“He’s just being difficult — it’s his autism, he doesn’t need examining”

A CHANGE in behaviour (self-injury, off food, not sleeping, agitation) in a person with learning disability/autism who cannot easily report symptoms is very often a sign of untreated PHYSICAL ILLNESS or PAIN — not "just their autism/behaviour". Attributing it to the disability and missing the physical cause is DIAGNOSTIC OVERSHADOWING, a major cause of avoidable harm and premature death in this group, so new behaviour change must trigger a search for a physical cause/pain (here, jaw-holding and off-food suggest a dental abscess; also consider ear/throat, constipation, urinary infection) and treatment of the cause rather than sedation. People with learning disability/autism are entitled to REASONABLE ADJUSTMENTS (Equality Act 2010) — extra time, a calm approach, involving those who know their baseline and pain cues, gentle/desensitised examination, hospital passports and non-verbal pain-assessment tools — so "he hates being examined" is a reason to ADJUST, not to skip assessment. The examinable hidden agenda is the well-meaning-but-harmful overshadowing assumption (and possible carer fatigue); gently challenge it and advocate for Daniel, centre him as the patient, situate it in the health-inequality context (poorer access/outcomes, the annual health check), and find-and-fix the cause.