Advice on talking to SIL about her DS

[sobeda]

My SIL just visited with us from the States with her DS4 and DD2. During the visit, DH and I became very concerned that her DS may be on the autism spectrum. He has a significant speech delay, hardly any initiated speech, no eye contact, obsessive opening and closing of drawers when stressed, not potty trained, not interested in being with the other kids (we have 3 of similar ages) , finds it extremely difficult to change activities, hardly eats , looks more like a small 3 year old and melts down into an unreachable state. My SIL just says he's a sweet boy who is a bit delayed. DH is planning to speak with her on the weekend to suggest that she get her DS properly assessed. They have a good relationship btw. Can anyone give us some advice about the best way to handle the situation and the conversation? Other members of the extended family have the same concern, but no-one has really raised it. The other complication is that SIL's DH believes that their DS will 'be who he is' and doesn't need any help. Thank you for any advice!

[twocutedarlings]

I dont think you should mension it directly to be honest, has she mensioned if there are any proffesional involved with there DSs development?

[sobeda]

He does have speech therapy, but has never had a holistic assessment. They seem to be a bit in denial.

[cyberseraphim]

It might be a sensitive subject to raise. If they are based in US, it's quite likely these issues are being addressed as the services there are a bit more geared towards early identification of ASD disorders.

[twocutedarlings]

totally agree with cyberseraphim, the state are far more switched at i identify ASD earlier that we do here.

For now i would just make them aware that you are supportive.

[nikos]

I'm going to disagree with the above posters for two reasons. From what you descibe there is very clearly something wrong. It's not just a hunch, you saw this child in the presence of three other children.
Also you say dh has a good relationship with his sister. Presumably that means that she would tell him if the little boy was already receiving help. This boy is 4 so he should be receiving significant help by now.
Perhaps dh could point out the differences he noticed without actually mentioning ASD, at this stage it could be something else. Is there any history of ASD in the family?

I would be concerned that vital time is being lost because of their inaction and I would mention it.

[sobeda]

I am fairly confident there is no proper help apart from a speech therapist treating his 'delay'. There is no history of ASD in the family, I'm thinking DH should suggest a full evaluation, not just for ASD (I'm no expert, it's just my guess, it could be something else). I was just wondering if there was anyone who had been on the receiving end of such a discussion and worked through the denial phase to actually take action and come to terms with any findings?

[cyberseraphim]

I'm not really disagreeing with you about the need for an evaluation. My experience is that
I knew DS1 was ASD long before we got to the stage of assessments but I still wouldn't have liked someone else to point out the problems esp. if they had children of their own. There's no logical reason for feeling that way of course but logic does not come into the equation very often. You could try asking what strategies the speech therapist is using and if they are they happy with progress so far? An ASD child is likely to have more serious problems than those addressed by traditional speech therapy so it might be a starting point to find out if there are other problems.

[walesh]

Your husband could mention him needed a behavioural evaluation and then see a behaviour analyst. This person would be able to give an autism diagnosis or at least put them on the right track.

I'm an autism professional and used to work as part of a diagnosing team in America. We do try and give a dianosis before 3. In my experience most children there who don't get a diagnosis before then have parents with serious denial issues. I say before 3 because most doctor's now do an autism screening as part of children's annual check-ups and then we get an immediate referral, usually when the child is 18-36 months.

We have even had parents come in and do an autism test. We tell them their child has autism. They tell us their child is fine and doesn't have autism. And then they come back in 18 months for another test. You would be suprised how often this happens. I always tell parents bluntly, but not rudely, that their child is autistic and that they can make great progress if they start therapy now.

No one has ever told me they regret starting therapy early. But I've been told how much parents regret waiting years before doing anything.

[sobeda]

Thank you all, I appreciate the input.

[moondog]

Walesh, what is it you do exactly? Just interested as am a salt studying for MSc in ABA.

[TinySocks]

Hi sobeda.
My DS doesn't have autism, he has a general developmental delay, but I can share my story on the receiving end of the conversation of you like.

In my opinion, if you love someone, then you should be honest with them. I agree with being careful with what you say when it's friends, but if it is family then it is a different story. When I had concerns about my DS (as a baby), everyone kept telling me stories about how such and such baby was so similar, or how he is fine not to worry, or look he is playing peekaboo of course he is fine. When I told my PIL that I was concerned because the babies of my NCT friends were developing so differently, what FIL said was "Well in that case I think you have an unfortunate group of friends". I was desperately trying to convince myself that they were all right and I was being paranoid.

The only person that was straight with me was my sister. She really told me what she thought. At first it really hurt, and I thought to myself "how dare she!!". But we do have a close relationship and I am so grateful for her honesty. The sooner therapy starts the better, there is no point trying to hide the issue.
That is what true love is about.

[walesh]

moondog

I'm an ABA/VB consultant. I've also thought of doing a Masters in ABA. Where are you doing your degree? While I was doing my bachelors degree I worked with a university program that did diagnostic testing and then set up in-home aba/vb programs. I've done them independently since I graduated. Where are you located? Would love to talk to you more about what you do.

I've worked alot with children who have verbal apraxia and autism in helping to develop programs for them.

Sorry this is off topic.

[cyberseraphim]

What TinySocks says makes a lot of sense. It does puzzle me though that a child of that age would not be on the 'autism radar' in the US. Is it possible that he has a diagnosis but they just don't want to talk about it even to family? If he is getting speech therapy, wouldn't even the stupidest speech therapist think of ASD if that was what the behaviour suggested? They can't be completely in denial if they are accepting or arranging speech therapy for their son ? They might not want any other approaches at this stage, opinions do vary a lot in this area. I would raise the issue of speech therapy and how he is doing if you want a starting point but tread carefully.

[Aefondkiss]

I know it might be the right thing to talk, but tread carefully, I know the denial stage, though I was accepting help from the professionals and being in denial (not that my ds has a diagnosis yet), it was very hard to talk to even my closest family about this.

I hope your nephew gets the help he needs, good luck if your dh does talk to his sister, seeing my ds with children the same age as him is one of the things that makes me realise how different he is from his peers.