19 month old toddler autism

[AREJAAG]

Parents of children with autism, what were the signs you noticed around age 19 months?

nursery have contacted me today to say that they think my son needs his hearing tested as he didn’t respond to his name or loud sounds around him, until something was banged on the floor near to him which they felt he noticed due to the vibration

my mind has gone on a bit of a spiral about his development all together now due to a few other things recently which I’m unsure whether it could be his hearing or something developmental.

he walked at 14months and loves to dribble around a football. He climbs up stairs and walks out of our front door oven a step independently and I’m not concerned about his physical development. He loves to climb, move and run around furniture.

he goes to nursery 1 day a week and it’s taken him a long time to settle due to this but he seems to be enjoying it now

the following things have concerned me a bit:

• he knows about 30 words but has recently started to babble more and stopped repeating words in the last few weeks to a month. when I said can you say .. he would repeat the word but hasn’t done this for a couple of weeks
• He loves my in laws dog and said her name when he saw her but he’s stopped doing this recently but I think this may be because they have been on holiday for 2 weeks so he hasn’t seen them/her for a fortnight
• he only responds to his name probably around a 3rd of the time
• he does prefer to play alone but will sometimes come and sit on my lap with his toy
• he plays with his stacking cups the majority of the time but he will play with a ball and other toys inbetween - but he is happy playing with his cups for a long time and will carry them around the house stacking them, putting them in different places, throwing them etc
• he doesn’t do any pretend play that I’ve noticed but will sometimes try to give me a bit of his drink if I make slurping sounds
• He never asks me for things/leads me to things he wants but I’m not sure if this is because I’ve been over anticipating his needs and don’t give him chance
• he’s never pointed to things he wants but will stand at his sisters bed and jump up and down and make a noise if he wants to get up.
• if his drink is empty he will throw it on the floor and make an angry/upset noise rather than bring his cup to me
• if I point to something and say look, he doesn’t see what I’m pointing at but will look at my finger or look at my face and smile
• he doesn’t refer to me, his dad or sister by our names or try to call us
• he used to point at pictures on the fridge and say mama and dada when he recognised our faces. He still tries to do this but doesn’t usually get it right and sometimes says baba
• he used to say “ball” when he saw his ball but doesn’t do this very often. He has done this once in the past couple of weeks

positives:

• he will link the names of colours to his toys as I hear him do this and also counts when he plays with stacking cups
• he makes eye contact, smiles and joins in actions and sometimes words with nursery rhymes
• he smiles and looks interested when he sees other kids playing
• he’s recently learned colours, can count to 10 and some letters and I hear him saying those when he’s playing
• when his dad comes back from work and I say who is that or is it dada, he will say dada and gets excited to see him. He used to say his name when he saw him coming through the window but doesn’t do this anymore
• he does make good eye contact when we play with him e.g chase and hide and seek.
• if I have a book open and point to the characters he will copy the action but doesn’t tend to copy the name
• he understands if I say come here or get your juice or where’s your kitchen
• he will come and put his head between my legs and bounce or hold onto my pants and look up at me if he wants me to pick him up
• he will say bye bye and wave when we are leaving somewhere or he will say bye bye if someone closes the door. He says bye if someone else is leaving our house before anyone else says it so he is definitely aware.
• he will say hi and wave but I’ve not noticed him do this for a week or so now
• when he responds to his name (not very often) he does make eye contact and it seems deliberate

I’m not sure if I’m overthinking it. Could this be normal development and possibly a blocked ear? His ears are quite waxy.
Should I be concerned about him not pointing or communicating and not using some of his words

I am taking him to the doctors tomorrow to discuss all of this but wanted to know if anyone had a similar experience?

I feel like I have failed him but I do have anxiety and adhd myself and get very overwhelmed. I worry I have not been spending enough time with him trying to teach him things - could it be that?

I don’t know if I am just worrying for no reason but I can’t get it out of my head that it’s my fault and I feel so guilty

thank you if you took the time to read

You need to get his hearing checked. It could very easily be glue ear which is caused by mucus in the middle ear. Very, very common in toddlers (probably 1in 3 have it at some point). It usually clears up by itself but might take months. In the mean time, audiology may give him a hearing aid or refer him for grommets.

You can't get any autism assessment until hearing has been checked so do this first. GP can refer for hearing tests.

Autism or not obviously the first step is to get his hearing tested. That will confirm if it's "just" a hearing issue or needs more investigation.

As a funny aside, parents of a child in my family got a call from nursery saying she needed a hearing test. Parents asked "does she respond when you say there's cake?"
Child was just ignoring/avoiding things she didn't want to do!

Thank you. He has had so many colds recently and his ears are so waxy - to the point where it’s not enough using oil drops everyday so I thought it could be glue ear or a buildup of wax. Thank you

To be honest I’ve been so worried about him not responding to his name that I’ve been overusing it and he’s probably sick of hearing it!

I think you know the answer, you're overthinking this. He's still talking, interacting etc. 30 words is good for 19 months. I tend to look at the US CDC guidelines as I find them a bit clearer than ours, and they expect 5 words at 18 months. At that age kids learn words, seem to forget them, then learn new words. It's quite normal. Knowing colours and numbers is very good! And not doing things for a couple of weeks is not a long period of time. The only thing that is concerning is the lack of pointing, but that on it's own is not enough as kids sometimes just take time to learn things. And if you always anticipate, or he can communicate another way, maybe he just doesn't want to.

There is no need to sit down and specifically teach kids things at that age. I'm not sitting down with my 2 year old and going through letters! Just play, read and chat to them. You're doing great I'm sure.

Tbh nursery will be the expert here, and if they haven't raised autism concerns, only about hearing, then take them at their word. Also discuss your anxiety with the Dr and see if you can get some more help I think. I know it can be worrying having a child but not to this detailed extent to cause a spiral. I didn't chart this level of detail with my daughter, noticing oh she said parent's dogs name 2 weeks ago and now doesn't. I'm sorry you're going through this.

My DC was around 18 months when I started noticing some traits with my child, as I also booked a doctors appointment.

I think you’ve done the right thing, no harm in checking. Make sure they refer you for a hearing test as if you do end up going down this road it’s one of the 1st questions any of the teams we have to see ask, and it just slows down the process if you haven’y had it done.

My DC is now nearly 4 and we have had hearing tests, bloods to make sure nothing genetic, speech and language to name a few and we now have an EHP in place which I am so happy we have before they start school.

I do think you son sounds fine btw, but if there is any autism or adhd its best to get things rolling as soon as possible.

You need to think about Autism as a diagnosis of exclusion at this age if he isn’t displaying obvious (and profound) symptoms. So getting hearing, eyesight teasted is the priority.

I think you should keep an open mind and definitely get a hearing test done. Toddlers can be quite good at disguising not hearing, hearing loss can be intermittent, and it might be that he hears some frequencies and not others.

It sounds like he is pointing to share interest (eg at pictures) which is a strong positive, though it's unusual that he isn't pointing to request. At this age, a lack of gestures more than a lack of speech would be a potential (though not definite) sign of autism. Does he/did he hold things up to show you? Or check that you've seen things that he's seen using eye contact?

If anything does turn out to be amiss - either with his hearing or his development - please don't blame yourself. It won't be because you didn't notice anything or didn't try to teach him enough (you don't have to actively teach typically developing toddlers communication - they just pick it up). If you and the nursery have picked up that something might need checking at 19 months, you've done amazingly. Get the hearing test booked it, raise any other concerns you have with the HV and take it from there.

I think you just answered your own question.

My dd's school told me they were concerned about her not paying attention, and that she didn't respond when spoken to. Turned out it was nothing wrong at all other than her tubes were blocked. She tended to get a lot of colds at one stage and that made it worse. It was also worse after she'd been swimming and got water in her ears.
The school changed where she sat in class so she was facing the teacher. Job done. She grew out of it.

Thank you, the on and off responding to his name has been going on for a lot longer but as I said the more I got anxious about it I ended up overusing it and I think that’s why he doesn’t respond as much as I would expect him to.

im currently having time off work as I have a stressful job and some other things going on in life adding to my anxiety at the moment. I’m hoping the break helps but I think I’ve possibly projected a lot of stress onto this situation too which has made me overthink it.

I appreciate the honesty! Thank you

Aw I'm so sorry, that's always horrible. My job makes me quite anxious so I understand. I hope it gets better.

I would be surprised if a toddler did respond to their name every time tbh 😂 They're too independent. Sounds like a normal happy toddler otherwise, and doing really well with his understanding and communication. They've all got their quirks. My daughter didn't walk until 19 months and I remember being worried about that and thinking maybe I'd missed something. She was just very cautious and tbh lazy/energy efficient! I hope the Dr can alleviate your worries and sort the hearing problem.

My child was 18 months when referred and just turned 3 when diagnosed.

The thing I was most worried about was the fact they didn’t point. If your child is not pointing or following your point I’d say that’s reason enough to ask to see someone. Please try not to panic but I know it’s hard. I was in a similar place to you although my child had other signs too like not waving and very little language.

Sorry but it’s irresponsible of you to say she’s overthinking it.
My son presented exactly the same and actually had more words and was diagnosed with Autism at 3 years old.

He seems fine to me just get his hearing checked, it can be insidious if it's gradually getting worse, and you don't want any hearing loss to stop his development of speaking and understanding.

You have absolutely not failed him, he seems like a lovely, clever little boy, whatever the outcome.

You haven’t failed him at all and you’ve listed some really positive things there.

Your lovely boy will the same boy with or without a diagnosis so just follow your gut (not to trivialise your feelings here, I know it can feel very isolating).

If it turns out that he happens to be neurodivergent then early intervention is key.

(Mum of 2 diagnosed autistic boys here who are both thriving)

Why? At this point she's worrying about something that has a more obvious explanation. A lot of this is normal healthy development. He does respond to his name just selectively, he does have joint attention with books, he does make eye contact, it's a bit early to say on the pretend play, there's no language delay. Doesn't sound like he's having behavioural issues that urgently need tackling, doesn't sound like he has delays at this point. The nursery hasn't said anything about autism, just hearing issues, and he has a wax build up that she's using daily oil for. She's going to the Dr to get that checked and discuss concerns. If there isn't hearing issues, then maybe it's time to look into something else. But I wouldn't start worrying down a spiral if there's a more obvious explanation that could be ruled out.

Could he have autism? Sure, so could a lot of 19 month olds. A lot of times you can't tell until they're older if the things that are normal in toddlers continue past an age appropriate timeframe. Not every toddler who points late or only selectively responds to their name has autism, and this is not a case where you'd say yes definitely.

Update:
thank you everyone for your comments. We have been to see the doctor this morning and she said his ears have so much wax that she wasn’t able to see far down enough to tell if he had glue ear. She has referred him for it removing

That's great, sounds like it's the cause of not answering his name due to all the wax! Hopefully a bit of a weight off to get that sorted. Hope you feel a bit better. Look after yourself!