Triadic gaze when pointing and receptive language

[Arhumuk]

Hi

Some of you seen my post " should I be paranoid or am I being paranoid"

My son who I have suspected of Autism for the last year but his initial assessment with Salt (13months)concluded he had no social impairment he had displayed 3 point gaze social referencing. Then nursery raised some concerned in Oct (19 months)but in Nov at parents evening his key worker took her initial assessment back. we also took him privately to a develop pead at the time the nursery raised theor concern who in conclusion said at the time he did not meet the criteria for referral and suggested return at 2.5 years. However my wife and I continue to have our doubts.

In all other respects he ticks a lot of NT boxes, imaginative play including role play with figures, imaginative eating with toy food , points to requests, points to share, expressive language increasing every day, Loves to sing songs like wheels on the bus, bingo and dances along to baby shark,nursery says he joins in with circle time and that he understands humour well. No Motorskills issues infact fine skills were advanced.

However my doubts surround a couple of issues. Firstly pointing he has been pointing prolifically sine 16/17 mnths before that sporadically . when he points to share he rarely looks back i'd say only a handful of times from what I have observed since he started pointing. otherwise 3 point gaze shift at other times during play and dinner time is a lot more common. For example this morning pointed up in the sky to a plane and said plane when he was in my arms but did not look back at me but kept staring at the plane. Is there anything to worry about this or are my concerns unfounded, does the fact that he has displayed the triadic gaze on occasion give me reassurance it's ok. @MapLand you have expressed in a post that your son also pointed but went on to be dx with ASC could you eloborate whether your son pointed to share or request and when did he start pointing.

Lastly receptive language comprehension , my son is going to be 2 in FEB and still his comprehension is inconsistent. back in oct my wife an I laid out different item on the carpet and requested him to bring us each item individually when we named them he subsequently did it 100% and this gave me huge releif that there was some comprehension. But recently when we ask him he ignores these requests. However recently we were sitting with the family I asked him to name the family members "where is? " and he pointed at the family memebers naming them also will give you a kiss when requested will tidy up if you ask him but comparing to the comprehension of other 2 year olds I feel he is well behind as he doesnt understand most of what we say to him. Today asked him if he wanted to watch peppa or bam bam he said peppa but not sure if this is a fluke and whether he actually understood the question. Is his comprehension what it should be?

Response to names there are weeks when his response are consistent but then there are phases when his response is terrible.

Sorry for the long post but I'm confused and anxious need people to talk to about this. Been thinking abut it more often in light of his 2nd birthday.

[Jannt86]

I've seen your previous post. Honestly he sounds fab. My daughter is a similar age. She's very social but she's also a toddler! Whatever the resources tell you they won't always want to answer their name and they won't always want to point to or name objects like a trick pony, especially if you yourself are quite stressed when you're trying to illicit this as they will pick up on this anxiety. Think about it. You're presumably socially able but do you always feel like chatting away with another person? How about if it seemed like all that person was interested in was testing your general knowledge? They should be answering their names and understanding instructions some of the time but they're not robots. They're individuals. Sometimes they'll prefer to ignore you. It doesn't mean there's anything wrong. Nobody can be sure just from a few posts but honestly it sounds loke your little boy is lovely and healthy. Please try not to worry too much and remember that nobody on here is an expert so they're not going to be able to offer any more reaasurance than the professionals who have already seen your child can. Good luck

[Arhumuk]

Thanks for your response and I understand the response I get but as as parent I know something is off.

I'm wondering if it's pdd nos.

[Jannt86]

My daughter I don't have any concerns about and have never even considered any such disorder and tbh she sounds pretty similar to your boy. I was slightly concerned about her speech initially but currently she seems to be catching up nicely. She definitely responds to commands and her name and has brilliant receptive language but it's still touch and go whether she'll actually choose to listen to me. Sometimes she'll sit really well and listen to a story or concentrate on a task eg a jigsaw or imaginative play, others she's literally bouncing off the walls and it's hard to get her to pay the blindest bit of attention to me. Sometimes she will take other children by the hand and even engage in simple games with them, other times she's so engrossed in her own play I don't think she'd know or care who is in the room with her. I would honestly class this all as a completely typical toddler. If someone came to you when yoi were perhaps engrossed in something else or tired or hungry or poorly and started asking what the capital of Cambodia is or how tall mount evorest was (probably the equivalent of when we ask our LO's to demonstrate their knowledge) then you're not always going to feel like obliging. I totally understand that you're concerned and I'm sorry if you feel like something is wrong but I honestly think from what you're saying that your boy is developing within perfectly acceptable limits. It's great that there's more understanding and awareness of ASD and similar conditions and I totally agree that early intervention is useful in the small percentage of children. However I think it's leading us to be a bit hypervigilant and unaccepting of our children having the slightest quirks without putting a label on it. We all have our own personalities and the world thrives on this. If you continue to be concerned I'd recommend a book called 'late talking; a.symptom or a stage' It's primarily focussed on talking as the name suggests but it explains a lot throughout the book that even the majority of babies who display traits associated with autism will often grow out of them and don't go on to develop autism. I'd also recommend looking at the blogs on //www.teachmetotalk.com. Again very speech focussed but she gives some lovely, simple ideas of games to help improve a child's social skills as well. Please just try and enjoy your lovely son who will always be your lovely son mo matter what though and get help for yourself if things are getting too much. Take care

[AladdinMum]

From your description it is incredibly unlikely that he has any pervasive development disorder. At this age they will know when you are playing with them and when you are testing them and would not be uncommon for him to ignore requests for him 'to perform' in a home environment, and the more you test him the better he will get at ignoring certain requests (and that includes testing his name response). Children who consistently point to share interests while also displaying all the other examples of social communication that you have listed from 18M to 2YRs while having autism are extremely rare, I have never seen a case. If you look at the detail it tends to be children pointing early from 12M before they suffer an initial regression closer to 18M and loosing those skills (also referred to as the onset of autism) or children pointing around the 24M mark who have "learned' the skill (nearly always girls as by 24M some have already started masking very successfully) - initial regressions after 24M are also very rare. Lookbacks while pointing to share interests are infrequent, specially if they are at a close distance to the person. Large tests have consistently shown that toddlers showing the strongest social communication skills compared to their peers would look back around 25% of the time while pointing to share (carers would be at least 5 meters away from them) and that would be considered a high number, around 10% of the time would be a more normal number for the rest of the peer group. Of course nothing is ever for sure and time will tell but the odds of him having any pdd diagnosis at a future date are incredibly small.

[Jannt86]

Also with the pointing; I can't say I'm an expert. I know it's an important milestone for a number of reasons but couldn't tell you how often my LO looks back at me or how often she does it nowadays tbh. I think it probably depends entirely on their reason for wanting to share the experience with you and their proximity to you. I would imagine that once they've been doing it a while for example they learn intuitively when you are engaged with them especially if you're close by and tend to respond with something like 'oh yes I see the plane' Also, remember that an aeroplane, as per your example, is pretty much the most exciting thing ever for a toddler. I'm not sure if my LO would care if I was on the same planet as her never mind linking eyes if she saw something like this I would also have thought that the need for pointing reduces as their language improves as they can use more language to express shared interest in something and become more secure to explore their world independently. In fact one of the age 2 milestones is 'uses words more than gestures' I wouldn't put too much owenership on it and if you're really worried then find other opportunities to make eye contact with him talk in motherease whilst you're changing his nappy and massage him a bit. Sing songs to him and make eye contact whilst he's in his buggy/highchair or whilst he's sat on your lap, get on his level and make eye contact with him plenty whilst you're playing. This is all stuff that I'm sure you probably already do but I imagine this is probably pretty much the majority of what any kindof intervention or speech therapy would involve at this age anyway (happy to be corrected by anyone more in the know about this) and it will only improve your bond and attachment. Again, I honestly think he sounds great though!

[Arhumuk]

Thanks @AladdinMum and @Jannt86 for your responses I should be grateful for his progress.

I was sitting with him and asked him where the door is he pointed to the door and said door then I asked him to close it something I went over with him yesterday he got up and closed it. So he is absorbing what I'm teaching him.

He also communicates by saying no to things he does'nt want not in response to a question but if I try to feed him something he doesn't like he will say no and shake his head.

Many thanks for your response.

[Mummy0ftwo12]

He sounds fine, he's not even 2? of course his comprehension is inconsistent. Go and see your GP if you're worried and if your GP says all is fine then try not to worry - fwiw my NT daughter pointed all of once at 18 months and that was it, I remember being astonished when her peers at nursery (ag e 2) could reliably identify and fetch their friends shoes when i don't think she could have fetched her own, there really is a) a variation in their development and b) they have very short attention spans at that age

My son was totally non-verbal at 2 and looked to be classically autistic, he wasn't though.

Your son will be due the 2-2.3 year check soon, if there are any problems he will be referred.

[Arhumuk]

Hi

Let em start of by apologising posting this message not sure who else to talk to need to put on a brave face for my wife. I thank you for your advice in response to my post about my son rarely looking back for the triadic gaze as well as should I be worried or am I being paranoid.

My wife and I had a chat yesterday and she broke down I think she's also on the cusp of depression, she admitted to me that she thinks there may be an issue with our son, she works in a school in London she makes referrals for children but normally deals with 14-16 year olds . When we talked about autism and I asked whether our son fits the bill she said she could not be sure as he does not tick the boxes ie repetitive behaviour and he does not fit the DSM V definition of autistic. She admits she can't tell because she has never worked with a child as young as our son, however she feels there is some thing there she is not sure what it is. We both agree he shares toys objects his nursery has even confirmed this in his daily diary with eye contact although it may not be prolific but it's not absent. he does have imaginative play and nursery says he is very sociable at circle time and follows the action and as I said they have taken back their determination of Autism however as his parents we feel there is something there because of the rarity of eye contact when pointing that there is an issue. she is also concerned with the progress of language.

@AladdinMum You've been kind with your time I just wanted to ask you have mentioned that you work with children with pervasive disorders can I ask have you had experience with children as young as two? In your response to me last you said you have never seen a case of a child with the social skills i had listed with consistent pointing that went on to be diagnosed with autism, I hope you dont mind me asking are you involved in the diagnostic process? It's just that I take comfort in your advice.

I hope to hear from you .

[AladdinMum]

@Arhumuk Sure no problem, I work in the research of early detection of pervasive development disorders specialising in autism of children between 12-18M, so 24M is not too young and by then, in the majority of cases, autism is very obvious to see. I have been present in many diagnostic schedules for many young toddlers. I have never seen a case of a toddler showing all the skills that you describe your son to have and then be diagnosed with autism at a later date.

[Arhumuk]

Hi @AladdinMum many thanks for your response it means a lot to me. Im going to park this issue I can't allow it to consume me but your advice has been invaluable and so have those who have also responded.

I know I come across as paranoid but this has been a particularly difficult 12 months.

[Arhumuk]

@AladdinMum how often should a child be sharing, for example bringing things. Also he points request prolifically but again look back is seldom. I know I sound like a broken record.

[Arhumuk]

Could he have learnt the pointing we did model it quite a bit

[AladdinMum]

Toddlers with autism that go on to learn how to point tend to do around 2.5-3YRs old, it would be very rare for it to happen before then.

[Spaghetti0]

@Arhumuk Hi OP
Im not sure if you will see this/how much you now use Mumsnet. But I was wondering how you are and your son?

Your concern for your boy and love came across in all your posts. I’m an anxious parent and currently trying not to worry about my daughters development. I was curious as to how your son is progressing..