hits pre-school age with eligibility for special ed programs - and early intervention is often key to better prognosis - they are going to cost the tax payer a lot of money and visa refusals should be expected. It’s always wise to talk to one of the agents who specialise in medical conditions - every case is different.

[H12R]

11 hours ago, Quoll said:

Get a full cognitive/speech assessment. Nobody can tell you what they may decide until she has been assessed. It’s unlikely they would be interested in any assertion that you would cover all her costs because circumstances change and you could end up not being able to fund all the interventions required or may just change your mind. Once a kid hits pre-school age with eligibility for special ed programs - and early intervention is often key to better prognosis - they are going to cost the tax payer a lot of money and visa refusals should be expected. It’s always wise to talk to one of the agents who specialise in medical conditions - every case is different.

Hi Quoll,

So great for your advice. I just wanted to ask that how can I get speech and cognitive assessment. 

1. Do i have to get it from some doctors specified on panel.

Or

2. I can undertake it from any psychologist and submit the report?

3. When will i required to submit / show this assessment report during additional medical to the panel or to the CO who would be makong decision on my visa application, after medicals are done?

Looking forward for your advice.

[KazBaker]

14 hours ago, H12R said:

Hi KazBaker,

I am having similar issue. I have been asked to undertake additional medical requirments for my 3 yrs old daughter. She has delayed speech, speaks 50 to 80 words and is familiar with all alphabets and numerics till 20 to which she not only recognizes but also pronounces. The Bupa medical has sent me an email stating that we need to undergo additional health assessment of my daughter in a panel of peadratition or psychologist.

Can you please guide me what should i do to get them convinced as delayed speech exists in our family. 

As of now, i am afraid

1. What if they declare her not meeting the medical standards?

2. What should i do? Take up case as my visa class is 189?

Or

3. Render a statutory declaration that we would undertake her expenses ourselves?

4. how much chances are there that the CO would give us a health waiver on 189? 

You advice would be great in this matter.

Hi H12R,

Here is my remark according to your question below:

1. Your daughter has to meet health requirments in order to all your visa outcomes as all of you applied at the same time.

2. Now you need to see a clinical psycologist as soon as possible. It might take a long time to get an appointment to CP but patience to be appreciated.

3. Not necesarily needed.

4. As far as i know there is no health waiver available once you are migrating into Australia.

 

If you want to have more details pls check my above explanition step by step.

and where do you live. If you live in Melbourne i can provide you the CP i went to.

no need to be panic. Your daughter has still enough time to over come all the situation she has. It would be positive outcome indeed. Be patience mate. You will be alright.

Edited January 12, 2019 by KazBaker

[H12R]

1 hour ago, KazBaker said:

Hi H12R,

Here is my remark according to your question below:

1. Your daughter has to meet health requirments in order to all your visa outcomes as all of you applied at the same time.

2. Now you need to see a clinical psycologist as soon as possible. It might take a long time to get an appointment to CP but patience to be appreciated.

3. Not necesarily needed.

4. As far as i know there is no health waiver available once you are migrating into Australia.

 

If you want to have more details pls check my above explanition step by step.

and where do you live. If you live in Melbourne i can provide you the CP i went to.

no need to be panic. Your daughter has still enough time to over come all the situation she has. It would be positive outcome indeed. Be patience mate. You will be alright.

Hi KazBaker,

Thanks for your prompt reply. Please share your some detail so that i can get in contact at Melbourne with you on this matter.

Looking forward 

[Quoll]

I assume you're not in UK so I can't help you with where to go for paediatric psychological assessments but if you talk to her therapist (I assume she is already undergoing some firm of early intervention) and ask what assessments they  can do and also ask for recommendations for developmental psychologists who can do cognitive assessments. 

Edited to say / are you in Australia already? There are plenty of services you can access if you are. Your daughter should already be known to Early Intervention services.

We cannot reiterate enough the need for you to talk to one of the agents who specialise in medical conditions. Sadly the glib positive assertions of people whose kids have made it through the medical process are not likely to be of much use to you, all cases are different 

Edited January 12, 2019 by Quoll

[H12R]

1 minute ago, Quoll said:

I assume you're not in UK so I can't help you with where to go for paediatric psychological assessments but if you talk to her therapist (I assume she is already undergoing some firm of early intervention) and ask what assessments they  can do and also ask for recommendations for developmental psychologists who can do cognitive assessments. 

Okay thanks alot

[KazBaker]

10 hours ago, H12R said:

Hi KazBaker,

Thanks for your prompt reply. Please share your some detail so that i can get in contact at Melbourne with you on this matter.

Looking forward 

The clinical Psycologist name is Dr Mathew Hughes. You can google it. I have seen the Dr at Dandenong office. He has many other places where he sees patients. You can contact him. And you need a referall letter from your daughter’s GP to see him if you live in Melbourne.

Edited January 12, 2019 by KazBaker

[H12R]

6 hours ago, KazBaker said:

The clinical Psycologist name is Dr Mathew Hughes. You can google it. I have seen the Dr at Dandenong office. He has many other places where he sees patients. You can contact him. And you need a referall letter from your daughter’s GP to see him if you live in Melbourne.

Hi KazBaker,

After i meet the CP, she would give me a report, where can i use that report during the additional medical or once the CO asks. 

Will the panel guys accept this report or have a look at this one? 

[KazBaker]

5 hours ago, H12R said:

Hi KazBaker,

After i meet the CP, she would give me a report, where can i use that report during the additional medical or once the CO asks. 

Will the panel guys accept this report or have a look at this one? 

Commonwealth medical officer will send you an email address or a link where you can send them the soft copy to.

Hope this help.

Good luck

Edited January 13, 2019 by KazBaker

[H12R]

52 minutes ago, KazBaker said:

Commonwealth medical officer will send you an email address or a link where you can send them the soft copy to.

Hope this help.

Good luck

Hi KazBaker

Thanks alot

If u don't mind can you please share yiur email id so that i can get in contact with you.

[KazBaker]

8 hours ago, H12R said:

Hi KazBaker

Thanks alot

If u don't mind can you please share yiur email id so that i can get in contact with you.

Check inbox

[Noop]

Hi H12R/Ronkite,

Any update on your application?

Anyone got grant with developmental delay ?