Nursery raised a concern

[Luckystar1]

I'm asking on behalf of a friend whose DD's nursery has raised a concern about her lack of answering to name/unresponsive to calling etc. My friend told them her DD (20 months) was just rude.

From afar I have noted in my relatively frequent interactions with the DD that she is relatively disengaged (she has never come over to me, handed me a toy etc). She is also quite a difficult (but lovely!) little girl, with extremely frequent tantrums and slightly obsessive with wheels...

I appreciate it's none of my business, but I would like to support my friend and encourage her to seek help if necessary (we are close and I think she would like advice and support as I have provided in the past)

I think nursery wouldn't have raised a concern unnecessarily but perhaps they would who knows.

Does any of this sound problematic? And if so, what is the usual course of primary action?

Thank you

All of this sounds like red flags for ASD.

The normal course of action is for nothing more to happen unless the parent asks the GP for a referral.

I don't think nursery can initiate one.

I would guess the nursery are probably wondering about possible ASD. They see a lot of toddlers so will have a good idea of what is typical behaviour for small children and what isn't.

It would be up to your friend to start the ball rolling with regards to any possible diagnosis though. A GP would be able to refer her to a pediatrician if necessary. Nursery are not able to refer to health services so if your friend chooses not to act on their advice, nothing will happen.

The nursery can recommend mum seeks a hearing test
It's normally the first thing to do with concerns, rule out the obvious
If the test comes back ok, then the nursery can seek guidance from the inclusion teacher at the LEA
The inclusion teacher will come out and assess the child and help to write a targeted learning plans
If the targeted learning plan has no effect then he nursery can request guidance from an educational psychiatrist who will write a report and make recommendations
The parent will be encouraged to also visit their gp and health visitor who may be able to arrange some super in the home in the form of a portage worker
The nursery can also refer to the speech and language therapist if there are any concerns over speech or understanding
If the child has involvement from speech and language hen the health visitor can recommend 2 year funding which is 15 hours over 38 weeks
At 20 months she is still quite young and may just have delayed development but the nursery are right to raise concerns as early intervention is crucial to make sure children get the support they need

Psychologist not psychiatrist

Thank you everyone. I will see if she mentions it again, and perhaps advise a trip to the GP/HV.

In the borough I work in, nursery would be able to refer to audiology, SLT and paediatrician, with parents consent of course. It may be the same where you are OP. I agree with other posters that nursery are right to be concerned. You could tell your friend that if her DD does need extra support, then the earlier that starts the better the outcome for everyone

Yes as others have said those things do point to ASD, it's really important to get a diagnosis as early as possible as children's brains are more 'elastic' the younger they are. I work at a nursery and have had a few cases, it's so difficult talking to the parents about things like this, but something that we have to do. Most parents are great but have had one in denial who refuses any help, now the child is older and everyone who meets them can tell they have special educational needs but they are not getting any help, it's really heartbreaking. Ultimately the parent has to agree to seek help, I hope you friend does, and of course it might be nothing at all to worry about.