Is this a normal reaction from Nursery?

[ElsaMars]

Hi,

Been on here since 2012 but haven't posted in ages! I'm trying to include all relevant stuff.

Nursery are great overall but I've had concerns about DD2 (3) for a very long time, she has flat feel, is likely hypermobile and didn't meet physical milestones until very late e.g. if laid flat on her back, she could not move/get up until at least 18 months, couldn't sit unaided until around 10 months etc. I raised concerns about this over and over from about 9 months, to Doctors and HV.

Anyway, she's now 3 and for about a year she's displayed signs of having ASD. I've discussed it with the HV at length and she agrees with me, she's really good and wants this looked at.

Nursery have been great with the physical side of things and we've had meetings about it. I mentioned ASD several times over the past year to them, they came back with a firm no, she's not, no signs etc. HV feels this is a fairly common response.

HV has put in a referral for DD to be assessed and on receiving this, the Nursery Manager (who I get on well with) came outside to speak to me about it and was surprised that DD had been referred as she 'shows no signs'. I said HV felt she does, as do we at home and it's become much more obvious in the past year. She sort of 'manages' there and then it all comes out afterwards.

Nursery Manager then said to me that she hasn't got ASD as 'we would know' and then something along the lines of ' believe me if DD was it would be obvious, we have ASD children here and DD is nothing like that' I have expressed concerns re ASD for a while, so I'm not sure why she reacted like this.

Am I being treated as a paranoid parent now who is making it up or something?

Her behaviours are things like.
Fine at Nursery complete meltdowns at home after (and also on other days) This is not because of things she wants, usually over a change in routine etc.
Repetitive behaviours and does not like change
Repeats herself a lot, will only talk about what she wants to.
Doesn't really play
Doesn't like affection/cuddles with anyone apart from me but even then often wont
Zones out and doesn't respond to her name or see things when I point
But is very chatty and appears 'normal'.

All I can say is that my DC1 was diagnosed aged 5 in year 1. Looking back there were signs at nursery but they weren’t at all obvious. He was just a little high maintenance. Nursery had no concerns. I think in this age group only certain presentations of ASD are obvious.

Your nursery manager is not qualified to diagnose so your best response is that’s reassuring to hear but we will complete the screening process and see what the outcome is. Ultimately it doesn’t matter either way but if there is a diagnosis it might give you clues on how to help your DD.

Our DC is flat footed also.

The nursery are being completely out of order - they are in no way qualified to make assumptions about a diagnosis one way or another. Their role is to have a duty of care to your child, and to work with you and outside professionals, as necessary, in order to support your child.
It is good that your HV has put in a referral. It is important that when this process happens, that the people involved are aware that your daughter masks at nursery, as this can be quite common.

Odd attitude from nursery. Can you say something like 'I'll be sure to pass this on if/when we have DD assessed, thanks so much' and just drop it?

I think sometimes people are so worried that a child might be stigmatised for being 'different' that they imagine it's reassuring to keep insisting everything is just fine. It can be really counter productive and I'm not surprised you find it frustrating!

Interesting that your DC are also flat footed Springchickpea!

HV has said she's probably masking, so agree, I find it odd that they don't seem to want to take my word for it, I also have an older DD went there and who didn't show these signs so it's not like I keep on about it.

There is also a huge connection between hypermobility syndromes and neurodiversity. Sounds like the nursery manager doesnt know what she is talking about. If she brings it up again just tell her that an assessment will do no harm at all

Gloeor, yes been looking into that, thanks. Honestly feel like I know more than the HC professionals sometimes, no one has asked about that at all.

FWIW, nursery will be asked to input into the diagnostic process, but when school inputted that they couldn’t see the behaviour at school that didn’t affect the outcome. My child masks incredibly well, but 1:1 time with someone who really understands neurodiversity has always been enough for the experts to see it.

Girls with asd sometimes act in the same manner as neurotypical children at school/nursery as they're copying the behaviours of others. But at home, they don't have that and the mask can slip. That's why it's much more obvious to you at home

And some boys are very good at masking too - it’s not only girls (although I will concede that one of the problems is that girls tend to mask more often and are less likely to fit the traditional ‘picture’ of ASD).

You’re doing the right thing getting an evaluation, don’t worry about nursery, most of the children diagnosed at preschool age are those who are nonverbal or who have extreme sensory issues. Many more children are diagnosed later, as their development differs from their neurotypical peers.

Anyone who knows anything about asd knows when you've seen one child with asd... You've seen one child with asd. Their previous experience doesn't count here I'm afraid. Keep pushing.

She sounds similar to my DD - we went round the houses trying to get a diagnosis but as she was adopted at 6 months and birth parents had a history of alcohol abuse we assumed it was foetal alcohol syndrome. Eventually they caved and did a genetic screen (one of the criteria for a FAS diagnosis is a clear genetic screen, to rule out other conditions). Turned out she has a chromosome duplication. As soon as we found a group of people with kids with same condition we suddenly realised we'd found our LO's peers. I don't know how much leverage you'll have without the adoption backstory we had, but I'd try and get a screening. Our LO's condition (and many others, I'm sure ) almost always results in an ASD diagnosis. Whilst obviously vice versa isn't true, given your story & your LOs mobility background, I didn't want to read and run.

Very inappropriate of the manager - all she can say is DD is meeting all her developmental expectations at nursery and they have no concerns. She certainly can’t diagnose anything or rule anything out.

I would try not to overthink this. Nursery staff are not experts in clinical diagnosis of ASD. I think it's good that she has shared with you what they are seeing during the day and actually I would imagine she was trying to reassure you rather than you minimise what you see at home. But ultimately, they aren't experts, and it sounds like you have a very supportive HV and are pushing forward for an assessment even if for your own peace of mind.

My son has ASC and ADHD. Also hyper mobile and flat footed interestingly.

I was told repeatedly by his nursery and junior school that he was fine (and sometimes that any issues he gad(and there were plenty getting worse as he got older) he would grow out of.

We didn't get school support until secondary and he received a diagnosis at 13 along with finally some appropriate support.

Proceed with the diagnosis. Teachers, nursery workers etc are jut qualified to diagnose and sometimes seem to have their own beliefs and agendas that affect what they see and/or report.

Thank you all. It doesn't hugely help that DH thinks she's mostly OK, but agrees her behaviour and quirks are extreme. Feel a bit like I'm fighting it alone and then I doubt myself.

So interesting to see others have children with flat feet and or hypermobility and ASD.

The signs of social communication issues etc are often much more subtle in girls - I didn't think my dd had ASD until Y3 despite both her brothers having it.

She's now been diagnosed despite me saying that neither nursery nor we noticed anything until age 7...

@Jackparlabane Do you mind me asking, now your daughter has has the had a diagnosis so it’s confirmed, for want of a better phrase, could your daughter pass for neurotypical and does she/can she lead a ‘normal’ life. The term I’ve used is offensive but I can’t think of how to word it, I’m trying to understand masking of asd in girls and how far the masking can cover up?

This is why assessments are multi-setting based. It's not at all unusual for a child to present as NT in one setting, and completely different in another.

Nursery are just giving you their assessment, but it won't be the only information gathered, don't worry

She's 9, didn't cope with last year very well, but is now back enjoying school, doing well and has made friends with classmates again. She's not good at group interactions so prefers to play one on one, and is blunt or rude to adults but generally quiet very well behaved in school.

She and one brother could pass a lot of the time as 'simply a bit quirky' and 13yo definitely blends in with his peers much better than he did at her age. It was the meltdowns over school in Y2/3 when social communication demands got more complex that were the clue.

Nursery are overstepping and dismissing you. See what the psychologist says.