Feeling like nursery are really pushing to label my son

I think everyone agrees that any flags should be investigated and any help and expert advice gratefully received.

Before my experience with DD I would have wholeheartedly agreed that if nursery or school flag issues then there are issues but as I say in my experience they got it wrong even though they were adamant.

And as for those saying what is in it for the SENCO to push for diagnosis well there is a lot in it for them - showing their SLT how diligent and on the ball they are, showing Ofsted their excellent approach to inclusion etc etc.

I think for a nursery to be picking it up I'd take it seriously. They are frequently dismissive of parents concerns over ASD. I've got autistic kids and HV are a waste of space. Absolutely adamant my child's behaviour was 'normal' 'stop worrying' etc well now he's out of school and has alternative provisions where he has 2:1 support he has significant needs and support was held up by HV and nursery dismissing my concerns.

Having an autistic child in setting means more work for nursery. They won't bring that work in themselves unless they are sure the child needs it.

@Dumbledormer Your child sounds completely normal to me. I had a similar experience with my DS, he was referred for speech therapy and statemented as special education needs. He was also diagnosed with several other suspected issues (including autism) between the ages of 2 and 5. I remember one of his conditions was diagnosed based on the fact he liked hugging too much, didn’t play with other toddlers etc etc.

He is 20 now and in Japan doing his degree.

There are a lot of poorly educated people working in nurseries talking bollocks.

My best advice is, sure investigate things, no real harm in that but please don’t worry too much.

Saying that they’re pushing to label your son makes it sound like you think they have some kind of agenda. Really they’re just noticing things that could point to ASD and as they have so much experience of babies and toddlers they are going to notice subtle signs better than those who don’t have the same level of experience. To me it shows that they are attentive and thoughtful (even if he turns out not to be autistic after all).
My dd was diagnosed at 11 but looking back there were subtle signs from birth, there was just nobody to see them. (I saw them but just saw her as being quirky / high needs, and she didn’t go to a nursery much). It would’ve been a good thing for us if other people had seen those signs earlier. I think the nursery is only trying to help, let them have their say and you’ll find out in due course whether he is actually autistic or not.

You mention that nursery seem to be talking about a different child.
It may be that your DS presents very differently at nursery to at home.
Nursery can be a more challenging environment that home. More noises, smells, people, more/different expectations.
My own DS seems very "normal" (for want to a better world) at home but displays "autistic" behaviours at school. (Sensory seeking, zoning out, occasional distress)
School is more stressful and he needs to utilise different behaviours to regulate.
I'd ask for a referral at the 2 year health check. The process can take a long time but is pretty unintrusive. Your DS will remember having a couple of chats with a doctor.
If it's nothing then no harm done. If it turns out to be ASD you will benefit from having the diagnosis earlier rather than later.

I had the opposite experience in a way. I had a lot of experience with asd and I had very early concerns about ds. But I was also clinging to every well meaning, or ignorant reassurance that everything was ok.

One of the things I didn’t realise was that professionals (ten years ago) couldn’t diagnose at the age of two and phrases like “wait and see” meant just that. And I was getting pegged as an anxious mum.

I felt quite angry when they were telling me at 3 that they could now assess him properly, and eventually that he did have asd. I felt like I’d lost a year in his prime window of development

Agree with PP that I would listen to the nursery - they would have literally dealt with hundreds, if not thousands of kids the same age so know very well what is neurotypical and what is not.
Also just think to yourself what reason would they have to exaggerate or be melodramatic about his behaviour, therefore worrying you unnecessarily? What would they gain from that? Sounds like they are doing their job and informing you of things they’ve noticed, rightly so.

All nurseries are different but in ours we have a sen person if we the staff have any concerns we speak to her, she will then observe the child over a few weeks before even speaking to a parent after observation for a few weeks see will speak to parent if she thinks she needs to. I would atleast get the ball rolling for assessment as they take ages anyways.

Ah this is so tough OP
I’ll start by saying my 3.5yo DS is Autistic and the process of realising, accepting and documenting this was tough.

Firstly, it doesn’t matter if they do ALL of the things associated with autism it only matters that they do a few of them regularly. So for example, My son is non verbal and stims… but has great eye contact and eats a varied diet. He’s sociable and shares space with other kids. He’s just learning to copy. He’s still autistic though.

I remember reading the list of ‘ASD signs’ when he was about 20 months and feeling relieved because he only did about 40-50% of that list. The paediatrican later told me ‘a neurotypical child would do none of those things regularly’ of course there is always a bit of lee way in that a child may go through a walking on tip toes stage, or a fussy eating stage without it being a big deal… but they don’t do multiple things from the list regularly.

They also develop as they grow. So back at 2 my DS didn’t respond to his name, speak or socialise but from 3 onwards he has. He’s also just started saying words. I think if I really wanted to not see it I could have tried to brush it off ‘he’s a late bloomer’, ‘he’s a slow learner’ …etc but Ultimately it is autism and even though DS has come on leaps and bounds the gap between him and his peers has just kept growing.

I think you should pursue it if nursery are that adamant. I promise you no paediatrican will diagnose autism without being sure. It’s actually really hard to get an autism diagnosis for a young child there’s a lot of push back. So if they do diagnose him I guarantee you they’ll be sure and at that point I’d suggest just trying to work on accepting it and getting your DS the help and support he needs. A lot of ASD kids go on to live perfectly regular lives if supported correctly. If not supported though they run the risk of always being labelled ‘slow’ or ‘difficult’ and being totally misunderstood.

Of course there’s always a chance everything is perfectly fine. Time is the best detective, it will become clearer as he grows but waiting lists are so long that he’ll probably be 3-4 before he’s even seen and if you don’t need the apt by then just turn it down… you have nothing to lose x

Not really, it depends on the situation but nurseries, nor their staff are always right for a family. If this family has another 2 years before school then it might be the right thing to do. I wasn't saying the OP should, I was just saying I wish I had, instead of a miserable year in a stressful environment (the main reason that my son didn't settle) Nurseries and nursery staff can be amazing, but they can also be terrible. They're not varied settings, so if that environment isn't right then it's hard for some kids. They can be noisy and overwhelming. I find it amazing when people say 'nursery know more than a HV/see more child than a HV' etc. Not always! Plus "the majority of people don’t understand the slightest thing about autism until they find themselves raising an autistic child." that someone else mentioned, that's not true either. Many people spend time with autistic toddlers/children/adults and might have decent awareness.

If he is speech delayed have you had a hearing test? The toe walking could by hypermobility ds 2 is hypermobile in his hips he turns his feet in and toe walks because that is a comfortable position for him to be in I waited years to see an occupational therapist for them to tell me its fine unless he trips a lot

This

My DS is on the pathway to being diagnosed as ASD. I would listen to the nursery, children struggle more outside the home and any delays/differences will be more pronounced. My nursery regularly tell me things they see in my DS which I never see at home. At 2 my DS didn't seem to have many signs but at 3 they became far more obvious. His speech at 4 is now good, he responds to his name, uses gestures etc but I'm 99% sure he is Autistic. Feeling the way you are is really normal, my advise is to accept all the support/referrals as the process is so long. Start looking at ASD in a more positive way, stop looking at anything which uses negative language like 'red flags'. Focus on supporting your DS in the areas he struggles in for now and work with the nursery.

I would say definitely make an appointment with a GP to get some further advice and possibly a referral.

Do you know how long the wait is for SALT in your area? I waited 11 months for a 1 hour appt and it was rubbish. I would highly recommend seeking a private speech therapist if you can afford one.

Also give ICAN a call. They are a charity who can give free advice on speech and langauge. I found them very good. https://www.icancharity.org.uk/

This is going to be a complete condradiction, but go with me on this.
Definately push to get on the ASD pathway as soon as you can, because it's a long old wait!! But at the same time, just get on with yours and your little ones life and try not to let it bother you too much if he is happy!!
My little boy is now 5 and as early as 18m his childminder picked up traits, when he started pre-school they also noticed it and were fatastic at helping to get the ball rolling for a paediatric referral. Almost 3 years later we have managed to have a couple of blocks of speech therapy and one visit to the paediatrician - nowhere closer to any formal diagnosis BUT my son is HAPPY and doing well at Primary School (with an EHCP in place which was greatly organised by the Pre-school, so disscuss this with the nursery early too, as again this is another long process) and to me that is all that matters. Yes he may get some diagnosis in the future and if extra help is offered to me, i'll take it appreciatively with both hands, however for now i'll just take each stage of his development as it comes.
So anyway the moral of my story is, as many have said, try to take the nurseries concerns gracefully, as they will have been in the company of more children with a whole range of "traits" in the past, they aren't trying to say they know him better than you do, they're just trying to raise that little flag so that you can make an informed decision, at the end of the day if you get to the "front of the queue" when any kind of diagnosis may be required and you think it is no longer needed, then no harm done, just say thank you but the service is no longer required - better to be on the waiting list and not need it than later down the line wish you had got on it sooner!
Hope that helps and stay strong Mumma - we're all just doing the best we can and at the end of the day, all the little one needs is to know he's loved x

Oh and SLTs and OTs cannot diagnose ASD by themselves, there is a reason the assessment is multidisciplinary and looks at different aspects and evidence.

Hi OP I'm going to be honest and say I was highly offended and upset when my sons childcare workers mentioned to me that he was having issues but they were spot on.I absolutely wouldn't panic but I'd definitely press for an assessment. When we had our initial appointment with slt and OT they didn't think he had asd either but it wasn't until he started school when the issues became really apparent.

"His new thing is crying if strangers speak to him and most recently covered his eyes when an elderly gentlemen tried to talk to him. Again, all quite normal I think"

Nope not normal

YABVVVU.

Listen to the nursery, they know better than the HV.

Keep an open mind and accept all referrals, assessments and support that is offered.

The sooner you accept the possibility that your son might be neurodiverse in some way, the better.

And ignore the PP who advised changing nursery, how utterly ridiculous and potentially damaging for a child like this to be moved for no reason.

Oh and unless you have any qualifications in child development or child psychology, you don't know what is normal or not.

@greroses I relate to your experience.

It's really really stressful when you feel there's a determination to diagnose your child and a closing off to any evidence that contradicts that. I have never in my life questioned someone in authority but nursery and school staff are not infallible and there is a well known phenomenon of confirmation bias.

Still, no harm in getting expert advice I guess.

I would push for a referral. Nursery will have more idea over a HV and like another poster said, they don't refer lightly.

In terms of the point "he's different at home" a lot of ND children have home as their safe space so will be different, more relaxed (or alternatively, particularly in older girls, meltdown after masking) in the home. They can cope with different things in the home than they can in a nursery (and school) setting.

You, the HV nor nursery are experts in this field. Get the referral (and wait times are long) and see.

Please listen to the nursery. I can tell by your use of “label” that you’re quite uninformed about the realities of how autism can present. And that’s not a criticism - the majority of people don’t understand the slightest thing about autism until they find themselves raising an autistic child.

So please don’t get your hackles up about what I’ve just said 😊

Ive walked in your shoes. I’ve acknowledged that my son had delays, but equally I twisted myself into knots looking for all the ways in which he didn’t meet the criteria - or the criteria as I understood them, which isn’t quite the same thing.

Autism can be subtle. Autistic kids can give eye contact, on their own terms. Autistic kids can be loving and social. Autistic kids can be speech delayed but then make huge progress.

I too had professionals (speech therapists, preschool staff) telling me that they didn’t think my son was autistic. And of course I clung onto that.

When you have a child who doesn’t have a bunch of big “red flag” traits waving around everywhere they go, it can be so easy to convince yourself it’s nothing. But many, many children don’t present with a few big red flags… instead they have loads of small pink ones 😉 And I see a lot of them in your OP.

That’s a rubbish analogy but hopefully you get what I mean. Please just keep an open mind and don’t refuse offers of help/paed referrals. Sometimes autistic traits get more obvious as they get closer to age 4-5, when the gap between them and their peers is a little more obvious. Also bear in mind that premature birth is a known risk factor for autism and ADHD.

Hi OP, I went through something similar with my DD when she started school.

She'd had some medical issues and so found school a bit of a struggle. The SENCO was convinced she had autism. I disagreed but of course wanted to follow the schools advice and guidance and we went through the whole referral process. We didn't even get to assessment because the CAMHS folk observed her in class and then individually and concluded there was absolutely no neurodivergence.

I posted on Mumsnet about the issue early on and everyone told me school would be right. But they weren't.

I am grateful for any care and support from professionals and tend to respect those with more experience than me but on this I knew they had got it wrong. No harm done other than a stressful experience for me though.

It's better to get an early referral and find you don't need it than wait a few years and then wait ages for a referral when your worried if SALT have no concerns you will be reassured