Is my son autistic?

[monarchbutterfly]

Ok so my little boy is 2.5 and I’ve just got a few concerns/things in the back of my mind which make me think it could be autism.

I’ve been on MCHAT (the autism symptom questionnaire) and he scored low risk, so that’s put my mind at ease a little, along with the fact he had his 2 year review a few months ago and she had no concerns and said if we were still worried about his speech in the coming months to get back into contact with her (he wasn’t making much attempt to join two words together then but he definitely is now) He gives great eye contact, he gestures, he points, he responds to his name every-time, he looks at me to make sure I’m looking at what he is, points, has lots of single words but is trying to add two together more frequently. Repeats animal sounds, if I say what’s that and point to it in a book he’ll repeat it to me and if it’s an animal will make the sound. Knows his body parts etc.

What makes me think it could be something more is the fact he just doesn’t stop, he’s constantly on the go and he’s a runner - he does stop and turn back now to make sure I’m there but his sense of danger isn’t brilliant. I often see children his age walking nicely by the pushchair on a road and I just think I could never imagine him doing that. He is very rough and tumble, he attends nursery 1 day a week, hoping to go up to 2 soon, they have said the only concern they have currently is his understanding. For example, they mentioned when they say ‘right it’s time to put your coat on’ and hold up his coat, he will look at them and just carry on playing. They’re not sure whether that’s because he understands but just doesn’t want to or he genuinely doesn’t understand what is being asked of him. I explained that at home if I say get a bowl please, he’ll go and get one, or I’ll say sit down let’s put your shoes on he will sit on his step and repeat shoe-shoes to me. So he does understand some, but I’m not sure how much he should be following to be classed as developing ‘normally’ - they said they’re happy to just watch and observe for now. They also mentions he struggled to self regulate, I asked what they meant by that, and they explained that he absolutely cries his eyes out when I drop him off like he doesn’t want to go but he is so happy when he gets in there but it takes him a bit of time to come round from crying, at home he’s very easy to pacify when upset usually a cuddle and he’s fine, but they’ve said he won’t allow them to cuddle him. At home he’s so cuddly always kissing and cuddling me. He also plays with toys appropriately but he loves to do the same thing for hours, one example is he loves to drive his cars all around the sofa, shouting ready steady go before going down the arms. He doesn't flip cars and just stare at the wheels type of thing, he will pretend to feed his little teddy bear, and answer my phone shouting hello. He plays with toys how they're supposed to be played with, however he will sometimes bring his toys, more so his whale figures almost like down over his face and his eyes follow, it's hard to explain, and he will say whale splash that type of thing whilst doing it. Not sure why he doesn't that? He loves to play with his older brother, throwing balls, driving cars, trucks, but I’m a little worried as he plays alongside children at nursery, they haven’t said he plays with others so that’s worrying me he’s not social like he should be, but he loves his brother and my nephew and always wants to join in with them. And his speech isn’t where a 2.5 year old should be I’m aware of that. So worried he’s also got a speech delay and what would be causing that. He does have a lot of single words, and some two word sentences now, I’m just worried if he does have autism or any underlying additional need the sooner he gets the help and support the better it will be for him.

Do you think I should be worried? Other professionals don't seem to be, but I don't know. If your child/ren have autism what were their symptoms at 2.5? That would be really helpful to know.

Sounds a normal 2.5 year old to me!

He doesn't sound autistic to me - very normal behaviour for a child his age.

Nothing at all you have written sounds like autism to me, sounds like a normal toddler.

My son getting assessed now, the only thing we noticed at that age was sensory issues with food and clothing, looking back maybe excessive tantrums. Maybe for now just keep a note of anything you notice as examples of behaviour will be really useful for any future assessment, and just see how things go

He doesn't sound autistic at all to me :) Speech delay is REALLY common without autism, and tends to only be a big concern if children struggle with comprehension of language, rather than expression, but his comprehension sounds good and normal! My own DS has speech delay, I'm a SALT and I'm not that concerned about it!

He sounds like a typical 2yo from most of what you've said. What's his pronunciation like? It could be that he needs his hearing checked for glue ear.
In a louder environment like nursery, it could be that he's just not hearing instruction properly but at home it's quieter and he is able to.

Your son’s behaviour appears to be normal at the moment, but I’d encourage you to reflect on is the extent to which you are proactive about your son’s development.

It sounds like you are highly observant, caring and what your child to have the best chance of success.

One of my biggest bugbears is messaging to young parents about ‘development’. It ‘others’ the process and positions the parent secondary to some kind of ‘natural unfolding’. Parents are encouraged to watch and wait, and their son will develop x, y and z milestone ‘when he’s ready’. The most distressing thing about this is the way that parents are made to think that language delay is normal and just sort of ‘happens’ like there’s nothing they can do about it. Imagine trying to learn a new language from simply listening in to other 2-3 year olds.

Get rid of the above terrible message from your mind. You are your son’s first, most important and powerful teacher. The best thing you can do is to be proactive about a) social norms b) language and c) knowledge. All children can learn and develop in a positive way, provided the environment (including the people in his life) gives the right signals and information. Some children just need more input and practice than others. In the absence of this, we risk merely observing maladaptation ‘naturally unfolding’ before our very eyes.

For social norms, be firm and fair and constant. Don’t assume that your son will just intuit the unwritten rules from his peers. Teach simple rules like ‘we walk on the pavement’. Give specific praise ‘such a good boy walking close to mummy’. Make sure there is a difference between the body language/tone of ‘no’ and ‘well done’ (I often see parents confuse their pre-verbal children because everything, even a mild ticking off, is delivered with the body language and voice tone of praise). Teach simple routines. Routines are calming.

For language and knowledge, books are your friend. Read lots and lots to your son. Fact books open his eyes to new interests and ways of seeing the world around him. Fiction books open his eyes to the baffling world of human emotion. Both kinds of books will steadily give him new language. Both kinds of books will give him ideas for play (which helps with making friends) and for the dreams that happen when he closes his eyes at night. As he follows your finger as it points to the words he may even begin to learn the way that letters make sounds. This latter phenomenon is why children sometimes start pre-school already reading - their mothers had taught them phonics without even realising it.

The other proactive thing you can do about language development is to ensure that your child has opportunities to look at you when you’re talking. It helps him to make connections between sounds and mouth movement, also emotions on your face. The dinner table moments are good for this.

Even if your son is autistic, all of the above will help.

Do not listen to those who may make you feel like a bad mother for ‘imposing’ rules, routines, knowledge and language.

Apologies if that’s coming across like a lecture!

I’ve just re-read your post and have some serious concerns about the nursery:

’he doesn’t understand’ and ‘we’re just happy to observe and wait’ are big flags for me. Likewise, their allowing him to not follow instruction is also teaching him that listening to adults is optional.

I’d be asking some meaty questions to the nursery leader.

’I’m concerned about my son’s language development. Can you tell me what you do to promote language development?’

They should be replying with the following

’Yes, we ensure the adults have proactive conversations with children, teach new words and also read them lots of stories. Every day we sing songs’

You can also ask what they do to ensure your son doesn’t develop a habit of opting out of following instructions. Please also ask them about what routines they teach so that all children, including children with special educational needs, know what to do in a calm way.