Do I potentionally worry my friend about her childs health/development

[barmysarmy]

I writing this due to concerns I have about my friends 18 month old DD.

The child concerned was very slow to develop but by the age of 18 months has reached all the 'normal' milestones. She is a friendly little girl with smiles for everyone but shows some very strange behaviour at times for example- she hates to be touched, gets obsessions with certain objects, looks through people- not at them, has abnormal fears, very limited speech (although can repeat certain words said to her) cant follow basic instructions, constantly isolates herself and often has vacant episodes where she stares in space for 5 minutes or more.
I appreciate that she is only 18 months old and a lot of the behaviour I have described can be normal behaviour for such a small child but I cant help feeling uneasy and sensing that theres something not quite right.

Today at baby group, she had a vacant episode on top of a slide and almost fell off, Would I be wrong to assume this can be a sign of epilepsy? Would it be wrong to mention these concerns to her mum?

As a side note, Her health visitor has had concerns about this child due to her her not developing as she should at her 9 month review but my friend wont attend any follow up appointments, told the health visitor she is fine and is a very proud person.

I dont think she would appreciate me telling her my concerns but on the other hand I wouldnt want anything to happen to the child if my concerns about epilepsy/autism are right.

I am no expert although I have a degree in early years and 3 children of my own.

Should I watch from the sidelines or say something to my friend and potentially upset her. Rally stuck dont know what to do.

YANBU but I think if she wont listen to the HV she probably wont listen to you

I really would not say anything to your friend. She will most certainly be v offended.

I would mention it. I noticed once that a friends child had a blue tinge round her lips which can be a sign of heart problems. I told my friend who then said she had noticed but thought she was over-reacting. We were 1st time parents and very worried about looking over concerned. Because I said I was worried she felt validated in going to the Dr's.

Her child had to have quite a lot of tests done, but fortunately was given the all clear in the end.

Tell your friend. If she then does do anything that is up to her, but maybe a friend voicing concerns rather than a professional may make her think something isn't right.

Gosh, that sounds like a hard situation :(

Did your friend witness the episode at the top of the slide?

If the HV has been told to bog off, do you think she would listen to you or think you were interfering or something?

I'm the sort of person who would rather know (or be told) but it sounds like your friend is a head in the sand type (that may be unfair). Presumably her DD will have a 2 year old check up fairly soon so it should be picked up at that if you are nervous about jeopardising your friendship.

YANBU sounds like you only have your friends DD at heart however IMO it's only going to cause you problems with your friend if she won't listen to a health visitor who has expressed concern and refused to attend appointments she is definatly not going to appricate your concerns and could really effect your friendship

could it be possible that your friends knows, but hasn't told any one, about her DC medical problems ( if she has one)

Thanks all, My friend did notice the vacant episode (She actually had 2 that I noticed in the 2 hours we were there) and commented on them.

On the other side of the coin I am aware that she exaggerates her DD's abilities- says she can count to 5 for example which is something that noone else has ever heard and says she was crawling weeks if not months before she actually did.

She will have her 2 year review so maybe things will be picked up then if there is anything to be worried about.

The vacant episodes are concerning. Do you know which HV team would be looking after her? If this was me and the mother didn't appear to be doing anything about it, I'd contact the HV. They won't be able to say anything to you about anything, but might then arrange a visit or ask the GP to get involved. If medical services are already involved, then they won't do anything.

"I really would not say anything to your friend. She will most certainly be v offended."

I would so much rather offend a friend than prevent their child from getting appropriate medical care for what might be a very serious medical condition.

From your last post, I'd say your friend is well aware that her DD has some difficulties but is in complete denial. Someone I know who has a child with aspergers reacted very angrily to being questioned about things at his 2 year review and it really wasn't until he he turned 7 that she really accepted the DX - it took her a long time to come to terms with it.

I would just be there for your friend for when she is forced to acknowledge it - she knows there's an issue and that's a hard process to go through from what I've seen.

Cross-posted with you there.

"She will have her 2 year review"

Is that a proper review in your area? We don't seem to get them here and instead get sent a ticklist of things they should be able to do. If we have any concerns, we are then supposed to get in touch, but the HV doesn't come near. To be fair, even the 1 year review was a nursery nurse coming round to ask me questions but didn't want to see DS do anything, so I could have told her anything!

will she be going to pre-school soon? if so I'ld let the staff there flair it up!

but it doesn't sound like this parent will in any way act on what you say
I don't think the 2 year check will pick up anything as the HV can only go on what the parent tells them at the 2 yr check

Your friend sounds seriously in denial and you would be doing her a disservice if you went along with her on this. Put the child first and tell your friend that the HV has concerns, you have concerns and if the child is not assessed she is putting her at risk of harm, or delaying her development with potentially huge consequences. If she is assessed and nothing is found to be wrong, well that's great. If she's not assessed and does have epilepsy or any other condition, well I wouldn't like to be a friend who sat back for fear of offending the mother.

I was in exactly this situation a few years ago. The Health visitor had expressed concern. The nursery had expressed concern but friend had endless explanations why her ds hadn't reached his milestones (e.g. he didn't sit up or walk because he was too tall, he didn't ask for things or point because she always responded to his needs before he needed them ). I decided not to say anything because I think deep down she did see and realise there were problems but she had to come to the knowledge in her own time.

Years later she mentioned her ds being on the autistic spectrum to me as though it was something that she'd always known. I'll never know when she took this on board but I don't think my saying anything in the early days would have helped her or her ds.

Even if the 2 year review is with a HV, there's absolutely nothing to say the OP's friend will take her daughter, it's voluntary and the friend has already refused to accept the HV's advice/concerns.

Yeah within the last year or so, children from my local area have reviews at 9 months and 2 years which is quite thorough and involves a one to one meeting with a health visitor who assesses your child and ask lots of developmental questions, when my two oldest were little it was a check list sent out every year from 1 year onward. I believe this system was put in place because so many childrens developmental problems were going un-noticed and unchecked.

The two year review where I used to live (London) was a face to face meeting with the child and the HVs spent time talking to each of them individually before talking to the parent. So it would have probably have been picked up at my one. Didn't realise they varied so widely.

I wouldn't even know where to contact a friend's HV and I have no idea which GP surgeries they're registered at either. I think I would be much more cross if a friend 'reported' me to them rather than speaking to me directly though.

the 2Y review here is also a 1:1 where the HV comes to your house.. but it's still 90% based on what the PARENTS say, you can't make a 2YO say all thirty words it knows on demand like that so the child itself isn't really "tested", its all on the parents feedback to the HV

If it was suspected autism/aspergers, it would be a concern but perhaps not an emergency. Symptoms of epilepsy are much more urgent, surely? If the vacant episodes are caused by epilepsy and are at a rate of 2 in 2 hours, that suggests something quite severe.

Maybe your friend would find the suggestion of possible epilepsy less daunting and more medical than the suggestion of autism?

Bearing in mind that 'absent moments' can be associated with autism, only if you are genuinely concerned about epilepsy should you say anything IMO.

If anybody had suggested to me that my 18 MO may have autism then I think I would have instinctively looked for reasons why that couldn't possibly be the case, so it would be a pointless excersise.

Many youg children display symptoms of ASD which they do grow out of, or show delays but then go on to catch up. Autism is not urgent, and it will be picked up in pre school or primary if that is the case. Children with autism are different, not ill.

Im ot so sure that sounds like epilepcy. Many children do this when thye are weeing

It probably won't have any relevance here but from now on 2 year checks will have involvement from any early years setting the child attends, they are asked for input regarding the child's development in key areas.

I sympathise with your concerns, could you ring the hv and let them come up with an excuse to see her? Explain the nature of the situation?
All children are different with regard to milestones so I wouldn't be concerned about that but the vacant periods are as you say are worth being investigated

The child is very young and you are not in any sense an expert. I think you should keep your thoughts to yourself tbh.
There is no such thing as 'abnormal' fears at that age. Very young dcs will have all sorts of different interpretations and fears as their imagination takes flight. Obsession with certain things is normal for many young children as is hating to be touched as is limited speech. Symptoms that would be concerning in older children can appear and disappear in young children.
I've got one dc who definately had some quirks as a toddler - very little speech, rigid routine. She grew out of it - though still thinks she is right and the rest of the world wrong at times. Dd3 is often reluctant to make eye contact if you're telling her off. She'll look anywhere but at you.
Increasded awareness of autism is a good thing but it does cause people to see it everywhere in a wide range of quirky behaviour.
I know a child who has absence characterised epilepsy but he was older when it started. I think if that is an issue time will tell. There is no need for you to act now and you could harm your relationship with your friend seriously.

I would wait till the child is 3 as at 18 months they would very much be wanting to wait and see how things develop. A lot can happen between 18 months and the third birthday and it might just be that the child is slow to get going. Language and understanding develops hugely usually by the age 3 as you know.

If by 3 things haven't developed, it would be worth encouraging friend to see GP/health visitor. An earlier recognition of his needs means he gets to access the help and support needed. It is a slow process at the best of times.

She has probably noticed all these issues and is perhaps not ready to face them. She may have sought advice but not be ready to discuss them. Having been in your friends position I knew my dd was autistic long before I sought a diagnosis or even discussed it with my closest friend. I needed time to come to terms with it and to feel ready to take any action. I would concentrate on being supportive and positive about her dd. if she raises a concern then by all means speak up and acknowledge that there may be a problem. however it sounds as if you have flagged up the possible absences and your friend has backed aay from any discussions so I would leave it for now. I personally would not have welcomed being pushed before I was ready.