Would a nursery notice if a child was autistic or neurodivergent?

[G172125]

I’ve had some concerns about my nearly 4 year old son since he was about six months old. I noticed early on that he would avoid eye contact if anyone spoke to him and would try to turn his head all the way around to avoid looking at them. He started to say words around 1 years old and could babble along with nursery rhymes. This suddenly stopped and he didn’t start to speak again till age 2-3 and he is still behind his peers with he’s speech. He has a speech therapist who has recently seen him and she says he passed the understanding part of her assessment but is missing the ending of some words a lot and is unable to pronounce some sounds. She also said he is nasally pronouncing some sounds. He has had frequent ear infections but has had an hearing test which he passed. He has been in nursery for nearly six months now but still has no friends and will get upset if any of the children or there parents say hello to him, he will also try to turn his head around so he can’t see them. He has become attached to one of the teachers and is always with her or he will play by himself. He will watch other children play but won’t join in. He gets distressed going in to nursery and has a repetitive routine of stepping over obstacles and touching wind chimes and looking in mirrors which he does everyday on the way to and from nursery. He will get upset if he doesn’t do this. He has become resistant to wearing any clothes that are new and will get distressed if I try to put them on him. He has also become really sensitive to strong smells like cooking food. He has no problem with eye contact at home and is affectionate and can pretend play on he’s own at home. My other children are shy but it seems something more with my youngest. I really thought nursery would pick up on his behaviours once he had started but they haven’t really said anything other then he seems anxious going in to nursery. I don’t have much knowledge of autism or SENDS and I’m not sure if I should bring my concerns up the nursery because they haven’t said anything

Not necessarily.

My dd2 has just been diagnosed at age 13. The first two schools were insistent she was just "sensitive" and "needed to toughen up".

All 3 of mine escaped notice as did I so no, not necessarily. In my experience unless your child is disrupting others in
class then they will deny any unusual behaviours or dismiss them as age appropriate. Then
puberty hits and all hell breaks loose!
It would be worth speaking to your HV or GP but I wouldn’t expect much from them either. Sorry to be negative but having had 3 dc and myself failed by schools it’s hard to be positive about it. I hope you have better luck!

It will depend on how obvious the traits are.

You should definitely raise it if you have concerns. Don't wait for them to tell you.

No. They often don’t notice, especially with younger children when the difference to peers may not be as obvious.

I echo @ButWhysTheRumGoneig your child isn’t disrupting others they are easily missed. Said as the parent of 3 autistic kids who was told not to worry all fine….

your description sounds like autism to me. It may well be nursery have noticed but they don’t raise it with parents unless parents raise it first. So raise it with nursery and speak to HV to get an assessment. Try get in before he turns 5 as once past that age the wait is 4years or more in many areas

Nursery raised concerns for my daughter but she didn't get a diagnosis until she was 11 years old.
My boys had asd diagnosis before they started nursery.

One of mine (boy) was picked up early despite being non-disruptive (he is very rule abiding) but it was the social interaction, extreme food preferences and obsessions that were noticeable and they were very proactive about supporting him but this was 20 years ago.

The other one (girl) went under the radar till mid teens even for me, apart from dyslexia which I did pick up by about age 9 (school did not).

I would talk to them and your GP/health visitor. Keep a diary of all concerns and think back to very early indicators. Also keep notes and dates of everyone you speak to.

They might be wary of bringing it up too quickly because some parents dont want to hear it. I advise you to tell them your concerns asap.

DC1 was in Preschool from 2.5 all the way through to Y13. No one ever mentioned that they may be ND. Was diagnosed as having ADHD as an adult. They’d also had a few rounds of SaLT and they’d completely missed it too.

DC2 in Nursery from 3. Again had SaLT. Was raising concerns wirh the HV from about 2. HVs, SaLT, Nursery and School all missed ND. SENCO at primary even laughed when I raised it with them. They now have a diagnosis of AuDHD and ARFID.

So from my experience, no I wouldn’t rely on the Nursery spotting the nose on their own face.

Not necessarily I mentioned concerns to the school about my son being autistic when he was around 5/6 years old they told me they didn’t see it and he doesn’t have any Sen as far as they are concerned, fast forward to 11 and he’s now finally on the waiting list for assessment.

Not in our case. Thought DD was lively, naughty, disobedient, rude, rough, etc etc. When in fact she has a raft of SEN. AND it's taken them 3 years to accept it. They refused to acknowledge until the care was transferred over to CAHMS.

Sometimes yes, sometimes no. We wouldn't diagnose anything, but we can get a very strong idea there's something that needs investigating.

They are very unlikely to mention a diagnosis (even if they're thinking it) as they are just not trained to diagnose. Plus some parents would be very offended!

But you could ask for a meeting with the key person of SENCo and ask if they have noticed any difficulties and specifically ask if they've suspected autism.

Not in my DD's case, they didn't notice anything at all until near the end, then they put it down to being autumn born and outgrowing the setting. TBF while I had some niggling thoughts, I wasn't sure until she really started struggling in year 2 and I'm autistic myself so had some idea what to look for in girls!

Yes they might have noticed and be aware but are waiting for you as a parent to initiate a conversation about your concerns. I am not sure whether it is always appropriate for staff to say whether they think a child is ND without qualifications to do this, so it might be they have their own observations but are unable to comment unless you as a parent raise it.

My dd made it to 16 with no school/nursery noticing anything. Then she was diagnosed.

What age did he first say mama and dada? What were his other first few words?

Even if they noticed they might not say. Parents can get mightily offended when it's mentioned. Also don't treat nursery as experts on this - they may know more small children than you do but they are not diagnosticians.

I have 2 autistic children, one of whom is in special school. I asked 2 nurseries and 3 school teachers if he might be autistic and they all said no. With the other I didn't ask, and no one mentioned it. Diagnosed much later.

You know your child the best. If you have concerns look into assessment yourself. You don't have to be certain, you just need to have enough of a suspicion to get a more qualified person's time to take a look.

@Ohthatsabitshit could say mama dada around 8-9 months and could sing along to row row your boat at 12 months than just stopped all talking around 13- 14 months. He had an ear infection at the time so I thought that may have caused it but he had an hearing test an all was ok. He started talking again closer to his 3rd birthday but he is still hard to understand a lot of the time

It depends how much they differ from their peers ime. Mine is ND but listened to adult instruction, got along well with his peers and achieved age appropriate milestones so it was a battle to get him diagnosed.

Haven’t you see your health visitor in that time? What did they say?

If you are concerned about ASD @G172125and you’re not sure how to go about raising concerns, i would recommend asking your HV to assess him. You’ll need to fill in both of these:

48 month Ages & Stages

and the 48 month Social and Emotional Ages & Stages.

The scoring should be at the end of the assessment. On the first one, it’s pretty normal for DC to score in the grey in one or two areas. If he scores black in any area he will need a referral to a Paediatrician first assessment. If he score grey in more than two areas then the HV might want to book a follow up appointment. If she does, try avd insist that she books the follow up appointment with you there and then so that your LO doesn’t get forgotten.

On the social and emotional Ages & Stages if he has a score between 70 and 85 the HV will need to monitor. If he scores over 85, he’ll again neex a referral to a Paediatrician.

You could also ask to speak to the Nursery Manager and say you gave concerns and ask if their SENCO can assess him. If you do both then hopefully he will get assessed

My dd nursery noticed at 12-18 months there was some kind of issue and they were extremely helpful with the diagnosis process and she was diagnosed with ASD at 2.5 years old. She had delayed speech, unusual ways of playing, feeding issues and severe problems with motor skills and sensory issues.

@FreshInks yes he has seen a health visitor she referred him for chatterbox lessons and then to the speech therapist which he still has

Based on your description I would say bring it up to them, the head turns lack of social interaction, rigid routines would be a flag for me but then I've trained in developmental psychology. Look up the criteria for autism diagnosis in the DSM-5 and see if your son matches the criteria. My 6 Yr old matched some criteria, I flagged it in nursery and was told she doesn't meet all of the criteria and it isn't impacting her school work so they can't refer her to the ed psych. Like others have said if he isn't disruptive they may not be noticing the other traits.