Nursery teacher thinks DS has autism

[Percythelittletrain]

He’s been there two terms. I had a meeting today and they mentioned that they feel he may have autism or ADHD or both.

His speech is very advanced for his age, as is his understanding, so I didn’t expect autism at all. Obviously it’s just a possibility at the moment.

The reasons she gave were:

• Unable to follow three steps instructions, needs things broken down
• Puts everything into his mouth or rubs on his face (very sensory)
• Struggles with balance using obstacles outside
• Needs routine

He can draw and label pictures and say what he’s drawn. He can recognise most numbers and letters and can write some of them/blend simple words when doing phonics.

She’s going to talk to the SENCO and put some targets together.

Just wondering if anyone has any experience. I feel a bit overwhelmed.

Sounds very similar to my son at that age and he got diagnosed with what was called aspergers at the time but would now be ASD.
He was very able like your son, he could count up to 100 and had already taught himself to read before starting nursery.
The 'gifted' thing is sometimes a sign.

Have they referred for assessment?
Autism is a huge spectrum my son was non verbal in nursery and still is at 12 and in a special school ,but some children are very academically able ,I would speak to the SENCO ASAP regarding referrals etc

@x2boys they said they were going to see how he progresses and it may not come to anything or it may do.

Sounds good that they’ve identified needs so early. Have a chat with the senco to find out the normal procedures in your LA.

In many areas, referrals to paediatrics for an autism assessment have to go via a GP so this isn’t something nursery/school can do

Wow fantastic teacher to pick up on that, many wouldn't when it sounds like he is high functioning. Mine was similar and it wasn't picked up till nearly secondary age, he is still very advanced and predicted all 8's and 9's for his GCSE's - being very advanced can be a sign. Just enjoy him for who he is would be my advice, encourage him in all the things that interest him, get him used to as many different experiences as you can while he is young, support him socially but let him have lots of space and time out if he doesn't want to be social. Oh and the balance issues could possibly suggest dyspraxia - mine has ASD and dyspraxia - I don't see anything here to suggest ADHD though. If he struggles with hand writing and is quite clumsy then I'd definitely think dyspraxia - how is he with a knife and fork?

It's overwhelming when you're not expecting it - I was the same! But it becomes normal and you've never known them any way other than how they are. You'll be ok, just read up as much as you can - I'd look at aspergers, that's the diagnosis mine got although it's not really given now I don't think. Have fun with him and don't worry too much about the diagnosis.

Tbh I would still want a referral because nursery staff are not qualified to say definitively whether it is autism/ADHD or not

I would say he may need a speech and language assessment if he struggles to follow instructions and needs them broken into smaller parts. This indicates his understanding may not be as good as you think. A speech therapist could assess him and advise. I would visit your GP and ask them to refer him to either SLT or paediatrician

@WhenIgrowolder

Thats the thing that puzzles me, he doesn’t seem to struggle following instructions at home.

She gave an example of he would struggle to follow:
Wash your hands, get your coat on and line up.
He seems to get easily distracted, not that he doesn’t understand, in my opinion anyway.

How old is he? 3 step directions can be tricky for 3 year old. Would expect 4 year old to follow them. As you say he may just struggle to follow instructions given to whole class but is ok with one to one instructions at home. Often it is due to difficulties with attention and listening and not necessarily understanding

He seems to get easily distracted, not that he doesn’t understand, in my opinion anyway.

I guess that’s why ADHD has been mentioned then.

My DS was similar, very bright, taught himself to read with minimal help from me before he started nursery, very fixed in routines etc and sensory issues. He is undoubtedly on the spectrum but didn’t want any diagnosis or assessment by the time we figured this out. It’s not always helpful to label people and it may be that his divergence is a blessing. DS now has a job where his memory and recall of facts and figures is a huge help and in fact I suspect anyone who does this job is probably ASD!

Please take any help/input that they'll give. If he doesn't have autism/adhd then he won't get diagnosed and no problem. If he does then great you've got a nursery willing to support and get any help for him they can. My ds is in reception and did 2 years at school nursery I've just got the school onboard to start the referral process I think at the end of reception. Like your son he is bright and excels in many areas but he struggles without routine/planning/preparation

I would follow through on this - might come to nothing
Nursery highlighted that our oldest might have difficulties- and my DH bit there head off so badly they refused to discuss it ever again. I tried to ask them, and they blanked it.
My DS is more or less ok - but he’s definitely dyspraxic - I can’t help thinking maybe early help would have stood him in good stead.

They are only young for a very short time- you need to be aware of future needs

It's not a label it's a diagnosis ,and for many people it's not a blessing ,to get a diagnosis there has to be significant impairment in the in social communication, social interaction and social imagination ,and whilst many people may not see it as a disability, minimising it helps no one .

This. I'd be talking to a HV and asking for a referral. It can take a long time

make sure you get his hearing and eyesight checked just to exclude any complicating factors, as following instructions and balance issues can both be a result of a number of different issues ...but otherwise good that they are on the ball and mentioning it even if it comes to nothing. Have a chat with your health visitor , sometimes this age group can access free groups that may help to expand the picture better eg. speech and language groups.

We had similar about 2 terms into nursery with my DS (which surprised me at the time). He's 7 now and looks very likely he is either got ASD or ADHD. I think it can be difficult to know for sure that age unless it has a very big impact on functioning but worth keeping an eye on. Left it too late with my older DS so he is stuck on the waiting list fir diagnosis although starting secondary imminently.

@WhenIgrowolder Yes. He’s 3. He’ll be 4 in October.

@CrowUpNorth

Can I ask how your 7 year old is doing now?

Does seem
young. She may be right she may not be.

I got called into nursery as they were concerned about DS’ development.

Was completely off the mark, he’s now sailing top of the class at age 7, advanced, zero development issues (in fact the opposite!) He’s very young!

I guess it’s a wait and see thing now.

He’s very articulate and able. Very sociable and confident. I just wasn’t expecting it to be honest!

Working with a lot of children you can usually pick up which are outside of average in a given area of decelopment. I can pick out children with likely ASD or ADHD now within a few sessions of working with them. Some will be clever and high functioning but there are still signs they need support in other areas. Early diagnosis simply means they get targeted support so they reach their potential in all areas. Accept the support the nursery are offering and get some referrals in place so you know for sure.

OP I work in autism assessment. Just a word of warning, we have had almost a quadrupling of referrals of children, esp under 5s, for ?autism assessment. Many of these are children who have spent almost their whole life up to September in lockdown and esp in only or eldest children we are seeing a lot of children needing more time to develop skills of negotiation, play with others, sometimes language, and attention skills. In many cases these children will develop these skills and are not autistic.

For this reason you may want the setting to put in goals and targets and see how he develops. Or you might want to get him on a referral list, but be prepared for a long wait.

The instructions thing can be hard to unpick.

It's easy to think if you tell a kid to do x y and z they are doing it because they understand.

Often it's because they are always told to do x y and z for that activity and it's a learnt response.

I would take everything offered. Some of us with children who have autism and/or adhd have fought a system for years before anyone will even be willing to notice the differences in learning style and ability being pointed out.

My son has severe autism and learning disabilities, he was diagnosed at three ,there is often a wait and see approach at that age unless it's abundantly clear ,a child will not be given a diagnosis unless they have autism which is why it can often longer to get a diagnosis .

My daughter was very advanced with her speech and could read fluently by the end of nursery self taught we knew she had some sensory issues but had no idea she could have autism. Nursery flagged up some problems with following instructions, changes in routine and she has since been diagnosed with asd. They gave us amazing support and my daughter is excelling at school. Nursery staff are trained to pick up on these things.