talk to me about autism or learning disability signs in 2/3 year old

[bumbleandbumble]

A friend of mine has asked me if I think her daughter has a language problem. I wasnt sure how to answer as some people get very upset. But I think there is some issue going on. She is 2.5, maybe closer to 3 and she barely talks. Says "by bye" or biscuit or mama or repeats the occasional thing, but never talks in response to a question. She often doesnt listen, never looks you in the eye...and does a lot of strange things with toys...mainly climbs into things, on top of things and prefers to play with hand soap or anything that is not a toy.

If you say hello to her or ask her anything she doesnt even respond or look, and often doesnt respond to calling her name. The mother said she asked the health visitor when she turned 2...but they said that nothing was wrong and now that she does speak (i.e has a few words) the mum seems to wonder if its ok.

She also mumbles and makes baby noises which I find strange. are these signs of a problem and how do I tell the mother gently and point her towards good advice?

This is tough but I would be pushing for an assessment by a developmental paediatrician. My own dd has asd and having observed the early signs in my eldest I spotted it by about 2 years of age. many of the things you have listed would have applied to my dd but it is complex and children are usually diagnosed by a pead in conjunction with speech therapists, OT and other professionals. Being able to say a few words does not in itself rule out asd. I think the best thing to say is that having her dd properly assessed will not make her have asd and could just as effectively rule it out or suggest ways to promote her speech and comminication skills. If your friends dd does turn out to have some special needs this is the toughest time and she will definitely need your support. I remember though that even when I knew something was wrong I was quite defensive when others tried to suggest all was not OK. It may take time for your friend to want to face the possibility that there is an issue.

I think as your friend has asked, you should be honest (but gentle) with her. In your place I would acknowledge her concerns and suggest she speaks to her GP.

Hi

Well the fact that her DS has a few words, and I'm guessing her understanding may be on the same level with her speech...her DS would not be able to answer questions anyway, which is expected because of her language and understanding delay.

Her DS should be playing with toys in a functional way. So I would be worried.

The baby noises- do you mean babbling? Vocalising ?- if this is what you mean, then that is a good thing.

Her DD could have a learning disability, speech disorder. Nether less, I would encourage to seek an evaluation from the developmental paediatrician, who would do all sorts of tests.

I would advise her to take her DD to a doctor or HV and request a hearing test. It will be the first step in any assessment of S&L problems anyway and people are more receptive to the idea of a hearing test than to bringing up things like special needs or ASD. That way you can point her in the right direction without upsetting her or making her defensive.

I mean she sort of mumbles/moans.. not any sort of talk, just noise, like humming instead of talking.

She also never interacts with other kids. its like she is in her own world just roaming around and climbing on top of counters/trees/furniture...trying to get into cabinets.

The thing I am concerned is offending the mother. I think she is in denial and seems to think its so great that she says "see you"...but its only when copying, never on her own. And she is nearly three.

Some HVs tend to fob parents off with a 'wait and see' approach. I knew that my ds1 had a problem, he then spectacularly failed to meet nearly all of his 2yr milestones - but the HV still wanted to leave it a bit longer. (Ds1 was later diagnosed with ASD).

I think she might be better off bypassing the HV and speaking to a GP about a referral.

Tell your friend that truth and then give her lots of support to push for a proper neurodevelopmental assessment for her child.

It's hard when you're being fobbed off but you know something is wrong. A bit of you wants the fobber off to be right even though you know deep down that they are not.

It's a long process, often with long waiting lists and they don't diagnose children without consulting the parents.

She needs to get the ball rolling now so that her DD can have any support she needs in school. It really does take that long to sort it out.

I'd say to her if she's concerned (to be honest she sounds it) then she should arrange an assessment for her child with a developmental paed.

My own child behaved very similarly aged 2.5/3 yrs. She was referred for hearing assessments (I was praying it was just glue ear) and from there we had numerous speech and language assessments, school reports, ed psych evaluations.

She was diagnosed with ASD just after her 5th birthday.

I buried my head in denial for a long time.

Yes it does sound like there is something worth investigating. Refer to a Pead thru gp. also have a look at the m-chat screening list for asd risk.

She speaks more than my son did at that age. My son is 3 and has a speech delay. Up until a month ago the only thing he would say was 'bath' - he loves water and the bath but nothing else. He also went through a stage of making minimal eye contact and playing with things in odd ways.

The health visitor refered him to a speech therapist who he has seen twice and only to discuss my son - not done any speech therapy as such. He has also seen a paediatrician who think it's an isolated speech problem.

He has also had a hearing test which was fine.

He was showing many signs of autism: lack of speech, little eye contact, odd behaviour for example at toddler group he would rather play with the tap then the toys, he would want to push the buttons on everything etc etc. He was also sensitive to loud noises.

But I tell you what since he's turned 3, he appears to of outgrown many of the signs. He plays with things normally now, he is not scared of loud noises and doesn't shut up.

Your friend is best off to visit a doctor or health visitor again for advice. If they think there is a problem they can refer them to a speech therapist, paediatrician or for a hearing test.

I think seeing as she's asked, I would go along the lines of "she is late, why don't you check with the GP, it's better to have them being on the waiting list and are fine to come off, than joining the back of the waiting list in a year's time". In our area SALT can be a year on the waiting list, so I'd always advise anyone with a doubt to get onto the list asap.

I would warn her that they'll probably want to do a hearing test first. Make sure she isn't going to refuse, as up the thread, ENT say that most of the time parents aren't aware of hearing issues. Ds (glue ear) has, at times, very little hearing and I couldn't have told you. His cute little trick of patting your cheek to turn your face to his wasn't about attracting your attention, it was about turning your face so he could lip read. ENT say children adapt very easily, and often mask problems there.

With a young child who is not developing age appropriate speech a hearing test will be the first assessment to be done.
It was during this that the audiologist picked up on my DD's "unusual" behaviour and referred us to the community paed for a proper evaluation.
I was asked if she often stood on tiptoes and if I'd noticed she looked at objects sideways.
My heart flipped over as I knew why they were asking those particular questions.
That said, I now know ASD (not saying your friends child has it) isn't the worst thing in the world.
It is definately best for the ball to be rolling sooner rather than later, if only to rule things out.