In thinking there probably is something not quite right with how ds is developing

[Worriedaboutitallstill]

I’ve posted here to get a range of views, as to be honest I think it will help to get it out anyway.

DS was 2 in December. For the first year he seemed to be developing ‘normally’, he hit all his milestones, no concerns raised by nursery (he started at nine months) or HV (she did a check at 10.5. Months but we haven’t seen or heard from her since.) I’m explaining that because she hasn’t seen ds at all in a year and a half so probably isn’t the best person to ask.

The first thing I noticed that made me a bit concerned was that I went to a first birthday party with a group of toddlers the same age and all were pointing at things, ds wasn’t, I should add here that ds was smiling, engaging, laughing, just wasn’t pointing. Mentioned this to dh who said not to worry, he was fine. Im not sure when he was pointing regularly but he definitely was at around 19 months maybe? He still does and makes a sort of ‘uh’ sound.

So the next thing I noticed was aggression, a friend visited when our children were both 16 months and ds was awful. Every time her child picked up a toy ds would snatch it from her, he pushed her, he wouldn’t let her look at anything. I also noticed that she was way more advanced than ds. My friend read a book to her dd and she was able to point out the different animals and so on. I thought maybe I hadn’t done enough with ds, I’d read with him but hadn’t said look at the rabbit, there’s a bee. I started doing that and making animal sounds. I think he picked these up again maybe a few months later, at around 20 months.

Also started getting reports from nursery about aggression, specifically biting. Utterly mortifying, but nursery reassured me it was normal. It did taper off, I still get the odd report now but it is occasional whereas before it was nearly every day.

He has lots of words but doesn’t put them together and I never feel we are having a ‘conversation’, maybe that’s normal for this age. He’ll just say things like daddy, car, socks. Still shows aggression to children, lots of pushing. If I say no sternly he cries but then goes back and does the same thing. He regularly just completely ignores me, other times he engages with me but deliberately disobeys, I feel this is more normal somehow, like if I say ds please don’t pull the curtain he’ll grin and pull it some more. If I have to physically stop him doing something or take him away he goes wild and thrashes around manically. He used to attack me sometimes, which was horrible, he’d grab the skin on my face or neck and twist it or yank my hair.

So - my worries are that he seems much later to do some things than other children (pointing, identifying things) and how aggressive he can be, mostly. I know people always look at the parent and let’s face it the mother and I am so upset to think something I have done or not done has led to this. I’m really worried about him not having friends because of how he is and I veer between thinking he’s fine, it’s all normal, he’s fine but maybe I’m not and I need to improve my parenting, and thinking maybe he is ND in some way.

Nursery did do a report recently as he moved up a room a couple of months ago, they did note that he struggled with his emotions sometimes but also said no concerns re development. But nursery don’t know everything? I wish I knew.

He’s been under an ENT since he was 14 months. His hearing him is fine; I have been onto this.

I think there is a huge delay in 2 year checks round here and I really don’t want to have the HV come out because i suspect there’s a problem because that’s perhaps creating a problem. Plus I have seen the forms and the one DS isn’t doing is three or four word sentences - there’s a small handful of two word ones.

He sounds like a normal 2 year old to me.

He may just be getting frustrated with his communication skills - and they don't call them the terrible twos for nothing!

I veer between this and thinking he’s so behind!

I don’t understand your last comment OP. If you say you have concerns surely the HV will just use the relevant assessment forms, and then either reassure you all is fine, or refer DC to another professional if indicated, or agree with you to wait till he’s older and review his progress then.

As soon as you flag that there may be a problem, people look for a problem. That’s natural and normal - of course they may still conclude there is no problem!

But it is a form when all is said and done and it doesn’t ask about aggression which is probably my main concern at the moment.

I really think there is a danger that you are inadvertently overestimating normal understanding at his age. Ds please don't pull the curtains is too complex for him to likely follow. No and move him away when he does is more helpful or no pulling. sayandplayfamily.com/language/language-development-milestones-understanding-no

I agree with a pp. The amount of people saying 'normal' is disappointing. Autistics aren't abnormal. Its a difference not an abnormality.

I also think people shouldn't rush to ASD when there other things that should be considered. DLD is far more common than ASD for example but is often mistaken for it.

Normal is simply conforming to a standard if you like. In this particular context, it is appropriate to use.

Yes and of course there are children with autism who do point. A young boy in my setting at work has a rare genetic condition which is always paired with an autism diagnosis/ causes autism but he does point (and makes eye contact if he initiates it from a trusted adult, though not with other children and not if initiated by the other person).

Normal range or "typically developing is quite obviously what's meant in the context of child development.

Of course "abnormal" can be pejorative and "normal" should never be used as a value judgement (anyway a talented athlete or artist wouldn't be described as "normal" either - it's not necessarily negative to recognise that) but it's deliberately obtuse to pretend that there isn't a normal range of child development and that it isn't legitimate to reference that when assessing whether a parent has grounds for concern and a child needs additional support.

It's not always "super easy" to distract an overwhelmed toddler or child (or adult with learning disabilities) focussed in the moment on attacking another child/ vulnerable person believe me - I've been part of so many multidisciplinary meetings around school aged children in this situation!

Obviously with a two year old you can just physically pick them up and remove them from the vicinity of other small children though, then put them somewhere safe to calm down and then distract.

If it's a normal toddler stage it'll pass quickly, but if not it's important to develop strategies to refocus whatever is causing the child to lash out and let the child calm down in a different way (usually by teaching them to leave the room and/ or use breathing exercises if capable or/ and fidgets/ sensory toys/ physical movement before they reach that stage, but that can be a long and challenging process), before the child is too big to scoop up or restrain from lashing out!

I think its deliberately obtuse to ignore that I made no mention of range and was addressing language that is ableist.

I have an autistic son and a neurotypical son both now teens and it was my NT son who behaved exactly like this at that age. He's a absolutely lovely young man now, extremely smart, he shook the behaviours off and picked things up at his own pace. Little girls do seem to pick things up more quickly I remember feeling concerned. Definitely get any assessments going though, if nothing else it'll put your mind at rest

Can you get his ear looked at again - ear pain is actually agonising and could account for the lashing out all by itself.

Toddlers are a little bit like dogs in this context 😳 if they're in pain their behaviours can change completely and they can become bitey/ aggressive!

Constipation can also cause this in toddlers, but ear pain is also something they can't always identify or explain, they just know they are miserable and either lash out or become clingy and whiney.

Children right up to 8 or 9 (even typically developing children) often can't accurately identify pain - often slightly older children will identify everything as tummy ache even if it's not, and toddlers will just know that they're miserable and nobody is helping.

Even adults often mis- identity ear pain as tooth pain and vice versa, and even normally mild mannered, independent adults are often miserable to the point of being snappy with either!

I didn't say that you mentioned the word range - I wrote that normal range is quite obviously what's meant (by the word normal) in the context of child development.

@MrsMullerBecameABaby that is very helpful. I’ve found him challenging this past couple of weeks and I wouldn’t be surprised if his ear does leak pus soon (which is generally what happens) or if he maybe has his last molars coming.

A plea for the thread not to be taken over by tone police as well.

You need to speak to your Health Visitor OP and ask for a visit if you can't get to the clinic.
They will refer to a Speech and Language Therapist if they think it is required.

We don’t have a clinic. A HV will be in touch in due course but I don’t want to hurry this along especially, in a way the more time the better as if there are problems it will be more apparent the older he is and at the moment it is very much ‘jury’s out’ as far as I can see.

I would write all of your concerns down and I would start saving. DD got her diagnosis at 13 and it was so difficult to think back to toddler and babyhood. Your DS may or may not be autistic (or have a different condition) If he doesn't need a diagnosis then you can use the money for a holiday etc but being able to bypass the NHS wait (4 years in my area) and going private if you need to is a game changer.

I also wouldn't worry about your child not hitting all of the 'autism boxes', a good clinician will see through their ability and see their struggles if it turns out he does have autism. DD was always a quirky child and her language skills were very good, Primary school didn't see a problem so I brushed most of her quirks off as being an only child and not have a lot of unstructured time with other children. It wasn't until starting Secondary school that she started to really struggle with the school environment ending in autistic burnout. She was able to be seen within 12 weeks of me making contact with the clinic.

This is exactly how I would have felt a few years ago, so I sympathise. Back then I was just worried about my son, and wanted to know what to do, in very practical terms, to fix things. No time for these kinds of discussions.

But I do feel different now. The tone upstream in this thread, and in so many other threads, reflects a narrative around autism that is prevalent and important. Autistic people often feel alienated by these attitudes and it really, genuinely harms them. So this stuff does need to be said, it's not just posturing, or a distraction from the important practical stuff.

I don't want to keep banging this drum, and if people are getting defensive then it's probably counterproductive. But it would bring me genuine delight if anyone on this thread (not specifically the OP) were to say that they had listened to the comments on attitudes and language, and were prepared to reflect on them. This is not about point scoring it's about the welfare of autistic people, and it may affect OP's son if he does prove to be autistic.

I haven't taken issue with that.

I took issue with some replies where the language was ableist, just like other posters did.

It is worth getting on a waiting list for speech therapy if you think that may help as waiting lists could easily be a year.

DS was speech delayed and the frustration of not being able to communicate often led to biting and hitting. He was actually kicked out of the gym childcare centre for repeated biting. The biting reduced as his speech improved through speech therapy. He's now a lovely and gentle teen and it's hard to imagine the angry biting toddler he used to be 😂

Probably different in different areas, but here there are drop in sessions with a speech and language therapist at some of the children's centres. You don't need a referral Whether or not it turns out to be part of a bigger picture it does sound like some of his behaviour is frustration when hes not quite able to communicate yet.

I went to a similar group when my youngest was around 2 1/2 and picked up a few tips to help us both.

Has he started putting 2 words together? E.g. ‘no mama’, ‘want car’? Some children do this later, but I’d keep an eye on it. Keep reading lots of books and actively create ‘conversation’ through them.

Some of the aggression sounds within average expectations for a child of that age. My ds used to do that horrible skin pulling thing around 2. He’s 4 now and fairly gentle, but I did worry there was an issue with his development at times. I would go back to the hv and ask her to do another assessment. They can do play assessments in a bit more detail to get a better idea of his development.