To ask you if my almost 4 year old has autism

[WorriedMum11]

I feel like my almost 4 year old daughter has autism. I’ve name changed and also I have an older daughter and I try not to compare them but I look at other 4 year old girls in my almost 4 year old DD’s nursery class and think she is possibly on the spectrum. My husband thinks IABU and these are typical behaviours for a soon to be 4 year old. She’s 4 next week.

I have read that AuTism can present itself differently in girls to boys.

• labels and sleeves these scratch her and feel tight. She won’t wear her nursery jumper because of the cuffs. I have to lie on cold days and say the teacher says you have to.
• at night will only wear shorts doesn’t like material on her legs
• won’t wear certain colours e.g green. Is adamant she doesn’t like certain clothes - I have so many clothes I have bought her thinking she would wear them and she doesn’t. It’s the same old skirt and top she’s happy to wear.
• I almost feel like she tries to fit in at nursery. I sense the exhaustion in her at home. When she’s home she has her meltdowns.
• she has one best friend and obsesss over her all the time.
• she struggles to be out of routine. She’s still in pull ups at night and likes to wear knickers over her pulls ups - if she doesn’t get knickers it’s a meltdown
• she does pretend play but it’s like she feels she has to play like that rather than wants to and does a fake American accent (maybe too much barbie and an older sister)
• goes to ballet with a group of girls in her class and doesn’t sit or talk with them
• does stuff if she knows it’s a rule. E.g at ballet wouldn’t stay without me until the ballet teacher said no sticker for her and then because she knew she would get a sticker would stay with out me.
• refuses to any other class other than ballet
• will only do swimming lessons one to one
• copies her older sister - hasn’t found herself
• if people don’t play her way has a meltdown - conversely she will generally easily share
• obsessed with one little toy rabbit to sleep with
• can write her name but refuses to learn other letters or sounds
• feels she must be compliant and so should others e.g will have a meltdown if she feels her old sister is doing something ‘wrong’ or not the right way

All her teachers / learning assistants say she is fine interestingly her group leader at nursery has said she knows when DD is about to have a meltdown and so she said she’s built up different ways to distract her if she does as she’s realised she’s sensitive.

So am I worrying about nothing? She plays dolls, shops, likes her scooter and playing in the park. She wants a pink butterfly and diary bedroom like her big sister.

If you do feel I need her checked out/assessed who do I speak with? Can I get it done privately?

Sorry for the long post but I need to speak to DH and he’s not having it and thinks IABU and she’s a regular almost 4 year old girl.

Hi, I didn't want to read and run. I have a 6yo DS with HF ASD, and I know it presents differently in girls, but some of the traits and behaviours you describe are ones that he has as well, and that he did have at 4yo. The things I recognize are the rule following, unimaginative play (he tends to work off 'scripts'), and the masking at school/letting out emotions via meltdowns at home.

If you are in England and your DD will be attending school soon, it is worth asking for a referral. I have heard it takes a long time and sometimes requires fighting for ASD diagnosis in some local authorities there. (We were in Scotland, so I cannot help there.)

Thank you I’m not sure how to tag people I do t have the app.

I do feel like she masks at nursery - I can’t be sure. But I’ve arrived at nursery and she’s in a corner playing on her own. I think she’s very strong willed. Likes people to play her way or the highway literally so I think would struggle to keep friends.

Rule following too - nursery would describe her as sensible. She dislikes ‘naughty’ children. They call her sweet.

I feel like I’m on edge trying to manage her meltdowns and worry when the next one is coming.

I manage the exit out of school in the morning ensuring everything is exactly to routine - if anything goes out of routine I’ll have a meltdown at the door before we leave.

My 7 year old daughter was never like this

The bit that stood out for me in your post was this

I almost feel like she tries to fit in at nursery. I sense the exhaustion in her at home. When she’s home she has her meltdowns

This describes my friends dd to a t. She is 12 and has recently been diagnosed. She has masked it for years through copying behaviours and social mimicry. She holds it together outside the home and most people don’t realise she has autism. At home she lets the mask drop and has meltdowns.

However, it could also be that your dd is only 4 and is finding nursery tiring, over stimulating and over whelming.

Is your nursery attached to the school she will be attending? You could ask to speak to the SENCO there to ask them for help and advice.

Yes I mean this is my interpretation. So I’m not sure how much of the same child she is at nursery as she is at home.

She is in wraparound too at the school - it’s school nursery.

She could be tired. She goes in wraparound 3 times a week twice until 320 and once until 6pm because of my work.

When she’s home she lays down on the sofa wants peppa and just wants to rest. Everything is more carefully managed for her -

In saying that she loves Moana and Frozen too - but will mainly only wear dresses or skirts.

I’ll ask school about SENCO thank you. She starts Reception at the school in Sept.

Yes sounds like HF ASD,
Not so much the sensory stuff, because anyone can have sensory issues, but there’s a lot of things in your post that mirror my DS’s ASD (although he’s moderate, not HF)

You can get it done privately, ours cost around £7k, we had it done in Kent. She’d need to be seen by a team of professionals as part of the diagnosis, but a paediatrician will give the diagnosis.
If you want to go NHS, depending where you live this can take 3 years or longer & you start the process by going to your GP to get a referral.

I have a DD now 20 with autism (high functioning) and yes, the challenges and issues you are describing could possibly be attributable to ASD and she displayed similar behaviours. The fact you are sensitive to her difficulties is really positive. The sooner you can get support in place the better for all of you. Speak with your GP and the nursery about your concerns and don’t be fobbed off. If you can seek the advice of a clinical psychologist who has experience of girls and autism and get a full observation/screening and appropriate support put in place. Read as widely as you can and inform yourself. You are absolutely correct in the masking and meltdowns, masking is exhausting for your daughter and it takes a huge mental toll. She is lucky to have you as a such a sensitive Mum. My DD was diagnosed very late, life would have been so much easier for her if we had known and she had had more support. Please private message me if you would like any more support or info. Good luck.

Not sure op it's such a strange age they have so many hormones thrashing about.

Re materials I was super sensitive to them as a child and my dc are as well.
One time dd literally ripped a dress off and is sensitive to fabrics.

Thank you for your help. I just know she is because I feel like I’m constantly working around stuff/life to make things less distressing for her and my DH does it without realising. Even my 7 year old does it she’ll say things esp to my DH like Daddy don’t do that because you know DD2 will not like it done that way.

Car journeys are another problem honestly my eldest was nothing like this and I’m really worried about my younger one. Even when she was with her Childminder last year I knew it then.

It’s like I’ve always known.

I will look into matters and will PM.

I just googled and got these points from an article

Not wanting to play cooperatively with female peers (for example, wanting to dictate the rules of play or preferring to play alone to maintain control) - this is her she wants other kids to play like her if they don’t she gets frustrated BUT sometimes she will share but that makes me sad because I feel like she’s sharing to fit in- to feel it’s the right thing

A tendency to ‘mimic’ others in social situations in order to blend in - totally does this so she’s playing with her older sister at home and will be her shadow in play and speech - I can’t see she is actually being herself ever

An ability to hold their emotions in check at school, but be prone to meltdowns or explosive behaviour at home - literally leg thrashing crying over the pull up this evening and my DH will let her tantrum but I won’t ill listen to her as she’s distressed she’s not misbehaving I see she’s struggling.

Strong sensory sensitivities, especially to sounds and touch (for example; clothing tags, socks or even deodorant). - clothing and smell

She sounds a lot like my 5yo DD, op. My eldest DD was 15 when we finally go her diagnosed (privately), and for years I'd been saying how similar 5yo DD was to 15yo DD at the same ages. When she was diagnosed, I was like, "...oh...".

I found a doctor in Australia that specialises in girls with autism, and she has a checklist for preschool girls. www.google.com/amp/s/taniaannmarshall.wordpress.com/2013/06/22/first-signs-of-asperger-syndrome-in-young-girls-pre-school/amp/

My 5yo DD hits about 90% of that checklist. I spoke to school straight away and she now has an assessment in a couple of months. I'm convinced she is on the spectrum ; family/genetic links already there, plus she has digestion difficulties that are also linked with many asd children. The pieces fit. At least my little girl will be diagnosed at the beginning of her school life rather than at the end of it like my eldest.

Understanding of girls with autism is improving, but we have a ways to go yet.

My DS has Aspergers Syndrome. The traits you mention are very similar. I was robbed off by health visitors, doctors, nursery staff and even a special nursery he attended which was supposed to observe him and were supposedly trained in spotting ASD's all said he was normal and had no signs of ASD's.

First week in primary school I got a call from the head teacher asking to meet me. Turned out they thought something was wrong!!

School refered DS to children's mental health services and over his year in primary 1 he was observed, interviewed and tested and by the end of term he was diagnosed.

School told me it's always best if the school refers your DC because it gets delt with much quicker than a doctors referral.

'fobbed off', not 'robbed off' 😊

Digestion problems!!! Yes - she will only poo every couple of days and dislikes her poo- the sensation of having a poo. Has often said that poo isn’t my poo it’s someone else’s to almost disassociate herself from it - I wasn’t sure if that was normal!

I would say that it certainly sounds as if it's possible.

That said, would it make you feel better or worse if you were to get an official label? If she's high-functioning, she's unlikely to qualify for any extra funding. It sounds as though you are already making allowances and adaptations for her 'quirkiness,' which is great.

Do you think she is happy?

My ds is 3 almost 4 and is diagnosed ASD he is in nursery and is perfectly normal there. It's amazing how he puts on a "front" I suppose. Other than his obvious learning delays. He's trying really hard though. They do sound similar in some ways. I recently attended a post diagnosis course and they said in girls it can sometimes come across as anxiety which is why girls are harder to diagnose. We started our referal through the health visitor we went onto speech therapy and then via the paediatrician. I'd try senco at school first. I wouldn't go private until your OH is on board or if you aren't getting where you want to be quick enough via the nhs.

Hi OP I have a 4 yr old with HF ASD and some of what your post says sounds familiar to me.
My DD gets by by copying and mimicking others. Whilst she pretend plays she only ever acts out situations she's seen in real life, read or watched. When she's been somewhere or even just to school she's exhausted emotionally and tells me she needs quiet time and will go up to her room for half an hour or so a little bit like your DD.
She's never been too worried about clothes but certain noises can upset her. She's also v controlling and likes to do the same things over again, watch the same programmes, eat the same food. Opposite way round to you but now my youngest is growing up more I can also see how different they are.
My DD was referred by the senco at her nursery which is how she was diagnosed just before she turned 4. It doesn't sound like your nursery are too concerned. Could you share your concerns with your HV perhaps or your dr?

My eldest is sitting her GCSEs this year. She wishes she'd had ab official diagnosis sooner, if only to obtain a bit more help from school. They've been great since the diagnosis, but she struggled as she got older, and the pressures of secondary school plus socialisation and the "weirdness" of other teen girls just got too much.

A diagnosis helps open doors and gives both the parent and the child a vocabulary to advocate for the child's needs. My dd can now say "I have autism and this makes me uncomfortable" which has been hugely helpful for her.

I am very much "pro" diagnosis.

I don't know, OP. Could be autism, but all of those could be normal behaviours in a four year old. Lots of four year olds have tantrums if they don't get their way, pick clothes they don't want to get out of, fixate on small discomforts, care more about what teacher says than what parents say and are exhausted by the school day. They're just getting to a stage when they can do things themselves and lots fixate on the things they can control because they're so helpless still in other areas and that frustrates them. WRT the social element, I had no friends until year three and really had trouble fitting in. Some NT kids are like that too.

If it were my child, I'd wait and see, personally. As her peer group ages, any symptoms will either stand out more or fade as she matures. I think as awareness of autism grows, people think about it and look for it more (I've caught myself doing it with my DD) which is good in some ways but can also cause unnecessary worry.

Gosh I read that list and now I’m worried about my 7 year old!!!! I need to send that to my husband.

What would a diagnosis do? What help is given? I think generally as a family we have become sensitive to her main Group leader is sensitive to her. So I should speak to the school?

My eldest may well have to be another thread!

Also took ages to get DD fully toilet trained. It took until the summer holidays before she started school that she finally cracked it!

I have a dd 11 who presents very differently, in a more traditional way. But it sounds like your dd is displaying how typically Autistic girls display with the masking and mimicing. Therefore because they do that, it can be harder to diagnose.

My dd is 7 with ASD. I'd say she shares about half the traits you mention but also recites huge chunks of stories and doesn't mask well, does just not understand social rules or games.

She's not considered HF or Aspergers yet she does manage at school without support now she's in year 2. Mostly she just seems emotionally immature, really less mature than her 5yo sister. This is the feature if autism that made the most sense to me - we were told her emotional age is third less than her actual age.

I'd pursue a diagnosis. It was worth it for us though quite painful having it confirmed dd would not grow out of her 'quirks'.

Yes also to the digestive problems and yes, we worked around her and make allowances as a family without realising to the extent we did so (and it came at a cost) We would call her our parenting challenge and also tiptoe around/arrange things to avoid what we called her ‘meltdowns’ which in her case were with drawls and shut downs emotionally when things were too overwhelming for her. When I finally began to suspect (at around age 15) reading the descriptors developmentally of girls at different ages was gut wrenching, she pretty much ticked every box. Trust your instincts and get support.

Have a read of what Tony Attwood has written about girls with autism, what he says make so much sense.
I knew my daughter was different at 2.5 but it took until she was 9 to get a diagnosis.

Even if your DD doesn't have autism, some of the techniques for sensory issues and meltdowns might be helpful.

A diagnosis is helpful to get support when needed, and for your DD to understand herself and not just feel different, especially important as she gets older.