Autism v development delay v settling in

[Crechendo]

My little boy has been with us for 5 months. He's 15 months old.

He has development delay, which wasn't expected as we were told he was meeting his milestones but given the learning ability in his birth family isn't a huge shock. His delay was flagged as part of his 12 month review. But he'd only been with us 2 months at that stage and looking back now I think he was still grieving for his foster carers at that point.

He's come on so much but even now I would say he is around 12 months developmentally.

Reading another thread on Mumsnet caused me to look into autism. There is no indication of risk factors in his birth family. But reading the early signs I can match a lot to my little one. I've also done the mchat test online and he scored 12 which was high risk.

I'm conscious I don't want to go running off chasing a diagnosis for something when it could be developmental delay, or even just he's still settling. At the same time, I don't want to bury my head in the sand.

I've contacted my health visitor and plan to talk it through with her but I really value the opinion of the people on this board and was hoping for your thoughts too. Would you be concerned at this stage or would you look to wait longer and see?

[SFCA]

Hi There,

It is very early days both in adoption terms and the fact your LO is only 15 months old. There can be quite a lot of overlap between attachment issues and autism so I would imagine you will be advised to ‘wait and see’ for a while yet.

Our DS is 3 years old and has just been diagnosed with autism. It is a huge spectrum too and whilst there are some things my son does that are quite typical traits there are things that don’t neatly fit either e.g he flaps and stims constantly but makes appropriate eye contact, is very cuddly and doesn’t mind changes in his routine

Your LO is only slightly behind and has been through a massive upheaval, it could be that he catches up. You can certainly flag with you HV and ask for advice in supporting his development but at this stage I don’t think they would pursue a diagnosis.

Congratulations on your little one

[raddledoldmisanthropist]

I agree, it's far too early to diagnose autism. Most of the things you might look for in a 3 YO to suggest autism are perfectly normal at 15 months.

A 3 month delay at that age is meaningless. I've know loads of non-adopted kids with significant issues like speech problems or poor motor skills and then catch up in a spurt. That's perfectly normal even after the start of school.

I think you are overthinking a bit (we all do). DD2 should have had difficulty walking and probably significant delays (and did at first). At 5 she can swing upside down from monkey bars, runs everywhere and is notably above average intelligence. Kids brains are very plastic- give them loads of stimulation and don't do too much for them, let them make mistakes (but keep up the bonding activities and do switch back to mollycoddling whenever they need it). But most of all, enjoy it- there will be dramas and frustrations soon enough.

[Jannt86]

Agree with above that it's too early. Your child at 15MO may well be a lot different to your child at 2 or 3YO. I was a little concerned about mine at the same age as she wasn't talking much and seemed a bit 'distant' at times. She's 2.5 now and very smart and just chatters away. I was never massively worried as she always had good receptive language and did social things like clapping/pointing/waving very early. Are you worried about particular areas of development or her whole development in general? It's very early days attachment-wise too. It's only looking back with my LO (adopted 9MO) that I realise that at that point the attachment probably wasn't quite there initally although I loved the bones of her from D1. You need to give that time as it will be having an impact on her development and might take her time to gain confidence with social skills and talking in particular. I would focus on building that attachment for now. Incorporating touch wherever you can even if it means taking half an hour to change her nappy/get ready for bed etc whilst you play 'round and round the garden' or do baby massage a million times. Letting her lead the way a bit with her play etc and encouraging anything that involves 'back and forth' interaction even if it's just taking it in turns to press a button on a toy. And talk to her relentlessly until you're driving yourself mad. Unless there's a profound delay which it doesn't sound like there is you're unlikely to access any intervention until age 2 at least and tbh what she needs at this age you can probably offer her yourself as above. Age 2 or 18MO if you're still really worried are much more reliable ages to assess things. The MCHAT isn't really reliable until then. Until then just enjoy her, focus on attachement and give her a bit of time. I wouldn't be too fixated on her BPs either. Mine's have a degree of LD but honestly my gut instinct is that she's really quite smart. Time will tell when she goes to school I guess but I'm not worried right now xx

[Porcupineinwaiting]

The MCHAT is designed for children of 28 months isn't it? So not unusual for a 15 month old to score more highly on it. If you want to use it to inform you about the likelihood that your lo is autistic, you need to give it a few months and run through it again.

[Porcupineinwaiting]

Sorry - 18 months not 28 months

[percypetulant]

Wait and see.

If I'd just been forced to move house, lost everyone and everything I knew, been given a new job, new family, new everything, my social skills would be a bit lacking! And I've learned them. So I would advise allow for a virtual reset when they came home, and count development from then. Let them catch up, in their own time.

[percypetulant]

So a development age of 12 months would have me thinking he's fairly advanced, given what's happened.

[sassygromit]

I think it depends on what sorts of things you are particularly concerned about.

Slow development might well not be a worry long term at all, like others have said, and what activities you do now with your dc will have a huge impact on their development - up to 3 years the brain is still wiring up apace and the stimulation and human interaction the child gets now has a huge impact on how things will be in the future for them - even if you don't see much sign of it for a while!

If however you are talking about things like really poor eye contact/lack of interaction/lack of interest/listless or quiet behaviour then I think looking into some therapeutic support and guidance would be really helpful. Autism and trauma can present in very similar ways in young children apparently.

[Jellycatspyjamas]

He’s very young for an autism assessment, 15 months chronologically is more like 10-12 months developmentally for adopted infants. It’s entirely possible he was meeting milestones before placement and has regressed upon placement - it’s not at all uncommon and realistic to expect given all he’s been through.

In terms of assessment/diagnosis it’s worth talking to your health visitor because she’ll be able to observe him and will have a wealth of knowledge about the wide span of child development to compare him to. She may tell you he falls within normal parameters but if you continue to be concerned keep a watchful eye and note any concerns you have.

It’s still very early days, I’d agree to work on activities that foster attachment and build security, and keep a watchful eye. There’s a huge overlap in patterns of behaviour/processing in autism/developmental trauma/attachment so it could be any or none of those.

[GML107]

I'm autistic, as is my husband and many members of our family. I have also worked in student services for over 10 years with autistic HE students.

I'm not sure how much you know about autism but the DSM, which is used by the NHS to diagnose autistic individuals as having a 'disorder or condition' was used to diagnose homosexuality as a mental disorder pre 1980s. Like the way homosexuals were treated autism is still very much mis-understood by the medical community and in turn society.

As such, its highly likely that if your son is autistic many members of his family are but do not know as there idea of autism is based on the inaccurate stereotypes that are portrayed in the media. For example, my husband had never considered he might be autistic until he met me and finally began to learn what that word actually means.

If you get to the point where you'd like to pursue a diagnosis the first point of call with regards to the NHS is the health visiting team, however, their understanding may be lacking. I rang ours in relation to my LO girl and was told it was too early to assess her but was advised that I must make sure I keep socialising her 🤦🏻‍♀️ Yet that will make no difference what so ever to her genes 🙄. Personally, I was turned away by the NHS the first three times I asked for an assessment despite being autistic. Consequently, I'm now going to pursue a private diagnosis for my LO as I feel I will receive a much better service and these practitioners will have a greater understanding.

The question is what do you think a diagnosis might do for your family? I was a late talker, walker etc. I was a very quiet child and still prefer alone time to socialising. However, as an educator, I've spoken at international conferences, managed staff etc. Developing differently to the majority of society doesn't necessarily mean there's will be any issues in adulthood.

In fact, many autistic individuals resent the fact that they are treated as outsiders due to their differences and made to seek additional support to change who they are to fit in with societal expectations rather than being accepted as who they are. As such, I'd let your son develop in his own time and only seek an outside assistant, such as SALT, if you deem it absolutely necessary.

I am seeking a diagnosis for my daughter as I hate the element of doubt by other family members and want to be able to say authoritatively that we're all autistic in our house.