Almost 3yo - poor two-way conversation?

[Veebs21]

My almost 3yo (in late Sept) DD has her NHS speech and language therapy assessment at the end of the month and is awaiting her first visit from Early Years support too. She has lots & lots of words, a lot is echolalia (delayed and immediate) but she has reduced that and made big strides forward in the past month or two in making spontaneous remarks in full sentences about things in her environment (what I’m wearing, what Daddy is doing, what her sister is playing with etc), better communicating her needs (no hand leading), sharing interests etc. She will respond to very specific what/where/who questions but has very little social conversation - sometimes she won’t even say hello to me when I say hello to her. Any more casual conversation is off the cards, though she will sometimes initiate something by bringing a toy to me and telling me something about it “piggie is sneezing” (a squeaky pig 😂)

Any ASD kids here present with the same and how have you helped/how are they now? Did it come eventually? I’m terrified about her having no friends at school 😭

There are a few other red flags for ASD (some sensory quirks - likes spinning, no fear) but this is the biggest one.

[Bigcitylights]

Sounds really similar to how my son was at that age - he was diagnosed at 3.5. The Hanen book. More than Words and when they have moved on from this - Talkability, are really good. Does she have particular interests? As using these and keeping back and forth conversation going as far as you can through games that interest her are really key. We also did ABA to build joint attention and social skills. Sounds like she is learning though and now would be a really good time to start encouraging her. Wishing you all the best.

[Bigcitylights]

Oh and yes, my son does have friends (age six now) and lives for play dates although his social skills still need some work particularly understanding others emotions, but if I could see him now three years ago I think I would have felt pretty happy.

[Veebs21]

Thanks @Bigcitylights that is really reassuring, I’ll look into those books. She’s an outside-loving kid, but also music/singing and books. The book conversation is where I have most success (what is Peppa doing, what colour is the ball, where is the horse etc), but have initiated more imaginative conversation recently as her imaginative play has always been ok (feeding dolls etc) but seems to have taken a leap forward again and she’s shown interest in her Little People figures and play animals - I asked her what the giraffe was doing that she was holding and she turning him upside down and said he was eating the rug 😂 That made me so happy and hopeful!

I also realised the other day I’d never asked her things like what she was drawing as I just (stupidly) thought she didn’t even know, that she was just mark making. So trying to start up conversations like that too. Baby steps but hopefully early(ish) intervention will help her get to where your son is now x

[LightTripper]

DD was a bit like this. Social is still the thing we notice most at 7 though she does very well, has friends, manages well at school etc. I don't think she had "friends" at 3yo (whereas DS did already at that age). I remember at that kind of age she was interested in other kids but watched from afar - or might run up to them in a playground but not know what to say. We did a bit of modelling if we were in the playground with another kid who was interested. In the end she really connected to other kids when she was a little bit older (4 or 5), because she had good ideas about games to play and they would ask to join her. I remember she went through a big phase of collecting sticks to make birds nests, and then leaves and things to line them with. To begin with she just let the other kids join in without saying much, but over time and with a bit of supervision she learned to talk to them about what they should do, what bits would be good to collect, etc. We often found conversation came much more easily around an activity or a craft rather than just chit-chat ("what's your name" or whatever ...). That's still true now. DD had a lovely play in the park the other day with a little boy collecting bugs together and trying to learn about them - talked about all kinds of stuff, but she came back with no idea what his name was or how old he was. But they'd both had a nice time :)

She can still present as very shy, and if the answer to a question is "no", even with us, she will often default to not answering. We just try to explain why it's important to answer and model appropriate answers. I agree with using interests to build conversation skills. Also, we found with DD she would do things with us first, then with other trusted adults, then with less well known adults, and only in the end with other children. Children are just a bit unpredictable and unsatisfying as conversation partners I think, so we always tried to give lots of opportunities to practice with us and other trusted adults first.

Processing emotions is also a big deal as Big City said. We found the Molly Potter books on feelings/emotions/friendships very good at that kind of pre-school/Reception age, and DD is still very interested in more grown up books of that type (like "Diary of a Social Detective") that now she is older.

Another helpful thing we did when she was 3 or 4 was a diary at the end of the day when she was 3 or 4. She'd tell us one good thing that happened, one bad thing, and one new thing (as she was very nervous about new things, so we wanted to normalise that new things happening is a normal part of life, and often good/fun). We'd write down what she said, and I'd draw a picture of something she'd choose from the day. We often learned new things in those conversations about what she'd thought about the day or things that had been challenging that we might not have realised were a big deal for her, so that was very valuable I think. As she got a bit older she started to put a few of her own pictures in.

Generally if your DD is into books I'd encourage that, as stories/fiction are obviously also a great way to learn about friendships, feelings, how feelings can map into behaviours, etc. particularly as kids get older and the books get a bit more sophisticated.

[Veebs21]

@LightTripper Such great tips and ideas here, thanks so much. I started recapping her day to her in the bath a few months ago, and she would add in where she could/wanted to… but I like the structure of the good/bad/new so will give that a try. Think I will be suggesting most of it now but that’s the start, right?

Funny you mention about DD not saying “no” - my DD will very confidently tell you no plenty 😂 But doesn’t say yes unless it’s connected to a need/want (would you like a snack). But those little “yeses” of acknowledgement that someone has spoken to you (hi Piper, are you ok?/ooh is that snack yummy?/did you have fun at the swings?) are almost entirely absent. I’m modelling as much as possible so hopefully it’ll come.

Your DD also sounds similar in play in that my daughter will look on at kids in the playground etc, and now happily plays alongside but I have to tell her to say hello if she’s in close proximity to another kid and only then she’ll sometimes say it. If it’s a child we know, she responds best if I tell her to give them a high five, she’s keen to dish them out! 😅

Also definitely does a lot more with us/Nanna than she showed at her private speech and language assessment (we were told there was a v long wait list so went private and had the NHS one through sooner than expected - I’m still waiting on the private report)… she said that was expected, but that we need her to be able to do more/listen more to unfamiliar adults when she goes to school so it’s good to see where she’s at now and go from there.

Thanks for your reply, I feel a bit lost and a bit unsure of whether I’m doing enough/right by her - it’s so good to hear from people who have been through it and how things are now. I’m just so comforted to hear your and Big City Lights DDs have friends, that has been keeping me awake at night ❤️

[LightTripper]

Try not to worry (much easier said than done I know!) I remember having similar worries for DD but so far none of them have come to pass. There are for sure things she finds harder than other kids and things she has to work harder at - but also things she is brilliant at and gets great joy from. She has a bestie and several other friends that she likes to have playdates with etc. and has a really nice relationship with her little brother and her cousins.

Of course now I worry about her being a tween and teenager and girls getting cliquey etc... but in the end some of those worries will be right, some will be wrong, and there will turn out to be other things I should have been worrying about and wasn't . There isn't much you can do except try to read and learn from autistic adults (YouTube is great for this), try to build a bit of resilience in her support systems (e.g. I do try to arrange playdates with a range of children and keep her in touch with cousins etc. so that if one friendship goes sour she still has others to fall back on). Other than that it's just keeping an open mind and open eyes and ears for what your child is going through, which sounds like you are doing in spades already!

Hopefully when your DD goes to school you'll find her teachers become familiar adults that she's happy to talk to pretty quickly. It's worth thinking now about whether to push for an EHCP so you have that in place in time for school if you think she'll need a bit of extra support (as there can be a long lead time to getting that in place - and if you do have one it could give you more choices of school, if you're not happy with your most local/accessible ones). Does she go to any kind of nursery/out of home setting at the moment? That could be useful if not (to get their input if she does need an EHCP and also so she can start to get used to being out of the home before school proper?) DD's nursery were good at scaffolding her social interactions at nursery (they had a SALT who came in once a week to see a few of the children and she helped DD play turn taking games with friends, chatted to her about her weekend to help teach her the to and fro of conversation, that kind of thing).

It should also help that she'll be old for her school year, gives you a bit more time to get things sorted if need be! DD doesn't have an EHCP but it was still useful that she'd been to nursery before Reception.

[Veebs21]

@LightTripper You’re right it’s so hard not to worry about all the what ifs & unknowns, but hearing from your experience has just been really reassuring (even though I know it doesn’t guarantee our experience will be the same, it’s just great to get some positivity into my mindset!), so thanks so much.

Yes, DD has been going to nursery since she was 11 months (August 2019), but just one day and with my Mum two other days. She was seemingly progressing well, no concerns apart from slightly late to point (but still within the timeframe) - then Covid hit in the March and we pulled her out of nursery/it closed.

Our concerns over her lack of conversation and things like echolalia/hand leading grew during lockdown. She returned to nursery in September briefly but then numbers spiked again and we removed her after 6-8 weeks until Feb half term this year to protect my parents. Aware of the amount of time she had missed around other kids we upped her days to two & raised our concerns with nursery who agreed, but did mention Covid delays etc. They have seen improvements in her since returning properly but suggested referring her to the Early Years dept (at the council I think?) for someone to come and observe her. That was in in March/April time & we're still waiting. However they have implemented some small group play and turn taking activities already which is great.

I’m still so unsure of the process but I’m assuming the Early Years report will be the start of things for an EHCP if they ascertain she needs extra support… our SALT referral came just from our SENco lead describing DD over the phone to the woman who will visit, and as I mentioned, that is at the end of the month.

DD will move nursery in Sept & by January will be going 5 days, school hours, term time only. I’m hoping that increase in structured play/being around others will help her too, and the nursery is outstanding in “personal development”, with good SEN experience too. They are aware of her situation and are ready to support her.

I’ve also raised it with GP too, to cover all bases, who has said once we have a report from SLT/Early Years, they can take it from there if needed. Definitely keen to have EHCP in place by school time just in case, if they recommend it, and hopefully we have time with two years til she goes 🤞🏼

[Veebs21]

Also a slightly unrelated question for you both - how were your DDs with potty training? I’ve been so laid back about it based on friends’ experiences of kid’s just getting there when they get there… but still no sign of being ready at 2y10m and wondering if that lack of conversation is going to hold us back.

[LightTripper]

We pushed potty training too early. DD started nursery at 2.5 and they really wanted her out of nappies, so we tried and she wasn't ready. She didn't have that many accidents at nursery, but we think it resulted in poo-holding/encopresis and basically a lot of unnecessary pain and hours spent in the loo being reassuring! We are eventually all fine and managed to wean off the Movicol very very slowly by the time she was 5 or 6 I guess. Obviously I can't know what would have happened if we hadn't pushed it, but we were in the slightly weird situation where DD was actually dry at night before she was reliably dry during the day.

My view based on our experience would be not to push it. Ideally it's good if they're out of nappies before they start reception, but you've got ages to go before then. I'd wait until she shows some interest. If that turns out to be late, there might be some support available from your local HV team. But I'm pretty sure we messed up by pushing DD too early.

Covid has been a nightmare for trying to provide any kind of stability or momentum hasn't it? Sounds like you have a good plan in place though. I would just say - do keep asking about EHCP, don't just expect people to push it for you or tell you what you need to do. We were always blissfully confident that we would get Dx in time for DD's school applications, but nobody in the paediatric department was at all focused on that (I guess they are just going as fast as they can), so we didn't have a chance of an EHCP (not sure if DD would have needed one or got one, but it wasn't even a discussion - you have to be really proactive). If there are any Facebook SEN parent groups for your area it might be worth joining already, even before a diagnosis, as we've found other parents by far the most knowledgeable information sources we have access to!