Best friend's DS - should I say anything?

[BeKindToYourKnees]

Not so much an AIBU, more WWYD?

I think that my dearest friend's DS, who has just turned 3, may be higher on the Autistic Spectrum than average and/or have SN.

I noticed when he was 18 months old that he didn't want to engage, play or make eye contact. He cannot speak yet (although his parents do seem to understand his vocal noises) and has never been seen by an HCP.

My friend has never taken him to any baby/toddler groups and last night I was caught between an argument between his Dad (who wants my friend to take him to sociable activities and his Mum (who doesn't).

I didn't know what to say

I agree with Poltergoose.

I also think if the Mum is reluctant to take him to groups, then she is most likely already aware of issues and putting a name to them and getting support would be helpful.

Faster diagnosis has a better outcome in the long run.

PolterGoose Absolutely understand what you mean by 'seeing it'. This is how I feel about my DF's son. Good on you for getting your son the extra support that he needed

I would say something but tread carefully. To have no recognisable words at two yrs old is not normal, never mind three. He might be a genius and about to start spouting poetry, but it's more likely he has some hearing or developmental problem and would benefit from speech therapy or additional support. You shouldn't attempt to diagnose him but I'd definitely suggest they approach the GP or HV to get him assessed. How has he not seen any HCP in 3 years? If it's not picked up until she has to send him to school next year he'll have missed so many opportunities for early intervention. Will he be taking up a nursery place in September if he's just turned three?
Why shouldn't Dad suggest he is taken to some sociable activities? He's not trying to micromanage their whole day, he's saying isolating him from interaction with other children is not helping!

Also, if he is not going to any groups and he is not in contact with any HCP, if you don't say something, who will?

I'd have to say I disagree with the "say nothing" advice. If you are correct that the child has special needs, early intervention is absolutely critical. The earlier he receives the help he needs, the more effective it will be. I absolutely understand you not wanting up upset a friend - and goodness knows you'd have to be delicate - but I think you need to put your own feelings aside and think of this child.

I would be absolutely beside myself with regret if a child turned out to have a condition and I had noticed something months or years earlier and said nothing. In a similar vein, a friend's daughter has an eye that often turns to the side. I mentioned it to her mum - very gently - and mum hadn't noticed it. She was very grateful that I said something, and her little one is now getting treatment. Which would be less effective, the longer it went untreated. I'm afraid I can't understand ThreeBeeOneGee's perspective at all.

If he's going to start nursery they will help with the potty training and are in a position to refer if there continues to be speech issues.

To have no recognisable words at two yrs old is not normal, never mind three. He might be a genius and about to start spouting poetry, but it's more likely he has some hearing or developmental problem

Not necessarily. And it's not for the OP to judge.

I would perhaps open up the conversation by asking her why she doesn't fancy the groups. If it's because she feels uncomfortable perhaps offer to go with her. If it's because she's worried about her DS being 'different' and people noticing say you'll go to GP with her and discuss getting some speech support. That way anything you say is because she began the conversation.

My DS has suspected ASD and has been referred for assessment by Camhs. He's always seemed 'different' and clearly had social difficulties and anxiety for a long time. However all school seemed to want to do was tell me about what he's done and when I've said he needs support and asked for it it's not been forthcoming. Eventually I begun to be very 'open' about DS struggles and a number of people have said they thought DS has aspergers. (as I always have done). For me, that was the time I thought/ felt validated and didn't feel alone and sought help.

I am really not judging, just asking how best to support my friend.

Could the dad not take him at weekends to soft play or swimming etc. Is the mum quite shy or perhaps had a bad experience at a group in the past ? do you have dc of similar age and could take them along to any groups with you. You shouldn't suggest any particular diagnosis nor nag to go to GP/ HV about it specifically. They may find a private school won't be best place to support him though and quite rigid so worth suggesting they keep options open for him longer term.

I think if the parents are specifically asking you what you think, it's fine to tactfully suggest they talk to their health visitor or GP.

Sigh, everyone seems to think they can diagnose kids on the spectrum these days, it's so tiresome.

Ok. 'Higher than average on the Austistic Spectrum' - you either meet the threshold or you don't. Some people argue that we're all on the spectrum but it's a load of tosh. You either have a triad of impairments or you don't. Some people have elements of the triad but their strengths in other areas allow them to function adequately in society.

People with autism or aspergers (now not diagnosed because the DSM V manual has classified all variants of Autism to be just 'ASD') have enough difficulties in all three areas of functioning to cause them difficulty in society.

That aside, if a child has SN they have SN and whether it is diagnosed or not simply means that they either get the help they need or they don't. People who think that children are 'labelled' with SN don't realise that it isn't a moveable feat. No-one but no-one would suggest that a person kept quiet if they thought a child showed symptoms of meningitis. No-one but no-one would suggest that a child was denied treatment for a broken leg.

This isn't about saving a mother's feelings. This is about a child getting the help they deserve.

When my DD started preschool I was approached by the staff within 8 weeks, asking if they could get her observed because she was 'a bit behind'. Long story short, she had significant SN, is now at special school and is functioning at around 3-4 years old at the age of almost 8 years old.

Someone spoke to me when she was diagnosed and said that she had thought she may have SN, but was advised by someone else not to say anything because if it were so it would be 'picked up.'

You know, when I thought I was a terrible parent because I had to take a portable stairgate with me to visit a friend, or spend the whole time chasing her up the stairs to stop her playing with soap, shampoo, etc., it would have been super handy to know that I wasn't the worst parent in the world.

DD1 would not have got the help she did if I let people 'pick it up' by the way. Once she was in the system, the Area Inclusion Co-ordinator thought she was just 'immature'. I had to fight, but finally she got into a special school. The same special school which is absolutely full to the brim each year now.

Edendance: "I'm going to go against the grain here... if there is a SEN at play here, the sooner it's diagnosed, the better."

Agree completely with this. Of course, the problem is that unsolicited opinions and advice are always unwelcome, so the OP would need to be extremely tactful. But it does sound like the child has problems. I also wonder why the mum isn't taking him to playgroups etc? Very odd.

I wouldn't say anything but really encourage her to get to take him to groups, nursery etc. My DD was 3 when a really good friend who was a nurse said she thought she might have Aspergers.

I shot off to the HV who decided there wasn't a problem and I was very very upset. However one house move, a new HV, starting reception and it became obvious she had Dyspraxia so friend was picking up on something, she just wasn't sure what. We're fine now but I will admit to having some dark thoughts at the time after the HV said she was fine.

True, Polter, but it will go, I think. Also, with the diagnostic criteria changing, there are children that would have been diagnosed previously who won't now, etc.

WynkenBlynkenandNod I know that feeling. HV said I was neurotic. Physio said I was neurotic. Area Inclusion Co-ordinator said she was just 'immature' although needed 1:1 support. Paed said 'We'll do an MRI but I don't think it will show anything, although she is behind.' 3 months later, Paed said 'Oh. MRI did show something after all....' Roll on 18 months, Special School. Now, end of Yr 2, still on P Levels for everything except maths (1c).

Suggest she takes him to GP for referral to speech therapist or account of slow speech - I said this to my sil who didn't realise her dd's speech was problematically slow. She has got help and has made good progress.

I'd be more concerned that your friend doesn't want to take the kid out etc. and never seen a HCP, what do you mean by that? As in relating to speech or more generally?

A great many difficulties occur because lots of people think it isn't their place to say/do anything, they don't want to rock the boat etc.

Most people are understandably upset about anything that appears like criticism of their parenting. However if I a) had a close friend and b) had concerns about their child not getting what they needed to flourish I would not feel like I had been a proper friend unless I had tried to say something.

Maybe it needs to be framed with lots of reassurance e.g. 'You're a great Mum' and 'All children are different and develop in different ways'. But I'd still want to say something about Reception Class being just over a year away - and wanting to make sure that was a positive thing for the child, sp it could be worth getting a bit of professional advice about helping them to get read. Because as things were at the moment it seemed as if the social side of Reception - talking, listening, being in a group - might be a bit much. Etcetera. Etecetera

You do need to get to the bottom of why she isn't taking him to groups &c. Whether it would be "picked up" there or not, it would give her a chance to see what other kids do and make comparisons. That may be why she isn't taking him, ie she has some inkling there's a problem but can't cope with thinking about it yet, or maybe is concerned what will happen if the problem is spotted - I have met people who kept their SN toddlers in the house because they thought if they were diagnosed they would be taken away from them and locked up (!) Then again, she may be protecting him: he may get stressed going out with other kids and she may feel he's genuinely happier at home. And she may well be right, whatever Dad thinks.

Is it all of a piece with him not being seen by a HP? Do you really mean not seen by anyone at all, were there no regular development checks by HVs in your area? Or were there checks and she deliberately refused them?

Fwiw, I don't think you can tell her what you suspect, at least not in those terms, because you could be wrong and if you are it's going to be hugely traumatic for her to no purpose. But encouraging her to get him seen by a professional is a different thing. There are good reasons for this even if there's no underlying condition to diagnose: if this speech delay continues he's going to have problems when he starts school, and SALT services typically have long waiting lists so actually she needs to start pretty soon. If it were my friend, I'd be advising her to get a GP to refer him to SALT to see if they can bring his speech on a bit. If SALT notice more going on than just the speech issue, then they can refer him on. And if they don't see anything more than that, well that's good news, isn't it?

Say nothing, it's not your place.