How do you handle it when a child you see a lot of is very obviously showing clear signs of autism but the parents genuinely can't see it?

[ZippedyBooBah]

Someone I know, single mum, has a 7 yr old DC. I see them daily (not explaining further as potentially outing) but don't feel I know her well enough to talk to her about this.

I assumed when we first met that her DC was on the spectrum (my 15 yr old is autistic, well what used to be called Asperger's). I didn't mention it because it's none of my business, but as we've got to know them I've realised DC isn't diagnosed and that their mum cannot see any issue at all.

The things that make me wonder are:
Walks on tiptoes
Avoids eye contact
Rarely speaks to me despite seeing me a lot, same for other adults from what I've seen (will completely ignore a "good morning" for example)
Practically has a panic attack if bread or other food isn't cut in the right way (we had a lot of picnics over lockdown so I saw this happen regularly)
Very limited vocabulary - about 50% of what I hear DCsay is just "mama" while jumping up and down trying to show her what they want without using words (ie will say "mama mama" and just tug her to what he wants, and if she refuses or says to use words they will use the absolute minimum to clarify ie "kitchen")
DC makes a lot of fairly expressive "huh" and "ooooh" sounds so you can tell if they don't know what you mean or likes something, but hardly ever speaks to anyone except their mum with actual sentences
Really struggles to relate to other children because DC just does their own thing and doesn't seem to get involved in play or communicate their ideas for a game
Sniffs food, and don't mean like anyone would with a new food, I mean full on sniffing and sometimes licking. Ie I made a cake and offered them a slice - they literally put their nose into the icing of the cake and took a big sniff to decide. I've seen this happen with other foods too. Will also take a handful of food from a shared bowl, lick it and sniff it and rub on their face before putting it on their mums plate (or back in the bowl ) if it doesn't appeal. It's not out of bad manners and being repeatedly told not to doesn't seem to sink in.
Can't use cutlery properly or dress etc, mum has to cut up food and help dress
Won't sleep in own bed (mum is very worn down by this)

It's not that they are a badly behaved or rude child though, I work with children and I do know the difference. This child is fairly quiet and as I said is not deliberately rude or naughty, but it's so obvious to me that there is something else going on. I assumed the school would pick up on it and their mum has told me they are suggesting DC might be dyslexic and she was very affronted by it, saying that 7 is far too young to read and write so she doesn't see it as a problem that they pretty much can't do either yet. Dad sees DC fairly regularly and is a full on QAnon conspiraloon who thinks deep state want to microchip our children so I can't imagine he is likely to pick up on anything either!

WWYD?

(Fully braced for an onslaught of MYOB ⛑️)

I would just gently suggest they explore what the school has to offer with dyslexia testing and mention the impact of early intervention making it much easier for the child. You do t want to push too hard and push her away. I suspect school has mentioned a range of potential issues including asd and dyslexia but she is just focusing on or telling you about the dyslexia as it seems less scary.

I can't believe the school haven't picked up on it. My friend had a son and by the age of 18 months it was clear he was Autistic but as her first child, she had no idea.

The HV missed it too

I encouraged her to send him to nursery in the hope they'd notice...I couldn't tell her myself.

They told her within the first week and she got a diagnosis quite quickly after that.

With a 7 year old you've got to either ignore it...or tell her. Nothing else you can do.

You don't know it hasn't been picked up on or mentioned.

You need parental consent to refer a child for ASD assessment. In my job, I have to raise concerns with parents about autism but it's their decision whether they pursue further assessment or not.

Personally, I wish I'd known when I was younger. So I would risk it and tell them myself. However, I am on the spectrum so am perhaps missing the nuances/normal approach - talking about autism wouldn't ever feel like an offensive idea to me.

Of course, its possible the Mum is on the spectrum too and has just ignored some things that seem obvious to you.

tell the mother.
she might or might not be aware that some if the 'quirks' of dc could be indicators of autism.
diagnosis can open doors for help.

My Ds is 16 and was diagnosed with autism last year. When you meet him he has quite obvious communication difficulties.

His difficulties were first flagged at school when he was 4 years old. Before that I remember the speech therapist that saw him for a year as a toddler asking me if I thought there was anything else going on.

I think Dh and I knew something was different with him but we didn't think about autism until he was around 8 years old (and we were still unsure). He then he seemed to be coping at school so we didn't ask for assessment. Unfortunately it all fell apart at Secondary. He had no support in school until year 10.

I wish someone had suggested 'autism' to us. Nobody did. I would have listened and pursued a diagnosis earlier if I'd had better understanding of ASD.

The late diagnosis has brought with it so many issues and significant mental health difficulties.

School may well have picked up on it but if the parents aren't interested there's not much they can do.

If the child is quiet and well behaved at school then it's harder for the school to push - suggesting a dyslexia assessment might have been the teacher's attempt at a way in?

I wouldn't mention autism to the mum at this point if she seems resistant, but you could have a conversation about the speech issues and speech and language therapy?
Could you invent a friend whose child had a couple of sessions with a Speech therapist and it has made such a difference? A SLT will be well placed to suggest further investigations for autism if necessary.

Could you not just mention the cake thing and say it’s made you link one or two of the other elements that are quite distinct. You could couch it by saying maybe you’re more sensitive to these things but you’d thought you’d mention. I think the help and support they might unlock to have the strength to tackle the bed thing might help a lot. I think you’d be doing a kindness.

I don’t think you can mention it unless she brings up any concerns herself

It’s really hard facing that your child might have any SEN

My own husband, not one to shy away from life’s problems. wouldn’t hear of it even though I knew fine well my son had ASD

I drip fed a bit then could see he really wasn’t taking me seriously and went for the investigations myself. It was almost as though he couldn’t believe there might be a problem until he could see that everyone else was taking it seriously 🙄

I have a few students who we know/strongly suspect based on years of teaching, have learning disabilities/SEN/differences that would benefit from identification and intervention, but the parents refuse to allow testing.
We muddle on, the kids muddle on. It's sad but like vaccination, parental choice.

I get the impression that both parents are very resistant to "outside help" which they see as interference. The dad very much so, and the mum more quietly so.

She was very open with me about how she felt when the school suggested dyslexia so I hadn't really considered the possibility that they had raised other concerns that she wasn't mentioning but it would make sense. When I say DC is "no trouble" - they aren't naughty or loud, but they do need a lot of help beyond what you'd expect by 7, and their skills in a lot of areas are very lacking so I'd be astounded if the school have noticed nothing. But I also know it's the squeaky wheel that gets the oil. If DC isn't the most disruptive child, and mum isn't the parent pushing for process to be followed, they will fall to the bottom of the pile.

If you genuinely think that neither parent, for whatever reason, won't do anything about this, then I think that I would either talk to the school directly; or possibly even talk to Children's Services about your concerns. At least then you have gone as far as you can, and if nobody does anything then you have tried your best for the child.

@Oxyiz

Of course, its possible the Mum is on the spectrum too and has just ignored some things that seem obvious to you.

Happens frequently in my experience.

In the course of my job I've come across a few teenagers who were clearly on the spectrum but not diagnosed. In one case I thought we had lost some of his notes because I couldn't find out when he was diagnosed - it didn't initially occur to me he hadn't been. In another case he got into a lot of trouble at school for not following the instructions which he didn't understand -teachers thought it was just an excuse. These young people did eventually end up with an ASD diagnosis, but it would have helped so much if people realised 5-10 years earlier what was going on. Another family I worked with, the child's mum realised she was probably also autistic and went on to get a diagnosis herself (I think as an adult the formal diagnosis wasn't the big deal, it was her recognising it for herself, apparently it made various elements of her life make sense).
However, in a professional context it is easy to raise questions, as a friend it is much harder. You don't have the assumption of knowledge and expertise, and the mother might not have actively sought your support. You also probably want to be her friend after. So tread gently and choose your moment! Good luck 🍀

I would tell friend to take up schools offer for dyslexia testing. When they do assessments, they also look for any other learning difficulty and things like ADHD and ASD. So the test may come back negative for dyslexia, but would say refer for ASD testing due to possible symptoms being flagged during the dyslexia testing.

Tell her even if she thinks her child is perfectly normal, it’s a good idea to accept the testing because if her child isn’t and she refuses, her child will be at a disadvantage for years and years and it will be very hard to get the school to re-offer such testing if she refuses now.

I did tell her that she should take them up on the dyslexia testing, because it's better to have a school that are aware and cautious than a school who don't spot any concerns at all. But she was really angry about it, saying that they wanted to put DC on the SEN register and she wouldn't agree to DC being labelled when children in Finland don't even start learning to read until they're 7 etc etc etc. It was quite the rant tbh I don't actually know what the outcome was but dyslexia has never been mentioned again even though DC still can't write any more than their own (short) name and that's barely legible. I've never seen DC read anything but based seeing on their attempts to play various age appropriate games with my younger DC, I'm fairly sure they can't read anything meaningful.

@Moondust001

If you genuinely think that neither parent, for whatever reason, won't do anything about this, then I think that I would either talk to the school directly; or possibly even talk to Children's Services about your concerns. At least then you have gone as far as you can, and if nobody does anything then you have tried your best for the child.

This is a little bit ridiculous. School won't discuss a child with some random that calls them, and choosing not to have your child assessed isn't a social services issue

I have a son with ASD. Can you gently say 'ooh my son was like that/used to do that' and 'he really reminds me of when DC was 7'. And if you are feeling brave 'he displays lots of ASD behaviours, have you ever considered?'. I assume she knows your child has a diagnosis?
She may not want to know, its a shame the school are not more proactive

Then OP, I think you’ve done the most you can as a friend. You can’t really interfere in a parental decision about their child’s possible SEN.
Really all you can do is wait and then suggest it gently again in a few years when it’s going to be more obvious. The parents may simply be going through a denial phase.

Normally I'd say be a good friend and tell her, but your last post demonstrates that she would be extremely resistant to it.

I'm wondering if by discussing your own son and your own difficult emotions, when you/school first suspected that something might be up, might be a route into opening up a discussion? Perhaps exaggerate a bit if need be. Talk about how initially you were resistant to the idea, and how you wanted to bury your head in the sand as you didn't want to believe they might be asd. Then see if she might open up a bit or if you can push it a bit further about her own son?

X post smartie

I don't think you can or should do anything really. From everything you've said about her approach so far, it doesn't sound as if she will "hear" the message in the spirit it is intended, if she hears it at all. You may well end up alienating her completely, and to what end?
The child is how s/he is. I presume the parents deal with them as they see fit, and a diagnosis might not make much difference to that.
The school may well have picked up on it, but if a parent is not open to further investigation, there's not much more to be done, unless things deteriorate substantially. We have a number of children in my school whose parents have flat-out refused to even entertain the idea that their child might be on the spectrum (or whatever). And others where one parent indicates that they are aware, but the other one is resolutely against. We just do what we can to support them in school anyway.

I have a family friends who is nearly 30 who is very clearly on the sceptrum. Walks on tiptoes, no eye contact, twitches, still needs his apple peeling for his lunch box (has a very good job as a carpenter) and he’s had the same lunchbox since he was at primary school. It’s really sad it wasn’t picked up on as a child and I wish someone had spoke to his mum about things.

Been there with a friend recently - school gently raised it and they came to me asking my opinion where I got the chance to put it across that it was a thought that had occurred to me, and with the waiting lists these days it's possibly "a good plan to get yourself on the list, you can always drop off if things improve"

Think they're pushing on with a referral now, but as it's a girl and it's not the stereotypical "boy" autistic behaviour I can understand my friend not quite thinking there was an issue there.