Feeling like nursery are really pushing to label my son

[Dumbledormer]

This is a difficult post. First of all I hugely like and respect my DS’s nursery workers but I’m getting a lot of mixed messages and I feel like I’m going crazy.

DS is two (literally just turned last week) and was born 5 weeks premature. He’s been going to nursery two mornings a week since he was 1. Nursery flagged a concern with me that he wasn’t responding to his name at around 18 months and that he walked on his tiptoes a lot and that these can be early traits of autism. Contacted HV who came out to assess him and was not hugely concerned. Advised to “watch and wait”.

Did my own research, panicked a lot then calmed down and looked at things to do to help. Managed to get a private speech therapist a couple of months ago who found him to be speech delayed on meeting him but didn’t think he was autistic (although mentioned later that she now wasn’t sure as nursery had a different view when she spoke to them). Anyway shortly after this, we broke up for the summer and he’s come on in leaps and bounds. Always responds to his name, follows instructions, has a handful of words that he uses functionally. Points to request and points to share excitement at something he’s seen. Really enjoys being around other kids, although doesn’t play with them unless they chase him or he chases them but will try to copy what they do. Eye contact is great and loves people copying him. Still walks on his tiptoes but this has got less and less. Doesn’t appear to be phased by changes in routine at home, eats well although can be fussy with new foods which I think is fairly typical and he sleeps well.

Nursery’s concerns before we broke up for the summer was that he wasn’t happy when they changed the layout of the room one time and moved the toys back to their original place i.e. struggles with change. He’s never done this at home and we are in the middle of renovating so stuff is moved round a lot. Obsessed with water play and struggles to engage with others when water is about (it’s fair - he still loves it) and that he’s very sensory seeking, he won’t sit down for story time and wants to be off playing with toys and no spatial awareness.

He’s been back at nursery a couple of weeks now and is doing two full days. The most recent comments are that he’s just picking at his lunches (which are free at nursery) when all the other kids are eating their full meals and I’ve been emailed a list of SEN toddler groups to take him to as they think it’ll be good for me to get more support with him as he’s clearly struggling.

Spoke to HV yet again, who is still unconcerned but has agreed at my insistence to now refer him to SALT and talk and play.

He’s not perfect, he’s a toddler and the things I find difficult are the frequent tantrums when he doesn’t get his own way and when being made to wait. He really likes to be very theatrical and throw himself to the floor and scream but these last seconds and always end as soon as he gets what he wants or is distracted by something else. His new thing is crying if strangers speak to him and most recently covered his eyes when an elderly gentlemen tried to talk to him. Again, all quite normal I think and he usually warms up to strangers eventually if they give him some space initially.

Basically, I’m trying to be as open and as realistic as I can about my son’s strengths and weaknesses, I’ve thrown myself into researching kids on the autistic spectrum and I just really don’t see it in my DS.

BUT nursery do! Am I just completely in denial? How can I question their collective expertise but it just sometimes feels like they are talking about a different child. They haven’t always got it right either, I remember them flagging concerns that he had PICA when he was a lot younger and shoving everything he touched in his mouth. This also made me worry like mad but he just grew out of this behaviour like most kids do.

Sorry for the absolute essay but just wondering if anyone else has experienced this with a nursery before?

That's actually really normal for a 2 year old

@Dumbledormer I understand you don’t like him being treated differently- but from what you have said his needs are different. The nursery is doing the correct thing in making allowances/adjustments for what he needs- if he does turn out to be ND then you will spend the next 10 years trying to get schools to do this exact thing.

If you can afford it I would take him for a private asd assessment- it’s expensive but it will put your mind at rest one way or the other.

you could start by visiting other nurseries and childminders in your area, maybe ask around too for recommendations. if the current nursery is quite busy, maybe look for something smaller and calmer. In terms of giving nursery a reason, you can just say you want a quieter setting for him.
they may be outstanding but that doesn’t mean it’s necessarily the right fit. At this stage the main thing is that they feel happy, a sense of belonging, so that they can happily explore the world around them without anxiety. Some ofsted can be about box ticking /admin (not all) so I wouldn’t go just by the ofsted rating but by how well his personality fits in.

Nursery workers are def not experts, any who are very good will likely be promoted and eventually leave maybe after a degree to work as a teacher in eyfs or ks1.
Because it is mw or slightly over for room leader. The exception being if they have a good earning husband, others who love the job will find a way to progress.

Also outstanding often means good at paperwork more than anything else, certainly not children's experience.

This app might be helpful, it goes through the early signs of autism at different ages up to 2 1/2 (based on lots of research in Australia) https://asdetect.org/

Just find a new quieter nursery then tell the current one you thought your child would do better in a less busy one.

And don't worry about ofsted grades too much. Avoid the ones that fail but "outstanding" is based on one person's opinion on one day when staff are really trying. I've worked a some crap "outstanding" ones before.

Not as young as yours, but when my dd was at school nursery (she was just turned 3) they were seeing behaviours that I hadn't. I had already had a sense that in someway my DD wasn't your average 3 year old, but equally I had no real point of reference. They were very careful not to ever say 'Autistic' though until (in reception) after incident they were keen for me to get her assessed and I basically demanded to know what they thought the issue was.

What nursery say isn't gospel, but I would certainly say they have a better a clue than health visitors who I feel at best are nice and helpful but at their worst, judgey and clueless.

With my DD, she was assessed and found to be Autistic. In many ways she doesn't present in a 'typical' way and is very different one on one. But she really struggles in group settings which you simply don't have at home.

You don't have to get your child assessed. You could wait and see if things change. But I think you should be open to the idea that what you see at home and how they are in nursery are likely to be very different.

@Dumbledormer how is your son getting along? My son is 20m and sounds similar x

Having had a son who was diagnosed very late (aged 15) with Autism and having suffered the consequences of this, I would listen to what nursery are saying. If your son is ND it is far better to know about it and put adjustments in place as soon as you know about it - it could save a lot of stress and heartbreak later on.

I wouldn't change my son for anything - he is a brilliant human being. He's just a little bit different and needs a few adjustments to thrive - which he is now doing

Hi, he’s doing great thank you! Hard to believe I wrote this only a couple of months ago. Firstly, we had a meeting with his nursery which was actually really positive just to discuss his strengths and things he’s struggling with and what we do at home to help so we can all be on the same page. I think the nicest part for me was that they said he wasn’t the only boy who wouldn’t sit down for story time and that they have a few others with speech delays as well.

Anyway, we are still waiting anxiously for our two year review but his speech is really coming along now. We now have “mummy, daddy and nanny” which feels like a huge achievement! Answering yeah and no to questions. Stringing a couple of words together (more bread, water gone (down the plug). Also convinced he’s saying “what’s this” when he jabs at a picture in a book and looks at me to say the word but it’s not clear enough for me not to have it down as wishful thinking.

His private SALT has said she doesn’t want to see him now until January as she thinks he just needs a bit of time to catch up and she said if nursery still have concerns in Jan she will go and see him in the nursery setting which I think we will ask her to do regardless.

Nursery are happy with his progress so far though, they pulled me to one side last week and told me they could see how much we were doing with him at home as he was listening to instructions there a lot better, sitting with his peers and eating (or at least trying) the hot lunches with everyone else. Trying to engage staff and other kids in play. Apparently he will now follow the instruction to sit down for story time but gets bored after 30 seconds and runs off to play but progress is progress! I arrive 10 minutes earlier to collect him so he doesn’t have to wait for too long in the corridor which seems to be working well. Overall, just really positive stuff.

Went to playgroup a few days ago and without any involvement from me, instigated exchanging his toy for another one from another toddler there. Waited his turn to go down the slide. Smiling and trying to talk back to another kid when they spoke to him etc.

Obviously not all is delightful with him. There are SO many tantrums when he doesn’t get his own way (usually over a “no” for more snacks). Getting very jealous of any attention towards his baby sister and bit another child a couple of weeks ago at playgroup which I was mortified over.

So who knows whether autism is still likely. We are still behind compared to his peers in his speech so we will wait for our two year review and see what referrals they want to make then but feeling a lot more positive no matter what the outcome ends up being.

Glad all is going well

@Dumbledormer thanks so much for coming back and the update! My son is similar in that he hates having to stay still, at traffic lights I have to hold on to him tight as he will wait about 30 seconds and then really wriggle to go and get upset. He is the same if we stop in his pram. He will sit at the table and eat with other children at nursery. He walked on his tiptoes for about a month but seems to have stopped that now. His vocabulary I thought was good - he says loads of single words such as mama, dada, dog, up, down, bye bye, drink, snack, lots of different animals, car, truck, more etc. He doesn’t say many two word sentences other than “sit down”. I had thought this was normal for his age (20 months). He brings us a book to read though won’t sit for the full story, will tell us the name of things we point to and interact with the book. He has a busy book that has clips etc and he likes to bring that over to us and go “up” and then sit next to us and do it, and when he manages to close one of the clips he says “yay” and smiles to me to see if I’m going to applause him haha, he smiles at other children, but doesn’t play. Has pushed kids which he learnt from nursery. Will do the actions for hip little bunny and follow simple instructions from me, like sit down, go to the living room etc. There were a couple of concerns - he doesn’t sit still very long unless watching TV (we don’t give him much screen time), and he doesn’t respond to his name every time (but does it consistently enough for it not to be a fluke when he does, he just can get engrossed in stuff and I’m exactly the same), and he doesn’t give long eye contact, but will look at you when you start talking to him/when you come in a room/when he has done something and wants recognition etc - I had thought this was all normal 20m behaviour. Our nursery carried out an assessment for him moving out the baby class and only passed him on the 11-12 month assessment criteria. Not the 18 month or the one below that. What was frustrating is we had a parents evening and termly review 4 weeks ago where we were told he was developing really well, and some of the things they have said he did for his termly review he has been marked as not achieved in his assessment. His key worker didn’t carry out his assessment so is going to do it again, and over a few days and the SEN lead is going to observe him over the next couple of weeks and we have a meeting to discuss as they just gave me the assessment on my way out of pick up and I didn’t see it until I got home (I’m confident he can do most of the criteria - both at home and in settings outside of the home - for example I’ve seen him do these things at kids birthday parties where there are kids he hasn’t met before) :(

Try not to worry (although I appreciate that’s easy for me to say). 20 months is still so young and it sounds like your son is doing way better than mine was at that age. At 18 months my son didn’t really respond to his name, we had to teach him to point (he didn’t pick it up naturally) and definitely no words at all by 20 months! My speech therapist told us that being able to communicate wants and needs at that age is more important than being able to label a lot of items and the ability to share enjoyment (pointing at something and looking back to see your reaction) is also a really important skill. I wouldn’t worry about the lack of focus at his age. He’ll get there.

Google the M-chat screener for autism and see what questions they ask there. I found that really helpful to see what the professionals were looking for.

How is your son now OP?

I work in a nursery and I can pretty much pick out ND children from as soon as their settle session. Most experienced staff will have cared for many children who end up with a diagnosis and will be seeing things in setting you might not see at home.

Your child is still very young andwon’t get an official diagnosis for a while even if they are ND but it is worth allowing nursery to put a referral through for other professionals to observe too.

Ex nursery/early yrs teacher.
Im not saying your DS doesn't have issues and its obviously sensible to have assessments to help uncover issues etc....BUT
your son is 2, and if not at nursery wouldn't be seen expect from a HV as he'd be home with you. Ive had children in class at age 4,5,6 who struggle with carpet time activities when they are are expected to sit quietly and listen and focus without movement, yet have gone on to do brilliantly at school without issues/diagnosis.

I was SEND coordinator for a while and I can remember speaking with our wonderful EdPsych about a few concerns for a child. Her questions were
'are they a boy?'
'Are they under 7?'
'Are they a summer birthday?'
Maturity is a massive part of ability and can often suddenly settle in.
Expectations of young children in our education system dont match with other systems around the world, where movement, discovery and outdoor physical movement (gross and fine) take a much higher priority than in the UK. Child development is not linear its more like a spiral where some areas can develop quicker than others and then slow down, plateau, gor a bit.
I hope you get answers that help both you and your son.