Look at me writing two posts in two days, brings back those summer holiday memories.

But today felt important to record. One of those days I know I’ll look back on, so I wanted to write it while it’s still clear in my mind.

The Start of the Day

Today started off horribly.

Our food delivery arrived but my payment hadn’t gone through, so it was being held hostage by the delivery driver. I managed to get through to the payment desk and, as Kike was giving his card details, I unpacked the shopping. But then his card was also declined. (We’re not in horrendous debt, just bad luck.) The lady informed me she could only try once, why?, we’ll never know.

So everything was reloaded back into the boxes and given back to the delivery driver.

No food for us today.

Kike left for work and I managed to pull together some form of breakfast, did the usual tidy-up and made some lunch to take with us, as River and I were heading out. We walked Summer to a playdate (with the pushchair, I do learn), and once the screams of saying goodbye had died down, we set off for our appointment.

The Journey

It wasn’t the easiest of journeys.

We waited at the first bus stop but one downside of buses is that they don’t stop if they’re full and the driver can see that I have a pushchair. I may have sworn quite loudly at the first one. By the time the second arrived, he shook his head, but I gestured widely that I would close the pushchair. He reluctantly pulled over and let me on but refused to move until I had taken River out, seated him, folded the pushchair and awkwardly carried it to the back.

Three stops later, the bus terminated early.

So we walked, stopped for extra juice, and got on the next bus. This one was smoother and a very helpful man stopped River from going flying when the driver pulled off before we reached our seats.

You’ve got to love London commuting.

After a 30-minute bus and a complicated walk, we arrived at the medical centre.

The Assessment

For today was River’s final assessment for autism.

In case you’re going through one, know someone who is, or are just curious, this is what happens.

We were taken into a split room. An occupational play therapist worked with River, going through a series of games and activities, while I had an in-depth conversation with the doctor.

I told River’s story from the beginning.

We spoke about his missed milestones, his delayed speech, his reluctance for play, his need for routine. She asked about his sleep, eating, mobility, communication and relationships. We spoke for just over two hours.

In a way, the blog really helped. Having recently edited the book, everything was right there in my mind.

River did really well and only came to sit on me for the last half hour, having a little spin and making his quiet noise to show he was tired.

What They Saw

We were asked to wait while they discussed everything. They told me it might take a while, but as I sat there, the therapist reassured me, “This won’t take long.”

Ten minutes later we were called back in.

The therapist spoke first.

River is very self-directed, a polite way of saying he does what he wants. He was reluctant to change his play and only did so twice briefly after a lot of coaxing and promises that he could have his preferred toy back.

He communicated his needs but did not participate in conversation and largely ignored questions.

He showed hyper-fixation on certain toys, particularly those with a sensory element. He spent at least 20 minutes with a toy made of plastic pins, pushing them in and out. During this time he completely ‘zoned out’ and did not respond.

He did not engage in pretend play. When given playdough to make a birthday cake, he took it but did not follow the idea. When the therapist modelled it, and tried to feed ‘the cake’ to a toy saying “Mmm, yummy,” he simply cocked his head and replied, “Not eating, it’s a toy,” and returned to his chair.

She offered him two books, expecting him to look at pictures or comment. Instead, due to his hyperlexia, he read them and handed them back.

He also, as expected, refused to mark make.

The Diagnosis

Then it was back to the doctor.

She explained that they use a diagnostic framework, combining previous reports, today’s session and her own observations.

To be diagnosed with Autism Spectrum Disorder, a child must show delays in three key areas.

Social-emotional reciprocity: River cannot hold a conversation, does not share interests and does not automatically register emotions.

Non-verbal communication: He can give eye contact but not consistently, does not gesture and uses fixed or rehearsed facial expressions.

Developing and maintaining relationships: He has a strong bond with his mother but shows limited interest in peers and struggles with change and transitions.

They both looked at me.

And the doctor said,

“As River clearly displays difficulties in each of these areas, alongside his sensory needs and stimming behaviours, he meets the criteria for Autism Spectrum Disorder.”

The Moment

And there it was.

They handed me a piece of paper, explained next steps, who to contact, courses I could attend.

I asked if there was anything more I should be doing.

They told me everything I was doing was already helping. To continue. To keep teaching him explicitly, especially emotional and social understanding.

A small tear escaped as I hugged him tightly.

Almost identical to that 20-month appointment three years ago. A tissue was given.

“I’m not sad,” I said again.

But this time I added,

“It’s just been a long journey getting here.”

The Journey Home

River was exhausted and fell asleep before we reached the first bus stop.

I knew I couldn’t do it. So I ordered an Uber and he slept the whole way home.

So… What Now?

When Kike got home, I told him about the appointment and the result.

“So, now what?” he asked.

And the answer is… not much.

I’ve done it all backwards.

Usually this is where things start, the diagnosis, the referrals, the support, the applications.

But I’ve already done all that.

I was so confident that I knew my little boy that I built our life around it. I wrote the blog. I’m about to publish a book. I’ve spent the last three years learning, adapting, advocating, challenging people and supporting him in every way I can.

So now, we just keep going.

A piece of Paper

That piece of paper might help him one day.

It might help others understand him.

But to me, it’s just a piece of paper.

He has always been, and will always be,

just River.

(yes we put Kate’s glasses on him to make him look like Harry Potter)