Posting for traffic - nursery suggesting DD is autistic but I don't see it?

[JohnnyMcGrathSaysFuckOff]

So nursery have raised some concerns about 4yo DD behaviour recently. Once, she "zoned out" in the loos whilst staring at the wall and she does go into her own little world a lot. Once, she got very upset over something trivial and slapped her own hand.

She does not repeat these behaviours at home - I know children with autism can present differently in different settings but surely not to that extent?

Nursery are now asking me to make a GP appt this week to get her assessed. I am torn because I want to help DD if necessary but I am her mum and my gut is telling me this is wrong.

Any advice or handholds? At work so will dip in and out. Thanks

I wouldn't dismiss concerns. Take her to the GP as requested by nursery and take it from there.

The zoning out does sound worrying.

Maybe ask for a hearing test too?

I’d follow it up. Do you have any other children? I have two children with autism and I suppose I don’t notice the differences between them and other kids until I see them side by side. You get used to their ways and it becomes the norm.

Nursery have experience with many, many children. I would not dismiss their concerns.
Better to be assessed sooner rather than later.

Kate yes 2 other dc but they are younger.

Tbh the zoning out is more "I don't want to put my shoes on/come to the dinner table so I'll just keep playing and pretend I can't hear you". She does it a lot but if you say her name in a firm tone she will engage and often has a cheeky smile, like oh okay I'll play ball then.

I am not dismissing as such but I have been around a fair few autistic kids and she just doesn't seem to have similar behaviours. She doesn't stim or have meltdowns, noisy situations don't bother her, she's a fussy eater but mostly of the won't eat veggies persuasion rather than being weird about textures etc.

I just don't see it....

The thing to remember is that an assessment can't hurt her. If she is assessed, and they don't agree with the nurseries concerns, then nothing has been lost. If they do pick up something then she can get the help she needs, which could make a massive difference to her.

I'm not sure why you wouldn't get an assessment? If your instincts are right, you'll get told that there's nothing to be concerned about and that will be it. And if there IS something, you'll have started the process of providing her with support as she grows?

Girls tend to be much better at masking so if nursery are concerned enough to be raising concerns then I would follow them up.

I guess you are right. I just don't see what "help" would do. She is meeting all milestones, is bright and verbal, bit shy but can be loud with people she knows, has friends and enjoys herself socially..... I don't want her to pick up the idea there is "something wrong with her" and tbh if she is on the spectrum it is so incredibly mild that CAHMS are really not going to be throwing resources at her.

Okay a colleague has recommended a private psychiatrist who works with children. I might go that route rather than GP.

I guess.....I am kind of working this out in my head....she associates the GP with "being poorly" and I think it would confuse her to go when she doesn't feel bad. Also without being patronising our GP is a very nice newly qualified young man who would see a well presented, developmentally normal 4yo and just say "nothing to see here", i think. If there is something wrong I don't think he'd pick it up in a 10min appt.

OP it does no harm to rule something out and tbh if she does have autism the sooner it's aknowledged the better. Autism isn't a one size fits all and no 2 people are the same. It also presents differently in girls.

Plus they don't generally diagnose until 7 (here anyway) as many traits that can present themselves they can grow out of.

Wouldn't you'd rather someone was keeping an eye out that can head off problems later on?

It sounds like maybe you are uncomfortable with the idea that (in your words) there might be 'something wrong with her'. You don't need to present an appointment for assessment as an indication of this. Perhaps see her gp without her first?

The GP wouldn't be assessing her, they just refer on.

We never saw it with DD - just thought rearing DC in general was hard. Montessori raised it with us in at one of the regular developmental meetings (every 6 months), had we noticed anything, they had some concerns, here were some specifics, and it might be an idea to get her assessed. But that she was still a lovely girl and talked about both her positive and negative things - so a mostly regular developmental meeting in that respect.

It was an utter shock to us.

But when we sat back and thought about it, lots of things then made some sense.

We asked GP about it, and a referral was set in train. DD started school about 4 months later, teacher dismissed it for ages, but at the end of junior infants agreed maybe it was something to consider. Actual assessment started Sept of senior infants (2nd yr of school) by which time things were becoming much more obvious.

If we hadn't started acting when we did, we'd have waited an extra 2 years at least for Dx, and longer for any supports.

As it happens, we have had to source and pay for most of the supports ourselves, including private assessments.

But it has made a big difference.

Partly because, knowing her dx (on the ASD spectrum), we have learned how her mind works and how to do things so that we can work WITH her and not always end up pulling AGAINST her. Which has meant that lots of things have gone better than they would have if we had stuck to what we were doing before.

And DD is still in mainstream school, does various activities outside of school, both individual and team activities, and is a happy DC. But we know what accommodations to make so that we don't have massive meltdowns (in our case - different parts of the spectrum have different issues, DD is high functioning).

So we are very grateful to the Montessori for not just noticing it, but raising it with us in a sensitive way.

The thing is, she might not need extra help now, but that could change, especially at transitions such as starting school, moving to secondary school. If she starts to struggle its better to have a diagnosis in place than trying to do it once problems have started, as it can be a long process. A diagnosis might not be an automatic ticket to extra support, but it really helps, both in terms of understanding her needs and convincing others that more support is needed. Of course the assessment might also show that there is nothing to be concerned about. It is hard, but I really would seriously consider doing it.

I work with autistic children and I think an early diagnosis can only be a positive thing. The teenagers I work with will often say that their lives changes the day they were diagnosed, and everything they had experienced/suffered in education made sense. Their only wish was that the diagnosis had come much earlier. This is particularly true for girls.

You might be worried about your DD being pigeon-holed, but this should not be a negative. I have parents who don’t want their child to be autistic, and they will fight professional advice.

If she needs funded help (EHCP) then getting an early start on this treadmill is helpful. If she doesn’t, then at least her teachers can make allowances for her unique behaviours.

Hopefully, your DD will be simply eccentric or quirky, but if she is autistic, it is only going to benefit her for this to be a knowledge early on.

I forgot to add that we don't see it as "something wrong with her", more that "she reacts to things differently to us" so we need to adjust certain things.

Like - there is no point raising our voices in anger when something is going wrong, as she will just shut down. Regular tones, gentle but firm, and keeping things moving in a positive way will have a far better impact on her.

Or knowing to tell her about plans in advance, and when plans change, as routine is very important to her. It doesn't mean she dictates everything, nor that things cannot change - but we need to be prepared if things do change that we need to build time to allow her to adjust to that change, and also work on flexibility in general when we are NOT under pressure because things have changed. Or learning to make a single decision (pick dinner A or dinner B) as a way to slowly building up to wider choices.

It's possibly also worth saying that one of the activities that we got her doing, that really worked well for her (it was mostly solo but needed interaction not involving social chats - and allowed her to develop enough rapport with the others to build into social chats), is something she's also very good at that I never did as a DC, but have started to learn as an adult and am thoroughly enjoying (and that she is quite enjoying telling me how wrong I do things but usually helping me do things better). So it can be positive for you too.

And it has also taught me an awful lot about listening to others for what they are really saying and noticing their body language as well - that I was not good at before. And how to react calmly to situations, and not panic, but deal with changes and come up with alternative plans without fuss to still get the end result we need. So that has helped me in wider life as well.

I've not had exactly the same experience, but my DS' (age 3.2) pre school raised a concern about his hearing a few weeks ago, and conversations since makes me think they move decided he has ASD.

The hearing concern was basically just a passing comment "have you had his hearing checked, because sometimes he ignores us". I'm confident there's nothing wrong with his hearing, as he rarely ignores at home unless watching tv, and even then he hears "do you want a biscuit"! But I decided to have a follow up chat about any other concerns, and they were all "very small things" (their words) eg he lies down when he plays with cars (WTF) and sometimes repeats back what they've said (doesn't do this at home, or if he does it's not echolalia, eg if I say "you're being silly" he'll say "I'm silly!".

I was a bit annoyed about some of their "concerns", as although they didn't say it, it was suggesting that they think something is up. I wanted to make sure I followed it all up though, so saw the GP - she rolled her eyes at their concerns. I also had the health visitor come and do the schedule of growth check for his age, and she was very happy with him, no concerns at all.

Could you ask your health visitor to come and see DD? No harm in that, and they will be able to refer you on if needed.

You and more importantly your daughter have nothing to lose by having an assessment.

There are mothers tearing their hair out desperately wanting an assessment, knowing a 2 year waiting list isn't unusual depending on their area and you're offered one and are not really keen. It's always the way, isn't it?

Do please have the assessment OP, then you'll know one way or another.

An autistic person is born with autism, it's a lifelong condition. A positive assessment will not and cannot make them autistic. They will be exactly who they were before the assessment.

Similarly, refusing to have a diagnostic assessment for an autistic person will not remove their autism. They will be exactly who they were before the assessment.

Blanket we haven't been offered an assessment. Nursery have told us to request one.

HV is a good shout actually. GP fairly useless but HV is senior and experienced so may ring her first.

We bypassed to gp. The HV went to observe DS at nursery after we told her their (and our) concerns. She referred directly to a paediatrician, who requested hearing and eyesight tests, then referred on to the psychologist who recommenddd assessment. DS is bright, very articulate and initially people had a hard time believing he needed assessed (apart from the professionals that is!) Now he’s in reception and struggling emotionally so I’m very glad we’re under way with the assessment process.

Lookingforadvice123

Nurseries are trained to look for all sorts of things in children, it's part of their job. If it's found that their concerns are valid, the child can be helped as soon as possible.

No-one at nursery can diagnose anything, they are not medically trained to diagnose anything. All they can do is observe different behaviour then suggest you follow it up.

GPs and HVs are not able to diagnose autism either they just look at the child for a few minutes, lots know very little about it.

Many's the parent who has noticed different behaviour in their children only to be told the GP and HV have no concerns and will not refer on. Years later the parent's concerns from those early years have been proven right and the child has missed out on help and interventions for years. Not helped by an extremely slow diagnostic service, 18 months to 2 years in some areas.

Autism isn't "something wrong" it's a neurodevelopmental condition that makes people see the world a bit differently. Very much not wrong, just a bit different.

Sorry JohnnyMcGrathSaysFuckOff I thought Nursery had organised one for you.

IF you do want to proceed, having nursery's support will help immensely towards getting an assessment.

I was one of those parents who noticed differences and was fobbed off time and again by the HV, the GP and primary school, so my child had years of vile experiences in primary school because no-one would provide the sort of help they needed. I wouldn't wish our experience on another child or parent.

BlankTimes I didn't have any concerns about my DS until the hearing comment from his pre-school. They only mentioned the other "things" because I asked. Now that the health visitor has done her assessment (it was an hour, not 5 minutes) I'm reassured more so.

I'd get her assessed just for peace of mind - I wasn't assessed until I was much older and a lot of my struggles could have been sorted so much earlier if someone had picked up on it.
She's so young you could even blag it as a regular test everyone has to do when they reach a certain age, and then never tell her about the outcome? If she's as borderline as you think she might be chances are not many adjustments need to be made, just more patience and understanding in certain circumstances.
When a child is in nursery I believe they ask parents to fill in a form answering questions, and the nursery has to do the same, and then the child is observed with you and at nursery.
If you don't test her, and she is on the spectrum she'll always be able to tell she's different and it can cause a lot of rage inside of herself because she's not understood and she doesn't understand herself (that's how I felt anyway).

Girls with ASD show differently that boys with ASD. I would recommend assessment a.s.a.p. My SIL didn't want her son assesssed till he got so incredibly difficult and unhappy that he was tgreatening with suicide. After that he had help understanding that he reacted different and when he needs to take a time out for himself. That coupled with ritalin for the schoolday has massively uplifted his mood. He's happy again. If she would have only assessed him age 4...

And she might not have it, that's fine too.