Dad looking for thoughts - possible signs of autism?

[woko]

Hello there Im actually dad, not a mum, I would like to get some input on my 31 month old son (3 in October). Sorry for the exceedingly long post!

He has speech and language delay and social/communication issues.
The main problem is that he barely says a word at the moment, he may sometimes repeat stuff he has heard from the TV on his favourite programme but that is about it. He knows his full alphabet and numbers (including recognising them when they are written down), but can sometimes be a bit nasally when pronouncing them. He can also identify animals and make their noises.
He doesnt interact too much with other children, although he does play with his elder brother (4 1/2), mainly a game of chase where they will run after each other, and he often copies him, eg if his brother falls to the ground so will he. His interaction in general isnt great, although he will keep passing me a ball when he wants me to throw it in the air, will pass me something he wants fixing and will goad me into blowing more bubbles again by pulling at my hand or the bubble bottle. He will also pass you a toy if it needs to be wound up to work again.
His imagination with toys is not great although he will play with them how they are supposed to be played with eg he will push cars along and make the noise cars make.
When playing he does have great anticipation, he gets really excited at the prospect of the ball being thrown or more bubbles being blown. We also do this little piggy with him, he will run off with excitement and hide, laughing when we find him to do wee wee wee all the way home he is similar with round and round the garden and some other rhymes too.
He covers his eyes during the perilous parts of programmes eg the gruffalo when the owl swoops down or where the mouse meets the gruffalo for the first time and is chased, but does so with a huge smile and peaks through his fingers to watch or will ide behind the couch and peak over..
Will occasionally flap his arms if super excited but will do so whilst laughing and with a smile on his face no other occasions.

The issue I am currently looking at is that he does not respond to his name (only sporadically) and barely gives eye contact, although he does give great eye contact during the throwing and bubbles games something where he has to wait for us to do something for something funny/exciting to happen.
He has no hearing problems
Some other things that may be of note are the following:
He has no problem with new textures be it physical things to touch or food textures.
He eats all manner of colours for his food, a little more fussy about his food now but will eat anything from pasta tubes with pesto, grated cheese, spag bol, potato wedges, potato skins, boiled potatoes, crisps, chocolate, biscuits, chocolate cake. Is also happy to do so with his bare hands
Absolutely loves being naked and will strip off at the first opportunity he thinks he will get away with it.
Sleeps through the night no problem (and I mean until between 8 and 9 the next morning generally!) he used to go off to sleep straight away but now takes an hour or so after we put him in a bed and moved him in with his bro! unfortunately as a result of this we are trying to potty train him with little success and are cleaning up his number twos from everywhere!
Is very daring but clearly dopes so with a calculated risk.
Doesnt have a routine handles changes really well (we recently moved house with no problems too)
Absolutely loves cuddles initiated by both him and other people.
Is not fixated on things although we bought him shape jigsaw the other day he took one look at it, tipped the pieces out and put every piece back in its place immediately as if he knew where it went and had played with it previously.
Doesnt line things up or any other unusual behaviour with the objects he plays with.
Does have major tantrums if he does not get his own way, he can now be easily distracted and they dont last long.
Gets really hangry when hungry he is a nightmare.
Gets angry and frustrated if we dont get out of the house sometimes or we return to the house and he doesnt want to go in yet
Loves flicking through books, turns one page at a time and then gos on to the next one. But also rips a lot of books if he is not interested in them (or bored).
Will wave by bye in the right situation usually without prompting.
Does not share experiences wont show you something he is enjoying or try to engage others to play with him (unless to wind up a toy as mentioned)
Walks fine (not on toes or anything).
He wont ask for anything, no milk or food etc, instead he will take you by the hand and lead you to the location of the things he wants you to get for him (if he cant reach it)
Hurts himself quite a lot always covered in cuts and bruises but will approach a parent for comfort if really hurt.
Loves his Nans and approaches granddads for hugs and to sit on their knee
Likes going to the park will go on swings, slide, climb stuff. However, he will run off out of sight without worrying where we are.
He is a noticeably different person when his brother is at school he is more lively and seems happier and more smiles. He also tends to get shy when new adults/people some to the house, although after 30mins to an hour or so will go back to normal this obviously hinders speech/language therapy and doctors appts since he wont interact with them.

Due to the severe speech and language delay, lack of eye contact I am concerned that my son may show signs of being on the autism spectrum. We have had 1 speech and language appt but they are slow to arrange another despite chasing them up which is frustrating. We have been referred to a paediatrician, but they delayed this also and he wont see them until he is 3. They gave us homework to pretend to sip from a cup and comb a dolls hair but he is just not interested. Although he did pick up a hair brush the other day and start brushing his teeth with it.
We will be putting him into nursery soon we had to pay privately for his brother to fit better around working patterns so we cant put my son into nursery until July when his brother comes out.
In addition we also now have a 6 week old which makes it hugely difficult to give my little mate the time he deserves and limits our opportunities a little to try and help him along.

One thing I should mention is that his elder brother was identical to this at his age including the eye contact, speech delay etc. His elder brother is now thriving, writing, wont stop talking, outgoing etc. his elder brother used to go months and months with no development and then all of a sudden start doing everything weve tried to teach him. He only properly started talking aged 3 . My younger son is now really starting to babble and talk gibberish sentences this is what his brother would sometimes do before he went through a language spurt.
However, the frustration of inability to regular access to NHS facilities relating to speech therapy, and coupled with the fact we cannot yet afford to put him in nursery seems to be causing my son more delay. I am hoping that this is just how my children develop and that he will catch up, but there seems to be very little progress of late, particularly over the last 2-3 months.

I am keen to hear of anyone elses experiences and opinion? It is very frustrating with the lack of access to experts (we are however waiting for a response from a private speech and language therapist). But it is also worrying, my son hits practically all of the speech and social red flags of autism, but he does not hit any red flag due to physical aspects of it (ie textures, fixations, repetitive behaviour etc).

thanks in advance everyone.

Would love to hear how this goes my son is very similar (but his eye contact is great and that's the only difference really, we are currently having a staring contest about refusal to eat fish fingers).
Apart from that I think loads of what you say sounds like toddler behaviour? I am not an expert but because mine is going through the same I have read (and googled) a lot. So it is encouraging to me that your older son is well and thriving? My daughter (who is now 5) was different but if you want you can always find autistic traits on 2.5 year olds.
I hope you can find someone that reassures you, and ultimately he grows out of it. I keep thinking that I would love to wake up and for my DS to be 4 but that's no way to live your life, wishing it away.

Well loads of things, most really, on your list are completely normal for his age. There are a few red flags though, the hand leading being the main one for me, along with the lack of eye contact. (I don't have a child on the spectrum but do have a child close to me who is at the most severe end). I think you are being sensible in chasing this up, but that it may well be nothing worrying. i agree with you it needs checking though, and I'm surprised they are saying not until three as the autistic child I know well was diagnosed at 2. Go back to your GP and push for an assessment, as I do know that earlier intervention is best if your DS is on the autistic spectrum at all.

Thanks everyone, you're comments are reassuring.
I go through phases where I'm convinced he isn't autistic, then others where I wonder.
I was playing with bubbles with him earlier, loads of eye contact, excitement, anticipation and was trying to blow then himself as well as saying 'pop'
Either way I think it's clear that he could do with more one on one then he's getting so we'll come up with a strategy.
Thanks again, Will keep you posted.

I could always take him card counting at the Casino when he's older...

Ps, just by way of possible interest, my oldest son didn't point until he was over 3!

I have a DD with autism and recognise a few things.

Have you raised it with the HV/GP?

First step would probably to get a hearing test to make sure there is no underlying hearing issue.

Google "M - chat" it is an autism screening questionnaire. Do it and if the scoring flags up take it to GP or HV and push for a referral. Don't be fobbed off.good luck!

Your son sounds a lot like my daughter, actually. She's now turned 4 and got her diagnosis in September last year. She's still non-verbal (well, pre-verbal), but very happy, interactive, and outgoing. There are a few differences: she was and remains fussy with food, her eye contact was always good (with me, at least) and she's only just started waving hello and bye bye, and not consistently.

She was always extremely daring, picking the hardest thing in the park, and climbing right to the very top. She's started stripping off the moment she gets home as well, although this has coincided with potty training (late, but so far very successful).

I think the red flags for me are the inability to share experiences and leading you by the hand.

The lack of sensory issues is a red herring, IMO. Some children with autism have very few sensory issues, some are avoidant, some can be sensory seeking. Being very active, for example, loving swings, roundabouts, rough play, can be sensory-seeking behaviour, although it could equally be the sign of an energetic toddler. Thinking about my daughter's sensory issues, there's nothing that couldn't also be explained away as 'normal' toddler behaviour. Nor has she ever had a meltdown.

His elder brother is now thriving, writing, wont stop talking, outgoing etc.

See, this statement bugs me a little, because none of this precludes autism. Is there any lingering sign that autism may still be an issue in the elder brother?

The long, long wait for help is shitty, shitty, shitty. My advice would be try not to stress about it (ha!), and concentrate on giving your son as much one-to-one interaction as you can and enjoying your time with him as he sounds delightful. That is what is important, not whether or not he gets a diagnosis.

Oh, and congratualtions on the 6 week old!

Thanks folks, firstly thanks for the m-chat link, having goods through it the main red flags seem to be communication issues, which I suppose could be explained by speech delay.
I always felt that a toddler with speech deejay would generally have communicative issues and possibly a lack of understanding, it was certainly the case with my eldest. Nevertheless, there are still some red flags.
My oldest used to go through developmental 'spurts', nothing for a while then I used to say he's kind of gone to the next level of conscious thought and actions. It was really frustrating and baby people thought he may be autistic between 2 to 3 and a half but then he just started thriving.
However one difficulty he does have is establishing new friendships, but for want if trying, he sometimes jest doesn't know how to go about it.

The thing is, I was exactly the same too!

Excuse the typos!

Communication issues can be Speech delay but there can be more to it. What was your score? I would really push for further investigation. It takes ages to be seen.

Score was 11 passes and 9 fails! All fails more or less linked to understanding and speech.
I've called the health visitor today, they're calling back later...

OK. Be persistent! You really need a developmental paed. HVs let us down badly. Speech is one thing. Communication another. I had friends whose DC had speech delay but the communication was still there (non verbal, pointing, shared attention etc) - my DD was not really communicating in these ways either.

what Choc said. Also I would be looking more closely at your older son. You say he is thriving, but there's an underlying assumption there that children with autism cannot thrive - not true. Your comment about him finding it hard to make friends is rather telling, I think.

Did he ever see a paediatrician?

To be fair, I am not worried about my oldest son at all – he sometimes finds it difficult when there is an already established peer group (whop doesn’t??) but he is happy to go up to someone and say ‘will you play with me’ he will sit on the outskirts of a peer group and watch in as he may find it difficult to integrate himself into it, but then that is kids as far as I am concerned and it is the same in adult peer groups.

I have no concerns over my oldest son at all.

However, If I had measured my oldest son using the CHAT test then he would have actually scored higher fails than my younger son does currently.

My oldest son wouldn’t respond to names, wouldn’t point or respond to pointing, lined up cars continuously and was fixated on them, wouldn’t eat anything but pasta tubes, didn’t mix with other children, didn’t engage in play with myself or my wife – eg peekaboo, didn’t point, barely spoke, couldn’t understand instructions.

As time went on he would become more and more angry and frustrated, he would lash out, cry a lot, make a droning moaning noise. Then literally he would wake up one day and do sop many things we had tried to teach him. The frustration would completely disappear, he would be really happy. But he wouldn’t sleep at night as he was constantly practicing his new skills, then this would repeat every 3-4 months, each time he would go to what I always called a new level of conscious thought. It was strange and frustrating, but now he is loving, social, intelligent, enthusiastic for learning, humerous, plays tricks, games etc etc.

My younger son seemed to follow this pattern and I am hoping that it continues – it has just paused a little. With my oldest son it would be just as we were starting to get really worried, that he would go through a development spurt. Who knows……

Having developemental spurts doesn't rule out something like Aspergers. I know a boy with Aspergers, and I was really surprised when his Mum told me, as he is, as you say, thriving. He comes across as a bit shy perhaps, but is often off playing football with the other boys, he's just a normal lad. But he did really benefit from the extra help and support the school have given him. Had you ever thought that perhaps you yourself could have Aspergers? Or do you feel it doesn't apply to you at all, having read the test? I am asking because the information you have given about your elder son has more red flags than for your younger. And high functioning autistic children can and do learn to fit in with others, and thrive. Just they may need a bit more support at certain stages, and a bit more understanding.

Hello,

I am currently working as an RDI (Relationship Development Intervention) consultant with families of young people on the spectrum. We use the programme to help re-establish social and relational development stages that may have been interrupted due to the presence of Autism.

My background is not diagnostic and although your post was fantastically descriptive it would I think be unhelpful to focus too much on is he or isn't he until you do eventually get the support and assessment you have asked for. However, there were some things around the communication development that I noticed and might be able to offer advise in.

• Eye contact - read up on 'social referencing,' what this is and how it develops. There is a difference between this and eye contact that is key to explaining more as well as shaping your approach to it. I am not a big fan of 'asking' or 'instructing' for eye contact as what you want is for a child to develop the drive and motivation, as well as realization that they can look to others to guide and shape their decisions in moments of uncertainty.

• Experience sharing communication - it seems your son uses instrumental communication well to let you know his wants and needs, which is a strength and will a vital skill for the future. Try to immerse him experience sharing communication, pointing things out to him, making declarative statements about your own emotions when he is engaged e.g.'I like bubbles. I think you do too.' Use non-verbal exaggerations to gain his attention - sharp intake of breath etc then look at something. Maybe try offering him two things he can take and will want to, then using non-verbal gestures to show him which one you want him to take.....

The other thing that really stood out for me was when you said how he interacted around bubbles and activities where there seemed to be anticipation that something will happen. This is fantastic and really positive regardless of if there is a condition present. I would build on this and use it as a platform to add in little variations to help develop flexibility of thought. Maybe try to introduce something where he has to take a role in the interaction - such as waiting until he does something before blowing, so put bubble to your lips and wait, and wait and lean in, and wait, then if he reaches out for it....blow. There kinds of activities are great for social development.

A game we sometimes use for attention if someone doesn't automatically attend to people is called 'Sneaky Pete' or the 'freeze game.' You basically sneak up on them until they look at you then freeze, when they look away, sneak up some more. Once you get to them, give a big hug or tickle or interaction they enjoy. Then go back and start again. The good thing is if they don't attend in the first place, you just sneak all the way up and tickle etc, then repeat.

Other things such as crawling towards them on all fours, wearing a huge ridiculous hat (promise this is tried and tested and not just a late April fools), or sneaking up and slowly taking away toys - making sure to smile and stop as soon as caught. Essentially the target for development is to show the value of attending to people, that it can be fun and useful.

Hope some of this makes sense and can be helpful. Our project has it's own forum and website with more information on Behavior Support Approaches, as well as guest forum professionals, if you'd like to find out more head to:

www.bis-net.org.uk

or follow us on twitter @cedabisnet or on facebook.

You can also email me direct at [email protected] if you like to be added to our emailing list.

Cheers
Sam Harris
BIS-net Manager & RDI Consultant.

thanks - since you mentioned it my son actually does similar things, he'll grab us by the hand if he wants to go out in the garden or in the front, and will lead us to the cupboards or taps if he wants food or a biscuit. He will understand and react appropriately if we say, 'dinner time, come on, let's sit down', bath time, let's go upstairs', 'do you want a cookie' (which he will then get ecited and say 'cookie'), 'come and get your nappy changed' amongst other things too.
with this little piggy we only have to start and he runs off with huge excitement and hides somewhere knowing that when we get to the end he will get tickled. likewise with row the boat - we adapted it to all sorts (eg gently past the street, if you see a little bird don't forget to tweet) - he will run off and then come back at the end waiting for the final part similing in anticipation.
I have spoken with the health visitor this morning and said that the length of time is becomuing a concern for us and we'd like to be sped up if possible, they were good and are getting another visitor out to see him soon and assess him and see if they can speed up the paediatrician referral.

@bisnet - sorry i missed your post on my mobile earlier - but it is very informative and has some great ideas - i really appreciate your response - thank you

No problem. Let us know how you get on with them.

Sorry, . Just catching up with some posts.
When I said my oldest has more red flags, I meant if he took the test aged 2-3, now there are no flags

That wasn't quite the point i meant to make, sorry, and maybe your oldest is completely fine, but all children change and develop, AS or not, and if Aspergers is an underlying issue in your elder son, as to me it sounds as though it could be (although as I've said I am not an expert in any way) then getting an assessment can be a very positive thing, as a little bit of extra help as early as possible can make a massive difference to a child. Particularly around transition times such as shifting to high school etc. If you are having your younger child assessed then I would think strongly about having the same assessments done on your older boy, because even quite small differences in social skills make a big difference as children get older. How old is he now?

I'm with SirVix on this one -- I think it could be worth getting both children assessed. If it turns out there's no issues, fantastic, you've lost nothing.

It was strange and frustrating, but now he is loving, social, intelligent, enthusiastic for learning, humerous, plays tricks, games etc etc.

This is the point I've been trying to make: children with autism can be ALL OF THOSE THINGS.

I'm going to bow out of this thread now, because I'm starting to get frustrated, and it's really not fair to be taking out my frustration on you when you're worried about your son (and you don't need a lecture right now), but perhaps have a think about your preconceptions of autism and children with autism.

It isn't always obvious, and so many of the symptoms can masquerade as the behaviour of a neuro-typical child.

Crap, reading over my last post and it seems unnecessaily combative. I'm sorry; I think I'm projecting just a little bit. I was in your position not too long ago, so I do know what it's like.

I really do with you and your family all the best, and I will add that upping the one-to-one contact you have with your son is a brilliant idea. I found Floortime brilliant for my daughter. You could also look into Portage, and check your local Children's Centres for groups for children with speech delay or other additional needs.

It's not so bad, you know.