Is there any point trying to get a referral for my 2 year old? Can they assess for aspergers this young?

[craftyoldhen]

He's 2 year 2 months old. I'm not sure about him. I've always considered him to be NT, but just got a report from his childminder for his 2 year check and it's really upset me.

She refers to his poor speech and understanding, which I've noticed too. His speech is a bit behind but not that bad. He either doesn't understand things or ignores them, I'm not sure which. If I ask him to get his shoes for example occasionally he will, but more often will just act like he hasn't heard.

She says he often doesn't use the words he does know (true). She says he has poor eye contact, I haven't noticed this.

Also that he prefers to play on his own - I thought this was normal for 2? She refers to meltdowns - but, you know, he's 2!

He can point, and he's good at getting what he wants.

My concerns up till now have been:

• his play. He's obsessed with the washing machine and DH's record player - he likes to watch the records spin round. He lines up cars and other toys, often in the same order, but not excessively. He doesn't do much in the way of pretend play, but will pretend to answer the phone or feed a teddy for instance.
  

• Also he gets upset at changes in routine, like if you go to a different shop than normal or if you take a different route to the playground.
  

He knows his numbers by sight and is interested in letters too - we have magnets on the fridge that has sparked this. I find this a little odd given he can't speak so well yet!

It's hard to know what is general toddler weirdness and what, if anything, is cause for concern.

Generally up till now he has been very laid back. Sleeps and eats well. No sensory issues that I've noticed. He doesn't like to be hugged by other children at play group, but that's it. Fine and gross motor skills are good.

For info - he has an older sister with a diagnosis of ASD (aspergers), SPD and is still waiting for dyspraxia assessment (comm Paed thinks likely). I didn't notice anything concerning about her at 2 years old, it wasn't until she started school that her difficulties became obvious. She is also completely different from DS!!

I'm wondering if I should I speak to the health visitor about any of this?

[craftyoldhen]

I don't know if he is or he isn't, I honestly couldn't say confidently either way.

If he is I imagine he will be like DD ie. at high functioning end of the spectrum.

When DD was 2 it was impossible to tell to the untrained eye. At her 2 year check my HV wrote "lovely sociable child" in her red book. Me and DH joke about getting that framed now!

[craftyoldhen]

It's obvious my childminder has concerns. I do wonder how much these are influenced by knowing DD though. If a child has an older sibling with ASD do you think people constantly look for ASD traits in them too? I have 3 siblings and i know the comparison thing happens a lot at school.

And I'll be honest, if it wasn't for DD I doubt I'd be worried about DS.

I think already having DD with ASD makes me hyper aware of any behaviour in DS. But might mean I'm looking for things that aren't there because I'm paranoid. Or something

On the other hand I feel very guilty about missing and minimising DD's difficulties for so long and don't want to make the same mistake again.

But I don't want to put DS through assessment when there's nowt wrong, just because of the mistakes I made with DD.

I think I'm a bit confused about what to do. I've only recently started getting my head around DD

[Shesinfashion]

I think there's enough potential traits in your son to warrant a referral to a community doctor. Your HV or GP can arrange it. Better to get him checked out then you can be sure nothing was ignored.

[craftyoldhen]

He has his 2 year check today. I guess I can only mention everything I've said here and see what the HV thinks.

[StarlightMcKenzee]

How did it go? My son received his diagnosis of ASD at age 2yrs and 3 months.

I would personally recommend making a list of your concerns and insisting on a referral to a developmental paediatrician. My reasoning is that though you are probably aware the path is anything but smooth, it is a massive advantage to have the diagnosis and possibly statement/EHCP in place before it places demands on the education budget and or the issues are confused by lack of understanding and training within schools.

[mary21]

I would also suggest getting a referral to your local community/developmental paediatrician. Your concern level has been raised so check it out. Either you will be better placed to help or your mind will be put to rest.. Also ask about SALT if his speech is behind.

[craftyoldhen]

Well she did the 2 year old questionnaire thingy and DS scored within the grey area for speech and communication, which is not cause for immediate concern, more a wait and see.

She said it was difficult to know what was normal toddler behaviour and what was more worrying, and it's only if he doesn't grow out of it that it becomes concerning.

I answered no to the questions about tantrums that last longer than an hour, delibrate self harm, repetitive behaviour that takes up most of the day. I guess these are the questions for obvious autistic behaviours that he definitely doesn't have.

She said she will come back in 3 months to see if there has been any improvement and she will refer to audiology just to rule out hearing problems. I'm happy with this for now.

[lamya190]

My older son has ASD and I have a 10 month old son. The older one was diagnosed last year at 4 years old. Like urs his issues became more apparent when he started out at nursery I seriously seriously thought they might have been exaggerating as he was completely different at home and around friends etc than at nursery!! In actual fact looking back at it now I cannot thank them enough for flagging it up and referring us on.

In regards to my younger one I am enjoying him as he his but due to his older brother having ASD I will flag up anything I see that is concerning if it arises, I'm sure professionals will take us seriously due an older sibling with ASD, they better lol!!good luck

[AntiquityReRises]

There are enough red flags in your initial post to warrant a referral, and of course a sibling with autism is also a risk factor.

Ds2 had a preliminary diagnosis (just needed to rule out genetic causes) at 2yrs7 months. I was fobbed off at his 2 year check with all children develop differently. By this point my childminder's teenage son, who attended special school, had asked my childminder if he had autism because he was like classmates. Yet somehow the health visitor saw nothing to be concerned about?!

[StarlightMcKenzee]

You must do what you are happy with but I would advise not waiting for specialist assessment.

[craftyoldhen]

I'm happy to wait for now because I'm not overly concerned at the moment.
Childminder said this morning she'll work on his speech and understanding and also listening skills (assuming he is ignoring us).

The only thing I'm worried about is that he often seems to have his own agenda that he's 100% focused on, and if you try to distract him from it he ignores you.

When the HV was here she got me to show him a book and point to the pictures saying "what's that?". He kept pushing my finger away and pointing to what HE wanted to look at and saying that word instead. This is 100% typical of him. I know he CAN do it, but he won't because he doesn't want to.

HV said toddlers can be stubborn, and uncooperative and he might grow out of this.

DD was just the same at this age, but still is at 8 years old! Everything always has to be on her terms.

But she was different as she didn't ignore you. If you asked her to do something she didnt want to she would scream and throw herself on the floor for 30 mins. DS's strops are minor in comparison.

[tartanterror]

This sounds like our DS and it was possible to potter along until recently without seeking a diagnosis. We are waiting for our referral appointment now. If all is well and your childminder is supportive then there's no rush.... Except do keep any eye on your local service rules. In our area up to age 5 is assessed by the Child Development Team based at a local health centre. They have SALT, OT, portage, psychology and paediatrics all together. Everyone I know who has been through their system seems to feel supported. After 5/school age everything goes through CAMHS which seems to be a nightmare. So ask around locally and see if it is similar for you - in which case I would suggest going for a referral age 4 if you are still concerned. Good luck

[craftyoldhen]

I know about the wait, DD 'only' waited about 18 months in the end, but everything at school went massively downhill in the meantime.

I do think it's best to go through the HV procedures first though, so check hearing to rule that out and HV can come back and review. I think it's helps with referral and assessment if other professionals who know him are onboard from the start.

With DD, she was referred by her old school with a letter with all their observations (the only helpful thing they ever did for her!) and I know this speeded up the process and meant they probably took me a bit more seriously too - which absolutely shouldn't be the case, but it seems to work that way.

[lamya190]

My son was seeing a speech therapist since he was a year and eight months. When nursery referred him at 4years old he was seen by educational psychologist, OT, initial paediatrician appointment and had hearing test within four months of being referred then got a diagnosis two months after, so all in all six months. It depends on area probably. We are in London borough of ealing.

[lamya190]

I felt when they suspected ASD and due to him starting school reception back then in September they hurried the process up..

[UrgentSchoolHelp]

I've heard about a baby diagnosed by a well known doctor (NHS & Private) at 16 months.

OP just get it checked out anyway? Still very young though.

[UrgentSchoolHelp]

PolterGoose 3 years is terrible. Have you got a source for that statistic? (Not that I disbelieve you, just that it's useful to have a link to email to others when discussing it).

[UrgentSchoolHelp]

Oh, crikey, that's appalling. Thanks for the link PolterGoose.