DD 2.5 yrs - Delay/ASD suspect - to nursery or focus on ABA?

[mumto3littleones]

Our DD is 2.5 years old and we realised she was delayed at around 20 months.

Since just after then we have been doing home-based ABA therapy for around 20 hours per week and treated her bio-medically. Both have shown results.

We have not received a DX and it could possibly turn out to be a delay but we knew the approach regardless was early intervention.

She still has almost no voluntary expressive speech. Just occasional 'chocolate' or 'garden' for things she wants. She can repeat words and label orally (Just poor pronunciation). She can label well over 200 nouns and verbs pointing. Her receptive language is good and can follow a lot of instructions. She can feed, undress herself, throw and kick a ball etc.

She has no sensory issues, restrictive issues or obsessive interests. (Although she has started doing this side eye thing recently.) She is generally curious of the world, loves being out of the house and seems to have a good play imagination.

We isolated all winter and had some very serious family stress. I think this may have effected her as she was on track before.

Her main challenge is social. Poor eye contact, often won't respond to name, minimal sharing of interests. Tends to be in her own world.

Our ABA consultant has said if we put the hours in she should be ready for nursery in September. She's only just started looking at other kids and my gut is telling me she would be better off in nursery regularly to learn to be social now.

My question to others on here that were in a similar situation, did your little one improve socially in nursery or would you say waiting to build skills and focusing on ABA skills was better?

Hugely appreciate and thank you for any experience shares :)

[MotherOfGremlins]

I'd highly recommend that you look carefully at the controversy surrounding ABA and the trauma that it can cause in later life for children who had to do it.

[mumto3littleones]

@motherofgremlins I am very well versed in ABA and the split opinions. I wrestle with many aspects of it myself but I think it very much depends on the individual child and how its delivered. There are unfortunately very few proven alternatives and as you will see across Mumsnet it has changed many kids / families lives.

I (the mother) am the sole tutor and whilst its unbelievably tiring we have a lot of fun. She views most of it as little games, is smart and loves getting things right and the praise. As soon as she is not enjoying it we stop and she goes off to play. I have a functional medicine background and am very conscious and mindful of the fact that stress leads to inflammation. I fully took over and let the ABA tutor go as their mindset was that the child should not be allowed to stop just because they didn't want to do a program. They said letting them 'do what they want' reinforced bad habits and that if they are going to cry for 20 minutes until they comply then so be it.

Without many of the skills learnt from ABA I don't know if my child would even come in response to their name which is obviously a huge safety risk when out and about.

I am hoping for experience shares on whether MS nursery benefited kids with social developmental delays / ASD or if it did the opposite. Thanks :)

[orinocosfavoritecake]

In our case it definitely, definitely helped. If at all possible I’d seek out a nursery with highly experienced staff - DS’s key worker when he was 3 was an qualified teacher who’d taught reception as well as nursery. It meant she had a good grasp of the help he’d need to cope in reception.

[Lesley25]

In our case it also helped hugely over just the ABA. The turn taking, sharing of peers isn’t an environment I could replicate socially.

[Lesley25]

I really wish if I could turn the clock back that my son went to Special school nursery with staff who use different ways of communication. But I wanted to try mainstream first and whilst my choice of nursery was hugely nurturing, the staff didn’t have the skill set to help with other modes of communication. But I don’t think back then you would’ve convinced me to go straight to the special school option.
Choose a nursery where the staff are nurturing and as a bonus, familiar with children with additional needs if you can’t bring yourself to go with the special school nursery choice first. But that choice would be the best.

[HotPenguin]

Are you sure your DD is autistic? If she has no sensory needs and no repetitive behaviours you should be open minded to other explanations. Have you had her hearing checked?

I think all children benefit from being in some form of nursery or preschool from the age of about 3, but if she is struggling socially I would perhaps keep the hours short.

[mumto3littleones]

@orinocosfavoritecake @Lesley25 thank you this is what my intuition is saying and nice to hear that it benefited your little ones. I will choose the nursery carefully and look to see if a specialist nursery might be better.

@HotPenguin - thank you yes we suspected hearing, had it checked and were no issues.

We do wonder if upheaval, family trauma and being isolated for a lot of her life (Covid) triggered a social delay and are hoping she will come out of her shell and engage more with people once she can speak.

She loved peekaboo etc as a baby and the social development / engagement stopped at the same time (14 months) of the stress however I do know that is around the same time ASD regression can happen anyway.

[cripez]

You are 'treating' her bio medically?

Umm, what?

Are you trying to cure your child of something?

[Lesley25]

@cripez this could simply mean vitamins, a lot of parents go down this route as any deficiencies in minerals iron etc can be an issue, I very much doubt this op would be doing anything other then that.

I think it’s important to focus on the issue the op has asked opinions about. Otherwise it can be construed as trolling.

[mumto3littleones]

Thank you @Lesley25 exactly :)

[Sausagepickle123]

It depends on the nursery and your child - we had to send an ABA tutor into my sons nursery as whilst the staff were lovely they didn’t have a clue how to engage him. With additional support from his tutor (could have been someone not an ABA tutor who was SEN experienced) he was much more able to engage and access the activities. We then worked on some other skills 1:1 at home in the afternoon.

[R0098]

We have an ABA tutor go to nursery twice a week as well as ABA sessions at home still. DD goes to nursery 3.5 days per week and I think it seems to be good for her.

[Bigcitylights]

The problem with sending them to a mainstream nursery if they are not ready is that they won’t just pick up social skills by osmosis. Where ABA is useful is that it can teach some of the foundational skills like joint attention that kids aren’t picking up on their own. ABA generally recommends that kids are ready to stop once they can learn naturally from their environment. I would really think about making sure she is ready to learn from the other kids before doing too many nursery hours. I guess it’s just about getting the balance right.

[floofyhens]

You say her biggest challenge is poor eye contact, minimal sharing of interests, being in her own world.

All of the above are safety seeking mechanisms that autistic children employ to help them feel safe.

If you train her not to do those things that anxiety will manifest elsewhere.

[tentosix]

If you train her not to do those things that anxiety will manifest elsewhere

You don't know this for this particular child. Every child is different and some gentle ABA techniques which encourage participation may reduce anxieties. Stop projecting and making blanket statements, I'm sure OP knows her child.

I would look at a very small nursery with good staff communication so that they can monitor her for you to see if it is the right environment

[Mtbdadder]

Hello mumto3, we have a 2y3m boy who cant say anything other than yes no and mmmm, dddd, bbbb, nnnn. He understands well but expresses little and can get socially anxious quite quickly. We have him in a nanny share but his sharer has basically outgrown him and we r now trying to decide if he will cope with nursery...

Good luck and if you can share how it went for you that will be appreciated.

Main reason for responding though is to ask what biomedical you are following? If you can share anything that will be great.

Our boy had Sepsis and heavy antibiotics at 12 days old. His stomach was a complete mess for the first 18months. We have now got it on an even keel. A few key things we have done that have helped him:

Switched from cows milk to hard goats cheese for his calcium intake.

Given him regular patties made from jerusalem artichokes and leek and potatoe soup (both high sources of inulin which is very effective as a prebiotic).

Given him kombucha, homemade kefir and unpasteurised cheeses wherever possible to boost his probiotics. I've read that unpasteurised dairy is particularly effective at boosting gut health as the fats in the cheese help feed the good bacteria and also keep them somewhat protected through the stomach enabling more chance of colonisation in large intestine.

Our son was toe walking and hypersensitive to noises. These have both receded to virtually nothing since his diet had been sorted out.

Be good to hear back although with three I understand if you are a bit busy! I'm currently up late looking after our 6 week old!

[mumto3littleones]

@Mtbdadder I have sent you a DM. Have spent hours of research on the biomedical, had levels tested and added in the according dietary changes / supplements and seen great improvements, many similarities to your story.

As I mentioned the biggest worry is she will barely engage with people. Basically looks anywhere but at your eyes. Rarely responds to somebody walking into the room. But will occasionally interact like being chased or hiding behind a curtain. Its all very confusing and a roller coaster with some days being better than others. We eased off the ABA and sadly in turn saw a drop off skills and engagement.

A psychiatrist watched her for an hour over video last week and said it possibly looked like it could be Dyslexia / ADD / dyspraxia combo presenting some ASD symptoms as she lacks so many of the core symptoms. Has anybody heard of this?

[R0098]

Hi @mumto3littleones I haven’t heard of that but I’m not an expert. I don’t think there is ‘core symptoms’ of autism, more like common characteristics. But all autistic individuals are completely different, so I wouldn’t go by that.
My dd has minimal sensory issues, I found out she was a seeker only when paediatrician pointed it out, it just isn’t obvious. Also can label a lot and make verbal requests but just isn’t very conversational at 2.5 years.
Very sociable and friendly, plays interactive games and is diagnosed ASD, sometimes it isn’t obvious in girls especially.
I’m not saying your child is ASD as of course she very well could not be. I’m just pointing out how different it can look.