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.

No problem, sorry if I came across as dismissive. I gave started looking into it. Online chat tests come back a nothing to worry about for my older son and myself.
I've just had 20mins with him and an over the moon after making more progress in that time in months.
I used bisnet's suggestion of playing with the bubbles but doing a sharp intake of breathe which was getting his attention.
He really interacted, I gave the bubbles to him, he was taking them to his mouth but couldn't do it, he gave them back to me and pushed then to my mouth and said 'come on, quick' very excitedly.
Using the sharp intake of breathe technique I did it and said 'look' and he quickly looked towards where my finger pointed.
Then I went into the kitchen and he actually took me to the overhead light button on the oven, pointed at it do I lifted him and he figured how to turn it on and off.
I think one of the major keys is figuring out how to gain his interest.
He was also saying hello to the window cleaner this morning apparently
I'll keep plugging away.
Thanks everyone

Just wanted to add a little of our current experience. Your son sounds very similar to ours, who is 30mo. We have been through group speech and language therapy and one-on-one therapy, mainly observing and understanding his communication style and creating strategies based on that (all NHS).

In our area there is a central point for dealing with all matters relating to children with disabilities and additional needs, which encompasses hearing tests and oversees/connects with speech and language. We were referred for a hearing test by speech and language, and the paediatrician present at the first attempt (couldn't even start it as DS wouldn't have it!) referred him for a developmental assessment. From this he was referred to the multi-agency team. We then had an appointment with the developmental paediatrician, child psychologist, and role which name escapes me but person who deals with assessments for social communication disorder, ASD, etc. They observed him a bit whilst the paediatrician asked a few more questions. Based on this meeting they have referred him for an assessment at what is known here as the complex communication clinic (perhaps it has other names in other authorities), where he will attend 5 sessions observed by various child development professionals, the setup is a bit like a nursery, and they use this to determine if a diagnosis should be made, such as for ASD.

We have been very fortunate with the provision in our area, however if you're getting nowhere I would recommend having a look at your local council and/or hospital's websites and see if you can find if they have a department or organisation that handles children's additional needs or disabilities. Ours comes under the local hospital but can also be found under the list of council services. In the past with different matters I have found it easiest to self-refer and I started DS with speech and language therapy through self-referral.

However like you also, we have a history for this, in that our son is very similar to my husband. He went for various assessments as a child with no results/diagnosis other than 'fine'/NT. He began talking around 4yo with an advanced vocabulary and form of speech, but remained behind at school throughout Primary. Then he became above average during his teens. Now he's a fairly ordinary, albeit quite intelligent, man So we also sway between, "He's just like his father" and, "Could there actually be more to this?". We're still in the process of finding out but either way we're not worried.

Best of luck to you in getting further with the authorities

I just wanted to provide an update regarding this post. It is getting on for almost 3 months since I originally posted it.
We paid for a private speech and language specialist who noticed that my son did not want to engage in any activities which were not on his terms and highlighted one or two red flags.
I harassed the health workers in our local authority who were excellent and worked really hard for us, we were eventually able to get a cancellation appointment with a paediatrician and saw him a few weeks ago ? he is a very well respected paediatrician in our area. We went over everything, providing a copy of the private S&L report, copies of observations made by health workers who visited our son at home, as well as notes from the NHS S&L therapist.
Taking a holistic view the paediatrician said he could see why some people may think he is on the spectrum as my son does hit a few red flags. However, he also noted that the majority of the red flags were speech related. He said that due to many reasons including imaginative play and particularly his affectionate nature with people he did not believe that my son was on the spectrum when viewed with all the information provided and after observing him (despite the fact he was having a major melt down!) He said that he did believe that my son has communicative delay and is around 1 year beehind. He was not overly worried as, although my son is 3 in about a month, he still has 2 years of nursery/pre-school to catch up
I thought I would be relieved with the news but I wasn?t really any different. I had come to accept that my son was going through a difficult time, and autism or no autism, we still have a lot of work to do just as parents in bringing a child up. I had thoroughly researched this, gone on past experience and was really trying to be truly honest with myself and though (well hoped) that the paediatrician would say that. I was prepared for being told my son may be autistic too. My wife however was over the moon and said she did not realise how much stress it was causing her, you could see she was visibly beaming afterwards and looked so light on her feet!
Since then my son started going to nursery 2 weeks ago. He has attended for 4 mornings so far. He hasn?t been great tbh. The key workers have said that he doesn?t like changes in routine, won?t engage with them and doesn?t give great eye contact. He has often freaked out when being taken away from his favoured toys.
I had a long meeting with his key worker and the nursery deputy manager. Apparently they change rooms completely every 40 minutes to stop kids getting bored which my son doesn?t like as he is only just settling. I think it a little unfair to judge someone on thee basis that they don?t like change as I think that is a lot for any child to go into a new place only to be moved into a new room just as they?re settling down (it would annoy me for a start!). Since then they put in his favourite room (books and jigsaw puzzles) last rather than first and he is improving each day. in addition, they have commented how cuddly he is with everyone and is happy playing with most toys with really good imaginative play. It was then the key worker said that it was for those reasons that he may come across as autistic in some ways but if you realised he has communicative delay then it would make sense ? I was very annoyed that despite putting this information in a welcome pack for his key worker she had not read it
So as you can see, it is difficult in a lot of ways to assess children as being on the spectrum, but I?m happy to take the experts opinion on the matter.
We have really focussed on giving choices in terms of drinks, using different colours, foods, even shorts and trousers/t shirts and jumpers, and my son is now starting to communicate with us. The other day we were in a park and my son said ?come with me this way, what is it? it?s a duck? and pointed ? lo and beheld, there was a duck! He also took me into the kitchen pointed at the bread and said ?toast? and I gave him toast for something to eat. My son has finally started communicating with us, he is pointing and saying words which make sense which is amazing to us. He is also babbling a lot more and really starting to copy behaviours and speech of others too. My mum called at the house the other day and he said to her ?ay up duck? which was a nice touch too.
I think because of the delay, because of my son?s frustrations and because of us really expecting him to catch up at some point, it made us slightly more lax in terms of managing his behaviour, that is the next challenge for us ? learning to discipline him despite the current communication difficulties.
We continue to move forwards!

can I ask what the red flags that have been highlighted are? only I have a 28 month old son and have some worries about toddler behaviour or signs of ASD and trying to see what are the main concerns.

It was a lot, eye contact, not engaging with others when playing, not pointing to what he he wanted, poor non-verbal communication. Now I'd just say it was communication more than anything
Our oldest son was exactly the same and is absolutely fine now.

Hello Woko/Wiko

First of all, your boy is so fortunate to have a dad like yours, he will most definitely do well.

A lot of what you wrote reminds me of my 30 month old son. He started talking although quite late (at about 18 months) but when I had my daughter, he stopped talking altogether and remained quiet for about 2 months.

We had a private SALT assessment and was told he was delayed in his receptive and expressive speech. He has since been babbling and will occasionally say a word but then not repeat it.

We have also seen the paediatrician who said we should wait for a few months and see how he gets on especially as he also has glue ear. The paediatrician did mention autism as he said he was delayed in his play and visual cues. I don't know what that means. I couldn't ask a lot of questions because my baby was a bit unsettled so I was distracted.

I am really glad that your boy is doing well and only wanted to write that your post has encouraged me.

Please do come back and give updates when you can. I will be watching this post.

You could be describing my own son who is exactly the same age!

I am also fustrated with the lack of assistance - for a while I just thought, OK I'll give him more time. GP and HV were not concerned enough to refer him a few months ago.

My son also lines things up, but is likes yours forms no sentences. It sounds like getting both your kids assessed would be good. I've just booked an ADOS assessment for next week as the amount of hoops to jump through to get one non private is really long - but have to wait 4 months for a speech therapy assessment.

I've also heard that kids like ours may/may not be autistic but may have hyperlexia (look it up) or 'pervasive development disorder' non specified - neither of these are clear diagnoses but both seem to respond to extra help and minding kids at school with transitions etc.

I have 4 children, one of whom had a speech delay, one who has HFA and I work with children on the spectrum.
My child who had a speech delay was later to point than the 2 NT children but did so by 18mths so at the top end of normal. But I already was as sure as I could be at 18-24mths that it was speech delay rather than asd because his non verbal communication was on track by then. He was also very engaged socially with both us and his siblings. And there is s difference between engaging with you because you can meet their need/want or are facilitating their keen interest in something and proper engagement just for the sheer fun of it. My asd child can be lively and engaging on his terms. My child with speech delay wanted my company. My asd child pointed eventually at almost 3yrs but only ever at things he wanted (imperative) never at anything he wanted to shore or share with us (declarative). In contrast, my NT children and my child with SD all went though that frantic toddler pointing stage at dogs, cats, butterflies, flowers and aeroplanes. They'd point furiously then look back at me to check I was looking at what they were showing me. Son with asd was pointing for himself.

I think it would be a good idea to have both your boys assessed. If everything is fine then great but if the paed thinks your older son is on the spectrum then getting help and support in place now will make a tremendous difference to his ability to cope as he gets older, moves through school, hits puberty etc. many high functioning children are missed until then reach 11 and fall apart at secondary school. Many of those high functioning children I have taught who have been diagnosed nice and early (well as early as we get in the UK) have been seen due to a more severe presentation of a younger sibling.

Your description of both boys displays red flags for me. The leading you by the hand, the late pointing, the lack of pretend and imaginative play. Some parents think their child is displaying pretend play when it is really just copied play. Check whether what you are seeing is genuinely from the child's imagination. The late gesturing such as waving and clapping is also unusual. How we're both boys at copying? When they were much younger if you tapped something would they copy? If you beeped your nose would they either also beep your nose (around 10-14mths) or beep their own nose (12mths+) Did they roll balls back and forth with you? How did they react to mirrors? Normally by around 8mths, babies get very excited by their own reflection.
You may find that nursery will flag up some issues and that will help your case with the paed. It may turn out that there is no issue with either boy and then you've lost nothing. But if there is then the earlier you get recognition of that the better for your boy(s).
Good luck
p.s Some children at 2,3 or 4 on paper appear to be classically asd but grow out of their traits because that's all they were, traits. Other children on paper appear to do things/not do things which some people feel rules out autism and they go on to receive a diagnosis. It often takes a train, experienced eye and a multi disciplinary team to spot the nuances which distinguish both sets of children.
Of course, you'll find that parents of asd kids turn out to be the most knowledgable group of people on Earth when it comes to autism!

Thanks for the replies all.
First of all - as mentioned in an earlier post - my eldest child does not show a single red flag associated with ASD anymore. He showed a lot at aged 2-3, but from 3 and a half he developed so quickly we couldn't keep track - no one at all - doctors, paediatricians, nursery workers, health visitors think he has anything to do with ASD. They all suspected at one stage but stated that it was primarily due to the speech delay - i won't be getting him tested for anything as there is no need whatsoever, there are no concerns about him.
With regards to my younger son, again we have seen all of the experts we could, health visitors, NHS speech and langauge therapists, private speech and langauge therapists, paediatricians. the paediatrician said there may be one or two red flags but nothing suggests to him that he is autistic and he stated that he believed that he has communicative and social delay and expects him to catch up. his development is practically mimicking that of his elder brother (who is fine!).
over the last 4 months or so my younger son now copies a lot more of what we say and is now able to apply it in life - stuff like 'look, it's a duck, quack quack' which he never would have done a few months back.
He is now dressing dolls, using mr ptoato head to work on body parts (which he can identify and apply correctly), he will engage in excellent imaginitive play - particularly dinosaurs chasing people and roaring, on top of putting people in cars and beeping characters out of the way, flying aeroplanes, pretending with a parrot that it is the owl off the gruffalo and re-enacting gruffalo scenes with many figures. he will point and ask for something, does all of his waving and bye bye etc. He has settled into nursery now which changes activities every 40 minutes which he is fine with, he has developed excellent affectionate relationships with his key workers, singing nursery rhymes with charcters he picks up, playiong with people in games such as chase and hide and seek. the one thing is that the paediatrician thinks he is about 12months behind in his language and communication development - he is doing now what you would expect a 2 year old to do - but he is progressing very quickly.
We have obviously been throguh all this with my first son (who again is fine!) and started going through it with my second son but gone one step further by seeing a paediatrician. Having read up about it, really worked hard with our son, but ensured that we were not baised, we allowed the paediatrician to have an unbiased view by not offering our opinion and just answering his questions honestly. The paediatrician informed us that it was communicative and social delay but had no major comncerns as he has seen many children like him. this is the only thing we can go by and is what we are going to go by. If we had no progress from the paediatrician appointment to now then i would be worried, but the fact is that my son has made major progress in every area.
a few things i will take from this are:

autism is different for everyone - what one child shows as a characteristic may not be seen in another child

take a holistic approach.

seek expert advice

just because an expert may think your child is on the ASD doesn't mean that they are.

just because an expert doesn't think that your child is on the ASD doesn't mean that they are not

speech and langauge/communication delay can cause your child to hit over 50% of the ASD flags, but may not mean that they are autistic (like my oldest son who, did i mention, does ot have ASD).

children can catch up on developmental delays.

research, be honest with yourself and trust your instincts - take note of the opinions of friends, colleagues or internet forums, but understand that some of them might not have all of the facts or may not have paid attention meaning that the advice they give may not be useful - either because they know too little about the overall situation (if you haven't explained it properly) or in case they think they know it all without taking time to properly understand.

make sure that you and your partner support each other.

don't give up on your child

remember - to you an appointment with specialists where you might find out your child has autism could be the biggest moment of your life - to your child it could just be an ordinary Tuesday.

stay positive wherever possible.

one thing i have learned being on forums is that people have really valued and educated opinions on important matters, but as a result can also really want you to understand and adhere to their advice. Advice is there to take it or leave it. An opinion can be taken into account, and an opinion without force or agression behind it, to me, is far more valuable than someone getting irate because you think their opinion or thoughts might not necessarily apply to your certain circumstances.

thanks folks - i'll post progress updates

Wow Woko ! Thank you for coming back to give us updates.

May I ask what you did to help your son achieve all these ? I am getting quite frustrated as my 30 month old son isn't talking, no matter how much I talk to him and label stuff

He doesn't engage in pretend play
He doesn't communicate his needs, all he does is cry when he wants something and I can usually guess what it is
He doesn't point or nod or shake his head though follows a point
He also seems to engage in joint attention
He doesn't listen. I tell him off constantly but he continues to do what I've asked him not to

I am now not concerned about an ASD diagnosis or not, I just want to help my child communicate better before he starts school, God willing.

What tips can you give?

Progress so far ? I am updating this more for a record/audit of everything that is happening and want to keep everything honest. Some may find it useful and it is also useful for me to look back at and see how things have progressed.

Anyway, my little one turned three a month ago. And he has been making progress which has kept my wife and I encouraged. He absolutely loved nursery, although he still engages in adults a lot more than the children. He will play with children if it is something he is familiar with (for example chase) but doesn?t have much interest in joining in otherwise.
He has thrown some humungous tantrums over the last few months ? I think out of sheer frustration more than anything else. If he doesn?t get what he wants ? such as a biscuit, or to go outside, then he has a mini-meltdown. At one stage the tantrums were lasting over 20 minutes, but with a little work they are now often over as soon as they have begun.
His eye contact has now massively improved and he will almost always respond to his name whereas previously he didn?t ? and this is really without doing anything additional to encourage it. On top of that his vocabulary has also massively increased, he will point out objects that he says in the street and say ? ?look a digger?, ?look a digger man? as well as similar with cats, dogs, fire engines etc. he loves nursery rhymes and often sings them and does the actions and joins in with others. On top of that he is also now bringing things over to us to get us to join in - particularly little action figures and books ? something which he never really did.
He also now points at a lot of things and will ask for toast, water, biscuits etc, sometimes when I give him a choice though he will look all confused and just smile ? which is heart breaking. But then that is mainly with colours (which he does actually know) and when it is two obvious differences such as toast or water, he will make his own choice using words.
Finally he has just started occasionally using the word ?mummy? and ?daddy?.

We were at my dad?s birthday yesterday, who sometimes get a little drunk and I generally leave before he goes to his older ways and turns into an idiot, I left it a little longer yesterday and didn?t gauge it properly. He then said, in front of everyone, ?he?s got problems hasn?t he? Hasn?t he??. I explained everything that the S&L therapist, health visitors and paediatrician have said and he just said ?come on he?s got problems hasn?t he?. It made me want to grab him and beat the living daylights out of him, but then I thought, what if we?re being blinded by the fact that he is our son and the issue is more than what we thought?

I keep reassuring myself that the paediatrician appointment was 2 months ago and he has come on leaps and bounds since then. The paediatrician?s report stated that he did not believe that my son was autistic on the basis of his observations, our professionally obtained reports and an overall holistic approach, and felt that he had speech/language/communicative delay. The report stated that he was about 12 months behind, which is also what we assumed ? this also ties in with his older brother who exhibited the same characteristics and development patterns but who is now thriving in all aspects of life in school aged almost 5,. My son still has two years to go until he starts school so there is plenty more time to get any more assistance we need and time for him to develop at his own pace too.

It is difficult, and my heart breaks for my little one. He is the loveliest little fella going, and so affectionate too. I sat him down yesterday and told him to ignore his granddad and he didn?t say anything, just gave me a huge smile and then the greatest hug and it really broke my heart that he couldn?t just say anything.

But ? we take encouragement from the fact that he has made huge steps even in the last 2 months ? he has started to do things which we never even would have thought about in August, his vocab is ever improving, his level of understanding is now rapidly improving too He is starting to communicate with us, and we can rest in the knowledge that we have accessed every bit of assistance and help that we can for him by seeking all the professional advice that we can, putting him into nursery and trying to get him on any programmes which may assist. As time moves on we may learn something new, but as frustrating as it is, we can really see his personality developing now, and it is one with fun, adventure, laughs and affection.

@woko
Hi
I hope everything is fine with you and you family ❤️
How did it go with your son? Any updates?