Does this sound like my son is autistic? 19 months old! Help please.

[momof3boys5]

My son is 19 months old. He says around 10 words right now, but he does babble all day long. I’m slightly concerned at the lack of speech but he’s my first born so unsure how speech develops in this age, but by what I’ve read it seems ok to have around 10 words right now. I’ve been on the Mchat screening for autism as I’ve seen a few people recommend it and after answering all the questions he scored a 0 which is the lowest risk. He points to show me things, to what he wants, he gives me eye contact, he’s affectionate, he’ll role play answering a phone, or he’ll watch me hoover and grab his little hoover and clean to. He’s smily, expressive. Loves other children.

⁃	Lays on the floor sometimes to push cars around. I’ve read somewhere this can mean autism? Something about the way a child views a toy. He only does this occasionally. But will move onto his front and says brum as he pushes them.
⁃	Last few days he randomly walks on his tip toes, happens for about 5 seconds and then he won’t do it again. He’s never done it before? Don’t know why he’s doing it now all of a sudden. He’s been walking since 11 months. 
⁃	Has started to line things up. Is this a schema that all children go through, or is lining things up a link to autism? He lines his  cars and dinosaurs up the most.
⁃	At nursery he will join in with the other kids but plays along side the other children/alone a lot of the time, but apparently children his age play along side each other. He only goes 1 day a week, so it’s still all new for him. He was 6 months old when lockdown began so didn’t have a lot of socialising and he’s almost 2 now, he does brilliantly with how little he was able to socialise with other children. 

Is he just a toddler being a toddler or is it something I should be concerned about? Members of my family keep making comments and it makes me so anxious. Advice please, feeling super worried and just need some advice.

@momof3boys5

I presumed lining things up was an sign of autism, same as tip toe walking and playing alone rather than with company. Are they not symptoms then?

They are all perfectly normal and common behaviours. They would only be flags for possible concern if they were happening alongside a whole load of other signs.

There are no behaviours that are exclusive to autism.
Every trait is seen in neurotypical people.

@Mayabay yes/no is social language, putting across needs and wants. So that’s a positive sign for the development of language. He understands more than he can say, but finds it difficult to follow basic instructions?

My advice to you would be get good early help now from an SLT, so many good practical ways of letting his language flourish. Most of it involves taking his lead - don’t talk over him - get down to his level - if it’s one words he says - also speak to him in one word - slow it down and allow him loads, and loads of time to respond. Play with him patiently.

Get some good OT to help with those physical needs - again it should be all play but things like trampoline, core strengthening or whatever the OT assessment says.

That is really what most of the support for autism is, speech and OT. Low stress environment. Refer him for a diagnosis but it’s not necessarily autism, but just to cover that just in case.

I presumed lining things up was an sign of autism, same as tip toe walking and playing alone rather than with company. Are they not symptoms then?
No, as lining up can be pretty common, as is tip toe and playing alone. However all of these together and marked social struggles / speech / development delays / rigidity.

However the diagnosis is really, really broad now. As a teenager or adult you could have zero speech delay, no motor delays, but feel different /socially struggle and be diagnosed with autism. As a child the bar is actually higher, as usually parents won’t bring their child in unless they have a significant delay or struggle that is noticeable to a fair degree. There are assessments such as DISCO and ADOS which have been validated where you have to score on a certain level - and they will ask about things like speech, lining up, toe walking and a lot of other things - well ADOS won’t it will look at your child playing with toys and see if they can play imaginatively, respond to speech, see how they interact.

But people are diagnosed without using these formal assessments also, esp as children get older, and there is pressure not to be too ‘strict’ as girls for example do not show most or many ‘traditional’ signs. So in a way there is a blurring between what used to be ‘classic autism’ = always had a speech delay, significant differences. And the now not used ‘aspergers’ or not classic autism = much, much broader range.

@Mayabay Do also remember that lots of things that are symptoms of autism can also be nothing to do with autism. For example, I had really strong sensory issues as a small child. To the extent of absolutely refusing to wear certain clothes (I can still remember how horrible they made me feel) and also had to have my hand held extremely tightly if it was held at all etc etc. I also had to go to a speech therapist as my language was delayed. Both of those are classic signs of autism but they weren't autism. The sensory issues I grew out of, the speech delay was fixed with language therapy. So I wouldn't worry overmuch so long as your son is getting help with the things he is struggling with and that help is appropriate to him.
If the speech therapists express concern, if the speech therapy doesn't seem to be helping (obviously give it time) or if he shows other signs then I would push them to investigate further.

He's probably walking on his tiptoes occasionally because he's just learning how!

@momof3boys5

I presumed lining things up was an sign of autism, same as tip toe walking and playing alone rather than with company. Are they not symptoms then?

At 19 months old, these are not symptoms by themselves of autism, no. I have two autistic children but they are both very different in presentation. My older one wasn't diagnosed until high school and actually did all the usual pointing, social smiling (seemingly) that you don't expect with autism, but had issues with moving between activities and routine changes. My youngest didn't point or wave or make social eye contact and speech and social communication was so behind what was expected at 20 months, so for them it was more obvious, and it was diagnosed under age 3 in that case. Nowadays both are doing great. You need to keep a watchful eye while trying to enjoy your son.

My boys all loved lining up cars and lying on the floor playing with them. One also toe walked (but could only toe walk) and was found to have hypermobility. None are autistic, as teenagers.

Ya it’s so hard to know.
My sons early years teacher said that so many of the children who started with her in September are delayed socially due to covid.

So hopefully he will pick up more skills soon and learn from the other kids.

I agree with what is said in that anything you google and autism comes up.

Sorry got cut off.

My husband also had huge sensory issues and was a label rubber. He also twitches when nervous.
I had a huge aversion to most foods as a child.
Lots of us have traits that could be defined as autism I guess

@momof3boys5

I presumed lining things up was an sign of autism, same as tip toe walking and playing alone rather than with company. Are they not symptoms then?

Lining things up can be a sign of autism... but also cars do line up in real life so it's normal to line them up.

It's more than lining them up. It's lining unusual things up, say all the pencils they can find, then doing the same for shoes, then the buttons form the button box... and then getting distressed at one being moved. Even all those things can be normal toddler, but it would be that combined with things like not pointing and lots more.

Tiptoe walking, sounds like he's just found he can do it.

Playing alone is normal at 19 months, they then start playing along side, but playing with another child is something that comes later.

I know you're worrying, but it doesn't sound like anything to worry about now.

Step away from Dr Google. Your son doesn’t sound autistic.

The problem is he's 19 months and at this age it is really hard to know if it's autism of just them being a toddler. Make a note of the things you've noticed so you don't forget and just wait and see. Don't spend your time worrying about all the time just enjoy your time with him. Lining up cars could be a sign - it doesn't have to be things that aren't vehicles or everything he touches although if it was autism it would be unusual if he was happy just for you to put it all away, he probably wouldn't want it touched. Tip toe walking could be a sign or not. Playing alongside is perfectly normal. Watching the cars at eye level could be normal - spinning the wheels and wanting to watch them would be more typically autistic although my son never did that or line anything up so it varies a lot.

@momof3boys5

I presumed lining things up was an sign of autism, same as tip toe walking and playing alone rather than with company. Are they not symptoms then?

I think that’s if the lining up becomes obsessive or is the only way the child plays. Your little lad sounds like an average toddler to me.

Hi hope all is well x
how your son doing now ?