To discuss potential SEN concerns with family member?

[28andgreat]

I have a dear family member that I am very very close with, our children were born 3 weeks apart and have grew up together. We both view each others child as one of our own and it’s such a lovely close knit family feel.

To get to the point - it’s quite clear both children are not progressing the same way (which is normal, I know) but DN is showing signs that I personally think would be Atleast enough at this stage to be speaking with the health visitor. DN’s parents have made one or two hints towards thinking their progression is slow, but still view DN as a baby and seem to be oblivious to the other signs. (She is 2.5 years old).

I want to clear, I absolutely adore DN and want nothing but the best for her. She is so funny, caring and unique - she truly is a treasure. But I also want her to have the best life possible, and that could mean having extra support from an early age.

I really don’t want to damage my relationship with family member, but I’m finding myself getting frustrated that they appear to be burying their heads in the sand. Is there realistically anything I can do or am I blurring the lines?

DN hasn’t had her 2 year review with the HV yet (it’s very slow round here) but imagine it will come soon, I’m leaning towards waiting for this and seeing if anything said - but I don’t know if family member will actually raise any concerns.

has anyone ever had to have this conversation and how did it turn out?

Don't- they will already know.

I wouldn’t say anything. They will know, they might just be waiting for the 2 year appointment.

It’s not your place. As much as you’d like it to be, it isn’t.

Don't say anything. Please.

I wouldn't. I might think differently if you were talking about physical delays? As I am assuming early intervention might be key there, but for SEN, unless it is very pronounced then my understanding is that it is usually watch and wait at this age anyway? Isn't 2.5 very young for a diagnosis?

I did think this would probably be the answer given.

I don’t feel it’s my place at all so I am quite glad to hear this! I just want my DN to be supported as best she can if it’s needed.

tThank you everyone for your advice x

There is nothing that you can do before the two year review that will be better than the review. The only thing you should even consider doing is encouraging them to ask about the review and hurry it along a bit, have yours as well, don't just make it their issue.

If they want to talk about this review, before or after, be led by them and spend the time listening rather than joining in and saying you'd noticed x,y and z. Instead say it's worth asking or looking into things and nothing more.

It is abit early for diagnosis yes but the waiting list for an actual diagnosis seems to take a fair while, and she could be at school age then.

There are delays; DN cannot talk apart from the odd word but those words aren’t clear, only really understandable by those close.
DN was a late walker (around 20 months) and her coordination/ balance is poor.

Definitely wait until she has seen a health visitor.
Sadly this kind of conversation is unlikely to be taken well. I wouldn’t start it until she does.
I have to disagree though that it’s not a given that ‘she will know’ . I deal with parents all the time who have no idea that their child is struggling or possibly neurodivergent.

I understand completely, my step daughter was quite clearly not progressing as she should and I even found it very difficult to bring it up to my partner and push him to get some help (he was completely oblivious) the HV referred her and she got input from SALT and is now on the pathway for assessment for ASD/ADHD. However, I think in your situation you'd be better waiting for them to have the 2 year check, I'm sure they must know and in reality they'll need to wait for the check to get any sort of referrals

Thank you for this.
I don’t think family member does think SEN, or if they do they haven’t discussed it. We usually discuss everything so it would be an odd dynamic in our relationship to keep something like this (although understandable not everyone wants to discuss everything).

They seem to just believe she is still a baby, that she doesn’t understand things and treat her as such.

Are you coming at it from any kind of informed position?

That isn’t intended in a harsh way - my sister in law did tell my partner that she had concerns about my stepsons development, and recommend they get support/advice. But she is also a paediatric nurse.

If they get the ages and stages questionnaire and answer honestly there’s not really a chance to hide it from the HV or nursery practitioner doing the review. My son scored grey and black on his at bearing 2.5 years old, with a clear picture of developmental delay, but I was very clear with the person doing the review that we had concerns about autism, and reiterated our concerns in detail. Often if the parents are not on board there is less chance of referrals and interventions being made. Parents at are the biggest advocates for their children when it comes to things like this. My son’s teachers see it all the time, where parents are in denial and refuse any intervention, to the detriment of the child. We had to wait for ours for ages even though I’d contacted the HV service months prior with concerns about my child’s development, and now he’s been referred for an autism assessment, but it’s been very slow.

Assuming she does see other dc developing within standard boundaries, I do think she will be wondering what’s happening to her DD. I’d leave it though and assume the HV check will prompt some action. Speech at the very least. Do they read books to her and talk to her?

I had a similar situation with my nephew. He was my sister's third child and I had my second one 6 weeks after he was born so we had a lot of experience with babies.

I knew from very early on that there were issues. My sister did to an extent but was avoiding the public health nurse and downplaying them.
He was delayed in terms of motor skills but there were other things like no interest in toys eg if you dangled a toy in front of him he wouldnt look at it.
I tried to gently advise my sis to speak with the nurse. She told her DH and his family of my concerns and they told her I was seeing things that weren't there and there was nothing wrong.
We didnt fall out but it was difficult as I was worried about losing time for early intervention.
He was ultimately diagnosed with a number of things and required a lot of intervention.
I think the most you can do is give gentle reminders (if you can) about an appt with the nurse.

I would urge you not to say anything yet. Talking from experience my. daughter is 4.5 and was diagnosed with autism just before her 4th birthday.

A parent knows, but accepting your child may have additional needs takes time, it's deeply personal and emotional and they are probably not ready to talk about it yet. She's still so young! I noticed signs with my daughter at around 18 months but I said nothing, not even to my partner untill she was almost 2. I was burying my head in the sand 100% and when I finally did tell my OH he count see it initially. He just thought she was a slow developer.

When he told my mother in law that I thought she was autistic my MIL said she agreed and had thought so for a while. I'm glad she hasn't said anything, because I was struggling with it internally, I think unless it's your child you don't understand the complexity of how it feels. There's a lot of guilt, and worry for the future that you have to overcome.

I understand wanting the best for your neice but imagine if it was reversed and your child was the one who was not progressing, how would you feel?

I will also say, just because they haven't mentioned it to family, dosnt mean they aren't seeking medical intervention Privately, it's not always something someone might wanf to disclose until they're sure. I felt guilty saying I thought she has autism close to the start of the process because I felt like I was labelling her prematurely. Once I had some professionals tell me that they thought so to I felt more confident in myself and could start to open up to family about it. But I was worried I was wrong and I'd look like a hypochondriac if she didn't. But she didn't and looking back it was glaringly obvious

Thank you all for your replies. I will try answer most the questions best I can ..

I am not coming from an informed position such as a nurse etc but I have worked with SEN children for a number of years although I will admit they were 10 years + so I am not as confident with signs from a younger age. But it seems quite clear to me there needs to be questions raised.

They do read to her yes, they are very active and involved parents and do really try their best that I am sure of.
but everything is met with a reason.
For example, if we go for a day out it is very rare that DN is happy to be there. To me it appears she is very overwhelmed by the noise, atmosphere etc. she will cover her ears and cry ALOT. She will not play with others, she will not really play at soft play etc.
We went to soft play a few days ago and she spent 30 out of the 40 minutes we were there stood by the adults, two stepping side to side on the same spot playing with her fingers, covering her ears, watching the other children but with no interest in playing.
Family member will say oh DN is tired today, she’s woke up un happy today she must be poorly etc.

I agree with everyone that says if the shoe was on the other foot I don’t know how I would take it either.

I won’t be saying anything, but supporting best I can x

You think they dont know?
My son is 14 and severely autistic, he's still non verbal at 14 ,of course I was aware he wssent meeting his milestones ,admittedly I didn't want to accept it ,it was a very difficult time I'm not sure a family member pointing out stuff i was very much aware off woykd have Been particularly helpful however well intentioned.

Could she have physical ear problems?
Does she get ear infections?
Has she ever had an ear test and examination?

That is a good question, she doesn’t get ear infections and hasn’t had an ear test since the newborn tests that showed everything was fine.

I have been researching glue ear and did think that could potentially be part of the communication delay - but there are still other aspects that I believe wouldn’t fall into this.

What you say would concern me but I think they have to come to the conclusion help is needed. Also I’m not entirely certain what extra will be provided for a 2 year old and they might not even worry about speech yet. I would also go out to quieter places so this child has a chance to enjoy herself. What about walking in woods or even an outside play area?

2 year olds don’t play collaboratively with others. It’s too early, Doex she go to nursery? That will help,

At the ages and stages review she’ll probably get a referral for a hearing test. If she’s covering her ears at loud noises, I doubt that it’s because she can’t hear. Is she non-verbal?

If she's as delayed as you say she is the health visitor will pick up on it and hopefully make the appropriate referrals ,my sin was referred to the paediatrician, SALT,Portage etc. At that age and was diagnosed at three.