AIBU to ask my doctor if she thinks my 4 year old may be on the Autistic Spectrum

[FirTree31]

Hello, I'll try to summerise.

My 4 year old started school this summer, before this he was in a private nursery 3 days per week. During his last year at nursery I had to attend meetings every fortnight regarding his behavior, I also had to call in a Social worker (I do not have social work involvement) and HV. His behavior could be awful and they threatened to not allow him back due to safety concerns of the other children. His behavior did improve approaching the end of nursery through hard work of nursery and I. School have phoned once regarding his behavior also. Nursery seemed to insinuate that he may have autism so I took him to the GP who said this was not the case due to his being able to keep eye contact, he isn't repetitive and usually answers when his name is said.

However, I'd like advice on more subtle signs if possible. His tantrums continue to far disproportionate to what is happening, he punches people's, says threatening things, hits me with things, often does not listen, stamp, throws things, slams doors, and demands. His elder brother (9) has recently had two panic attacks during DS2 tantrums because of the way he hits me and shouts and screams. DS2 also used to have ticks (coughing and clearing throat) but this seems to have calmed down in the last few weeks.

I don't want to pathologise bad behaviour, but I don't know what to do. I am on edge often and absolutely dread if I have to reprimand or say no to DS2.

Fir please don’t think this is down to your parenting. Our son has high functioning ASD and has moments when things are extremely difficult for everyone. Getting a diagnosis helped us to change the way we do things to help him cope better. It is really, really difficult parenting a child on the spectrum and you are doing the best you can. As his mother you know your child far better than any professionals involved- if you feel there is something that needs pursuing do not give up. Our lives improved a lot once we started putting certain strategies in place. It’s not perfect and there are times when it feels ridiculously hard. Hang in there and pursue a diagnosis.

The eye contact thing really gets on my goat. I was told this with my DS. It was obvious he was on the spectrum from the age of around 2. He had delays in development. Lines things up alot. Got very fixated on certain things, loved spinning objects close to his face, had speech and language issues. Doctor told me he wasnt autistic as he could maintain eye-contact. On starting school it became more obvious and he is now very behind his peers academically. Finally after years of fighting he has an ASD diagnosis and we are in the final stages of EHCP meaning my son will finally get the support he needs. My DS is 8. I have been fighting since he was 2. Listen to your instincts and the school should be able to help. My school were helpful with referrals but I done the EHCP myself. HTH

M-Chat is still used here. If it's possible OP I would go private, GPs in general don't seem to get it, especially if they're going on a 10 minute consultation when they're not experts.

Thanks so much, I will definitely speak to the school and also diary his tantrums. He is social, he likes people and will very often tell strangers about himself. I also read the part on inhibition, he's gone outside to pee at after school club instead of using the toilet as an example.

OP if you are on Facebook it may be worth checking out the Autism Discussion Page. It has some strategies on it which can be useful in managing meltdowns etc - even if your son does not turn out to have ASD/PDA you might find something helpful while you wait for him to be assessed. I found it very useful for my DS (ASD /ADHD).

He sounds a lot like my son, he's 7 and diagnosed with ASD with demand avoidance (PDA but it's not officially recognised here). He's come on loads since we started using PDA strategy (quite different from typical ASD strategies) and he's doing really well in school. We got him privately assessed.

Ask a different GP for a referral. My daughter has ADHD and the GP did a referral then the school gets forms to fill in. Luckily we have a supportive GP and school but it can be such a battle.

I was going to say have you looked at PDA after reading your first post. There's a good PDA support group on FB if you use FB.

Oh and for God's sake get yourself on a parenting course asap... It will save time in the long run as that's their go to first option, you can then say we do xyz and there are still issues. They do like to blame the parent as the first port of call.

GP told me ds does not look autistic, post diagnosis by neurodevelopmental consultant.

Look at pathological demand avoidance. That is what came to mind from your description.

Tbh, a paed with a special interest in ASD saw DD2 at 5 and said that he didn't think she'd meet threshold, etc., and she was just a bit passive. 6 years later, she was diagnosed with ASD with very high scores.

Unless a child is stereotypical in their presentation, they'll very likely be told they don't 'look autistic'.

Whether it's ASD or something else (ADHD?) it sounds like an ed psych or developmental pediatrician is justified ... ask school for a referral as that creates an obligation for Local Authority to pay attention.

Could of course just be belated 2-year-old -ism but if the specialist has no diagnosis now and problem persists then in a year or two you go back. Some problems just take a while to define. But don't panic.

God this doesn't sound easy... Why is is such a battle for diagnosis? Why do they blame parents?

First step would be to ask for a paediatrician referral (every region seems to be different, but that’s how it works around here). My son first saw a pead shortly before he turned 3, and the verdict was watch and wait. A year later he was put on the waiting list for an ASD assessment. Eight months later we’re still waiting. It’s a long process but I’m certain he will get a diagnosis. School SENCO can also advise, of course.

I.don't think there,s a battle for diagnosis as such I think.it's more that unless a child is very obviously autistic they need to be absolutely sure before they will.diagnose ,my son was diagnosed at three and a half but he's severely autistic and has learning disabilities ,and it was very obvious some children will have more subtle traits and at a younger age it could be Asd or not ,my friend for example has two.son,s one got diagnosed before the age of three and is non verbal and goes to a special school but the older child when assesed was just under the threshold ,that doesn't mean he won't get a diagnosis though and he does have an EHCP just that there needs to be more evidence .

Sounds like my daughter. I went to the GP thinking she had ADHD. He referred her to child development centre based on my description of her behaviour alone (he is a great GP). We had already had nearly 3 miserable years at primary where she had loads of communication interaction and Ed psych input but no one had suggested any SN, the teachers must of thought I was stupid not to have figured it out. My DD is very articulate and chatty but extremely demand avoidant. Will make eye contact but on her own terms. She has an ASD with sensory processing disorder diagnosis. Would have been Aspergers a few years ago. I think she had PDA but no assessment for that where we live.

School has been extremely difficult and a fight at every step of the way. She is in mainstream secondary year 7 with a package of support and excelling at English and humanities. Maths is a world of pain but school have a plan to support her with that.

It's a mixture of things, really. There's a push for SEN provision in schools to cater for 'needs not diagnosis', which sounds great - you shouldn't need a particular diagnosis to access support. But many children have SN that are pervasive - they affect their whole life, and those needs are not necessarily purely academic.

DD1 has a brain condition. It gives her global developmental delay and as a result she goes to special school. All her needs are catered for because her school is geared up for a whole school curriculum. Things like periods, hormones and resultant behaviour, language issues... it's their bread and butter. DD2 has ASD and is in mainstream. They say things like 'it would be nice if you speak in my class', then I get an excited email towards the end of the year saying 'she spoke!!', then they change all her teachers and it all starts again.

ASD is complex, pervasive and fluctuating in its affect. It's no wonder people don't know what they're looking at.