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.

@Favouritefruits I’ve been told about hyperlexia before. About 6 months ago he was completely obsessed with letters and numbers and even took letters to bed with him.

Sounds like my two ASD kids. Very articulate, advanced language early. Almost formal way of speaking. Though struggle with sequencing and routine, appropriate social response, distractions.
There we’re a lot of questions about what they could and couldn’t do at nursery age, so I’d say a nursery nurse is well placed to notice differences.

If you’re able to follow up an assessment I’d strongly recommend doing so. If there’s nothing, there’s nothing. But what there is in my area is a 2-3 year waiting list!

if there is something there, he’ll benefit from support sooner rather than later.

Why? It is only to ensure they get extra support IF they need it. It's not a bad thing and extra help won't do any harm.

I’ve looked at the criteria for ASD in a pre-school/nursery setting and I don’t see anything that stands out to me as like him, except the sensory thing.
I’m no expert though.
Things like eye contact, social skills and language are all fine with him.
Yes, he likes a routine, but he doesn’t get too distressed or have a meltdown if we deviate from that routine.

I suppose we will have to wait and see.

It's good to get a diagnosis because then you know how to help and make their environment easier.

I got diagnosed with adhd as an adult and I really wish I had been diagnosed as a child. I've done very well academically and in jobs but noone realises the constant internal dialogue and the procrastination of tasks and the constant leaving everything until the last minute.

I see 3 of my kids also have adhd. It is very clear. One of my children for example is very bright and capable and can focus, but only when she's interested. So she didn't read at all when she was at nursery/reception. Just wasn't interested. Noone was concerned because she is bright. Then as soon as she was interested she started reading Harry Potter books. It was incredible. And adhd manifests itself differently in my other kids. So talking about it, finding ways of harnessing the good points and getting support with the stuff that affects us, making sure that we try and do the tasks that interests us, varying things etc all helps.

My boyfriend is likely very high functioning asd. His brain works differently but again you wouldn't know unless you spent a lot of time with him. We all mask stuff and it's only experience or time spent together that shows us what is going on. And masking is stressful and tiring.

Do any of his behaviours worry you or cause problems either at home or at nursery? Sensory seeking behaviour is very common with pre schoolers. I wouldn't worry too much at this stage. See how things progress. He's still got another year at nursery which is good.

Sorry wrong thread have reported

@pinksquash13 The only behaviour that ‘worries’ me is putting things into his mouth. Other than that, no.

He is a confident, sociable, chatty and funny little boy. He has a good imagination and he loves to learn new things. He and his dad are reading a book about space before bed every night and he enjoys naming the planets. He loves his brio train set and we go on lots of long walks together.

He used to be scared of hand driers, but is slowly becoming less bothered, at one point he wouldn’t even go in the toilet if there was one, now if it goes off, he doesn’t mind.

See, this info along with other stuff you have said still sounds like high functioning autism to me.
My eldest never had meltdowns and sounds so similar to your son.

I hope you don’t mind me asking what the job/area of work it is @RoyKentsChestHair? No diagnosis, but sounds like it would suit ds to a T!

@DrRuthGalloway with routines etc does the child have to have constant routines or can it be big changes to general routines that are the issue? So say suddenly new music lesson at lunchtimes? But fine with getting dressed in different order. New school year/ or xmas with lots of dress ups at school and no work being done etc.
Stims- would just nail/finger biting be 'enough'
Can you get a 'flare' in symptoms that lasts weeks after a big stressor?

op my eldest was very bright at 3 but now at 10 being assessed for asd/adhd. Its not that she doesnt hear instructions its that she doesnt want to do what is asked.
anxiety has increased too.
we had issues precovid but new sound sensitivity.
She was very impulsive and it put kids off wanting to be friends so may be the root of her social issues. However covid did mean she wasnt in at all in those lockdowns, and is now compared with kids 9m older and who had 11m extra school. She only saw her younger sister.

Looking up about high functioning autism it sounds like it could be.

Although he doesn’t have ‘social difficulties’ yet

My son had adult diagnosed ADHD , (at 21) - I guess there were clues when he was younger but we missed them because like your child he was highly intelligent- and he was sociable too- he did however struggle with holding a pen correctly and his writing has always been awful, he also was very easily distracted and rubbish at anything involving coordination- sport etc. he is however a lovely young man, kind, fun , great with people, amazing general knowledge and has a great job paying 35k in Tech and he's 24 and has done it without Uni-

He sounds a lot like my eldest at that age .. who (shocker) now has an ASD/Asperger’s diagnosis (was diagnosed 3 years ago, aged 5). The diagnosis came sort of by accident on the back of some speech therapy for a stammer related to extreme advanced speech patterns. It was a total shock to us at the time, but now he’s older it’s more obvious. He’s a bright and articulate child who makes good eye contact and has friends. But if you look a little closer you begin to see that eye contact is entirely on his terms and he makes friends with some children and not others. He does have specific interests but they change over times and are harder to spot than a child who fixates on the same topic always. He masks well at school but has lots of undesirable behaviour at home driven by anxiety. Ultimately his diagnosis is a lifeline. It gives us a lens through which to understand him, it gives us the reinforcement we need to advocate for him with school.

He’s currently learning about his diagnosis and taking ownership of it, which is positive. It’s clear he knows that he is different in some way. I’d definitely explore if I were you. I think there are some children who just give off a bit of an ASD ‘vibe’ even if their traits are not so obvious. People who work closely with autistic people can spot my son a mile off!

Well. My two year old can do those things. And I don’t think he’s autistic. If he’s developing well then all you can do is sit back and see what happens.

We're currently going through the process, we're a year and a half in and still no peads dr app.
My son is the same age as yours.

Get in contact with your HV ASAP as depending on area your HV can make the referral (mine has) or it'll have to be your GP.
Even still the guidance and advise I have from HV has been amazing and I can't fault them for the care.

I remember the first time it was mentioned to me, I googled for weeks and honestly it made me feel awful.
The spectrum is so big and what appears to be the main red flags (eye contact, social etc) they aren't always the ones that are present within an autistic person.

It's good they have picked up on things and it's only to help your son. I would take everything you are offered.

Sounds very similar to my son who was diagnosed at 3.5 and more recently ADHD. He's now 11. I can't say to clearly enough, early diagnosis is key. I'd ask for a referral now as waiting lists are long. Early diagnosis made all the difference to my son. Also don't listen to the "labelling" thing. It's not labelling, it's ensuring that his particular needs are met and a diagnosis brings funding to the school to support him.

He used to be scared of hand driers, but is slowly becoming less bothered, at one point he wouldn’t even go in the toilet if there was one, now if it goes off, he doesn’t mind.

Ah. I was already thinking ADHD and sensory overload, but this is identical to my DD at that age.

So what might be happening with the instructions is that he can follow them at home, but nursery is simply too noisy for him to be able to do that there. I could not understand why, in Yr1, DD was unable to put on her coat or put her stuff in her bag at the end of the school day - but she was expected to do it in a corridor of 120 overtired children. Never happened. She's now diagnosed with ADHD, but inattentive rather than hyperactive.

If it's any consolation, the noise sensitivity tends to get better, but DD's ability to follow a series of instructions got worse, but is now improving ten years on.

I think it's easier to think of neurodiversity not so much as a series of discreet pockets - ASD, ADHD, dyspraxia - but as a wide-ranging cloud of symptoms and experiences, which includes high ability. So people may exist in a place on the cloud which is clearly labelled as ASD, but what the medical profession delightfully call co-morbidities are common and some people just have a mix of diversities. DD is borderline dyspraxia too, and is probably also dyscalculia as well (but this is masked by her abilities so she survives).

So the main advice I would have is just watch what he is doing and see how you can help him - it may, like the noise thing, take some thinking about to work out. And if he starts having bigger problems, then do look for a diagnosis. DD is very happy with hers (frankly, as a teenager, neurodiverse is quite cool).

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.

This is kinda how autism works, I can be doing one thing then all of a sudden I'm owing something else and I remember I was meant to be doing thing 1. It's not a lesser intelligence or anything. Many studies have actually shown that autistics are, on average, more intelligent than neurotypicals. It sounds like he's not heavily affected by it and a diagnosis may just help you in future tackle things the right way for him, everyone learns and thinks diffently, it'll just help you not expect the same way as a neurotypical child. Don't stress about it too much. He's still the exact same kid.

The "being unusually good at something at a young age" and the "being behind, or a bit odd, at something they should have mastered by now" can SOMETIMES be a marker of high-functioning autism.

My sister fell into this category. A self-taught reader at age 2, TORE through books, really chatty with adults, but couldn't run or ride a bike. Her differences became more and more apparent as she got older, and she was left behind by her peers, especially socially.

@Summer1912
with routines etc does the child have to have constant routines or can it be big changes to general routines that are the issue? So say suddenly new music lesson at lunchtimes? But fine with getting dressed in different order.

• it'd be multiple instances of change of some sort causing distress, and fairly consistent within the child, but different child to child. For some children that might be an insistence on wearing the same clothes day in day out whereas for others it might be finding changes to routines very distressing. For some children the flexibility issue is more in cognitive flexibility, for example overly pedantic use of words - I wasn't jumping in the puddle, I was stepping. That's a fiat 500 and that's a Nissan Micra. It's correct, but the insistence on observing the difference is unusual for the age.

New school year/ or xmas with lots of dress ups at school and no work being done etc. - Yes , common to cause issue

Stims- would just nail/finger biting be 'enough'?

If it were really intrusive. But observable stims aren't vital for diagnosis.

Can you get a 'flare' in symptoms that lasts weeks after a big stressor?

Yes, absolutely.

It’s also worth pointing out that whilst an education professional might have opinions about whether a child is neurotypical or not, they (and you) should also be very conscious that they are not qualified to diagnose, and the diagnosis takes considerable time. So really what the teacher is saying is that they are observing differences of development in your child relative to the ‘normal’ development they would expect from a neurotypical child. Those differences may or may not mean a diagnosis is possible, but whatever the outcome he’s still the same kid.

Though I have to say that for me, even though the diagnosis was a shock and I wasn’t expecting it, I also think I had always known. He had always been such a discontented baby and a clingy child. Whilst he was perfectly engaging and good at interacting he was hard work. Much more so than my second child who was just a peach (until he hit 5)