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

Sounds very similar to my asd son. Speech therapist can refer to child development/ under 5 team Also see if nursery have a senco? Also nursery can make a referral to portage or similar in your area.

often nursery and school will miss it as they often have very little training in additional needs or none at all.

Not necessarily and I think a lot of nurseries are so busy they don't really care enough to bring it up. My oldest was diagnosed as a teenager despite showing clear signs from a young age. I admit I could have done more to push for support but I believed professionals such as nursery and primary school would bring it up if they thought it was a possibility. They didn't and I trusted them (wrongly obviously 😅)

My youngest was diagnosed at 3. When nursery were doing the nursery views for his EHCP they wrote only 3 lines. Despite having a formal ASD diagnosis, medication for sleep, NHS SALT and OT involvement, housing adaptations ordered by the council OT, a 15 page autism specialist professional report from a nursery observation, educational psychologist report, receipt of HRC DLA 😅 I truly think that a lot of people in the SENCO job don't actually have training or just don't want to do their job.

Trust your gut.

Edit to add: it was my HV and my older sons paediatrician who noticed my son was autistic at 18m, after me first querying some concerns and they were the ones who did referrals needed to all the services.

It depends both on the quality of the staff at the Nursery, but also - very much so - the presentation of the child at Nursery. It will be clearer and more apparent with some children than others.
However if he has been assessed by a SaLT, and she doesn't have concerns, then that is quite relevant. SaLTs are part of the assessment for autism.

But, as pp said, if you have concerns, then raise it with the Nursery.

In my DDs case no, I raised my concerns at nursery and primary but she was only diagnosed in high school

I’d have his hearing rechecked.

You sound really observant and tuned in to him which is great. Save what you have written here.

Re the imaginative play I thought my son did too, then down the line I clocked it was all elaborate scripting of games his older siblings had invented, or copying a peer move for move. Might be worth looking out for that. The difference was subtle and is easily missed, especially in a group setting where it looks like 2 small children playing nicely together. But once I saw it, I couldn't unsee it.

They can notice - at my DS’ nursery there were children already in the queue for diagnosis/EHCP - but not noticing doesn’t mean it won’t get picked up later or that they are at fault for missing it, as different individuals can present diagnostically at different times.

I was very lucky.
DS’s nursery noticed something was up quite quickly. He was 3 and got diagnosed with Asperger’s Syndrome not long after.
I hasten to add that this was in 2000.

Yes, but it was dismissed by physio, only later were they proved correct. Bloody wish I'd paid more attention.

No, but I suspected. Different teacher.

I could spot autism in some 5 y olds. Who knows if I missed others?

Did you have a look at the assessments that I linked to @G172125?

No. DD1 has a raft of SEN. Went to special school from age 4. Not diagnosed until 15.

DD2 had chronic EBSA, obvious anxiety, etc., not diagnosed until 11.

DD3 struggled to go into school, sensory issues, OCD symptoms from age 4. Not diagnosed until 15.

@SleafordSods yes he scored 130 on the 48 month questionnaire. I was all set to mention it to his teacher yesterday but when he came out she said he had played really well with another child during the day so I just left it. Today he has gone in to nursery really upset because his routine in to school was changed and because I had thrown a tissue in the bin 😞. He really doesn’t like to throw anything away.

My DD was viewed as outgoing, chatty and a leader at nursery. If a bit explosive. It was as she aged that her masking fell away and she because less obviously able to cope.

She's AuDHD.

There were signs from birth, frankly, but many of the things that we view as flags are stages that all kids go thorough - so unless they are profoundly autistic, its hard to tell at such a young age. DD was put on the SEN register at school in year 1, when it became apparent that her behaviours were not temporary.

If I were you, I would flag with them that you have concerns, and then keep your own records of evidence. It'll come in handy later when you need to show this has been an ongoing issue since young childhood.

I think they only flag it up if it's really obvious, because a lot of behaviours in small DC are a passing phase and remember, they probably only get to see your DC for a few hours at a time, they aren't living with them or focused on them to the same degree that you are. Your DC is one of four or six that they care for and so they won't be scrutinising them - they're too busy changing nappies/taking them to the loo, setting up activities, clearing up, getting coats and boots on/off, supervising mealtimes, writing the daily sheet you get telling you what your DC has been doing, etc.

In addition, many people who work in nurseries are really young and simply don't have the life experience or the knowledge to be able to sort out whether something is a sign of ND or just a normal phase of development and quite honestly, it's above their pay grade in most cases to raise these things with parents, who can be very resistant to hearing anything that might be construed as critical or suggesting that their DC is ND. The women working in the nurseries my DC went to were often teens or early 20s and they were not highly trained childcare professionals. To work in a childcare setting you need an NVQ or a BTec, it's not a high level of education and those who are academic rarely go into childcare as a profession.

Our nursery flagged concerns with DS1 which we were totally oblivious to up till that point, probably aged about 3.5? He ended up being diagnosed with autism just before he was 7, though a lot of that was waiting list times. We had never really thought about it because he talked early and well, didn't have any obvious sensory issues, and because he was our first we didn't really know what to expect from his social interactions. But nursery saw him much more often with other kids and were the first to mention it. I think if they hadn't it would have taken us much longer to figure it out!

They don't pick up all kids, obviously, but sometimes they do, and if you're concerned it's definitely worth talking to them so they can keep an eye out.

All parents should be aware that Nursery staff are likely to be young, minimally qualified and lacking in the breadth of experience which would enable them to notice differences which would lead to a request for assessment.
However even experienced highly qualified teachers don't always pick up the signs and some children 'fall through the net' until they reach overwhelm and can't be ignored any longer.
If you are concerned, as the parent, you should request a referral for assessment from your HV/GP and then you may need to push to get it before he starts school but early diagnosis can make all the difference.

As a nursery we would certainly have noticed this and had a chat with you to find out if you'd noticed similar behaviours. We would then make our usual observations and flag anything that caused us concern, sharing that with you.

My ds wasn’t diagnosed until 10 but we knew very early on that there was something non-neural-typical about him. But because a lot of behaviours can be attributed to age/maturity etc, I wanted to give him time to develop as he was before seeking a diagnosis which I did when he was 8 (long waiting list though). It’s so hard to say with such a young child if avoiding eye contact is asd or just shyness, is lack of friends just an introvert? How can you distinguish between a toddler who has adhd and one who just loves being active?
unless it is the severe end of the spectrum of course and a specialist primary school place and 1:1 support is needed, I don’t always see the benefit of diagnosing kids so young

I think it definitely depends on the nursery. Where I work we have a lot of experience across staff of neurodivergent children that have attended our nursery, and would easily spot signs that you have described, as well as others.
if the child is struggling we ask the parents if they’d like to come in for a chat to see if there is anything they feel would support their child, and we offer ideas too. Some parents will then bring up concerns, but others won’t.
Do ask for a meeting to talk over your thoughts with the nursery and let them know if you would like anything in place to support your child.
we are attached to a primary school and will start paperwork to get children support if we and the parents feel they will need it.

Don’t feel you have to wait for them
to approach you!
Good luck, you are your child’s best advocate ❤️

Nursery, doctors, and even early childhood screenings flagged my child as an outlier, but never said the word autism. That label did not happen until she was 9.

I would be told she was perfectly behaved, but argued over everything. At nursery they had a strict no outside food rule. They very quickly asked me to send her food because they couldn’t see her starve anymore. She was obsessed with rocks at forest school to the point they had a conversation with me about it. No one ever said autism though.

No, mine was completely missed in pre school and primary and only anxiety was flagged as a concern in late primary. It actually can be a major barrier to diagnosis.