2.5yr old seems 'behind' for his age?

[RubySlippers77]

DS1 (2.5) is really starting to worry me - his speech is still very basic (he can manage a few words but nothing more), he throws the most enormous strops when things don't go his way, and I just can't stop him scratching people his twin brother seems far ahead of him.

He doesn't seem to tick the boxes for ASD - he makes eye contact and doesn't mind routine changes, things like that - but at the same time I can't help feeling that there's something 'wrong'. My gut feeling is that DS2 is NT but he isn't.

I know his speech would be helped an awful lot if he was calmer, but he screeches and gets completely incoherent when worked up. He started scratching in retaliation at his brother when they squabble but now does it just for attention or even to other children when he's a bit overexcited. It's like he just cannot calm himself down - I even have to hold him for him to fall asleep as otherwise he will wriggle and squirm for hours.

If anyone has any ideas I'd be very grateful. HV says they can't do much till he turns 3, as then they can properly assess his speech and refer him for further assessment if required, but nothing till then. I don't know enough about ASD (or anything similar) to insist on any testing before that!

Well firstly, your HV is talking nonsense. They can assess under three.

Go to your GP....tell him or her everything. They can ask for a developmental assessment. The lack of smooth speech will definitely be contributing to the tantrums as it's so frustrating for children.

Look at this site.
www.hanen.org/Home.aspx

They're very respected for speech help.

My daughter is 2.5 and at her 2 year check up I expressed concern about her speech and she has been referred to speech and language. If you look on the website you might be able to self refer for an assessment I'm not entirely 100% on that though. My daughter also had a hearing test to rule anything out and it turns out she has glue ear which is possibly affecting her speech as she can't hear properly. If hv wont do it maybe see gp.

Thanks both, I'll definitely look into more speech help and ask for a hearing test for him - even if it rules out glue ear then that would help. His pronunciation isn't great and I wonder if he simply can't hear properly.

Currently feeling awful as he had a lovely morning at preschool - came out absolutely beaming - but I had to sit him down when we got home and talk to him again about his scratching habit. The teacher told me that he scratched a couple of kids this morning, they're trying to encourage him to talk rather than just scratch but nothing seems to stop him... so now I feel awful that he hurt some other little children, bad that he cried when I asked him about it and told him off, and sad that at this rate no-one will want to be his friend

I think it's important that you only reprimand him for scratching when it's just happened. He will be corrected in school and that's enough at his age.

2.5 is very small still and he's completely moved on from that incident by the time you pick him up.

I'm 100% not trying to make you feel bad....you sound like a very loving Mum and very sensitive too. he won't have been damaged by getting told off after the event but just for the future...once the thing's happened, it's gone.

See it as work in progress and keep talking to his teachers....tell them you want to get him some speech assessment, they may be able to advise you and knowing you're trying to help him will help them too.

And remember to enjoy him...try not to let your worries overtake your pleasure in him.xxx

I’m sure you’ve got nothing to worry about but my DD who didn’t have any speech delay was able to point, made eye contact and was very imaginative from the age of two. She was flexible with routine change as long as she was in her own bed at a reasonable time every night. She was much later to tantrumming though. Just saying as ASD isn’t what I thought it was.

Thanks Ajas - you're right, he would have completely forgotten about it by the time he came home, but I was so upset I felt like I had to say something. Then of course DS2 felt left out and started playing up and all hell broke loose there too!!

I've been investigating and our local children's centre run behaviour clinics (appointment based) and speech & language therapy discussions (turn up on the day and hope it's not too busy!). I've left a message asking for an appointment for the clinic, but it's only once every few weeks, so no idea how long we'll have to wait. We only have one more preschool session before half term and then they'll miss two weeks anyway as we're on holiday the week after half term; hopefully that will give us a good amount of time to tackle the scratching issue and encourage his speech, or at least look into any issues.

And thank you too for the reminder to enjoy him - most of the time I really don't and I know I should, he can be such a loving little boy but this just overshadows everything. Between that and the daily grind of keeping everything clean and tidy, it feels like I struggle to breathe sometimes! xx

Tbh apart from the scratching you're basically describing my DD! She is getting better at her speech but most of what She says makes no sense to me and sounds nothing like the word she wants to say. But she is slowly saying more words and will string 2-3 together now. When she sings songs like twinkle twinkle she doesnt say any of the words at all but knows the tune. I'm hoping it's her hearing thats the issue. She gets very frustrated and has tantrums. Her and her sister are always fighting for my attention. Her sister is 5 and I'm a single mother. I have been told though that since she is developing just fine in everything else that its probs from her hearing and also combined with the fact that she used a dummy. Sometimes at the end of the day i am literally exhausted from all the drama! Hope you get some answers!

Thank you lyssie and Stone - DS1 is always fighting for attention too as his twin brother is much louder! And interesting to hear that ASD isn't always about lack of eye contact - that's a big flag for it and as DS1 doesn't have any issues with it, he didn't seem to fit that profile.

I'll call the HV again tomorrow (no reply to today's voicemail!) and ask if he could at least have the hearing test. If I ruled that out then it would be one thing off my mind.

I just keep seeing his big beam when he came out of Preschool and then his little face crumpling when I tried to talk to him about the scratching - my poor boy 😢

PS lyssie, that must be incredibly hard being a LP! My DP is fairly useless but he will at least do the occasional playgroup/ look after them for an hour...

DD has ASD (severe end) and had good eye contact and is not routine let.

if you worry about ASD, Google m-chat and see it flags anything up. if so, mention it to GP. definitely sideline the HV. IME, they are useless when it comes to child development and go via GP.

have you had a recent hearing test? that would be one of the first steps and it clear, referral to paed and salt.

Things like lack of eye contact or difficulty with routine changes might indiciate ASD but are not requirements for it.

Autism can present very differently in different people. This comic shows it well - themighty.com/2016/05/rebecca-burgess-comic-redesigns-the-autism-spectrum/ - especially the coloured spectrum part.

I would google the m-chat autism checklist if I were you and keep an eye on him.

Its hard to tell, based on what you've said, if your son has autism - as 2 year olds can be quite difficult to manage in general as they are still very young and still developing.

Thanks both - the M-CHAT comes up with 'might be autistic' which of course isn't indicative either way! And you're right, with such a young child it's hard to tell; but if he needs extra help I'd like him to have it ASAP, which I guess means pushing for an assessment. For example, he loves preschool and I don't want to have to remove him because of his scratching habit, I think more assistance would help him a lot - someone to remind him to speak rather than scratch.

I'm sure I could do more too but TBH I'm just so shattered after 2.5 years of looking after twins with very little help that I think my patience is at an all time low! DP is (occasionally) good with them but all the day to day care, night wake ups, majority of the housework etc falls to me...

Still chasing the HV for a hearing test (as she did say last time that they'd investigate if his speech didn't improve) - if I don't hear anything I'll definitely take it to the GP!

print out the m-chat and see GP. leave HV aside. and ask for a paed referral. 2.5 is young but not too young for assessment. other countries diagnose ASD before 2. And I know a number of 2 year olds who have ASD dx on the NHS.

M-chat flagged him up and the fact that he is developing rather different from his twin should suffice to be taken seriously.

It turns out we have a SALT clinic in the area next week so I will take him to that - the HV wasn't too helpful when they eventually phoned back, just said why didn't I take him to that - the answer being, that I had no idea it was on and it isn't advertised anywhere on their website or via the children's centres!! Grrrrr!

Had a chat with preschool again too, he was much better today THANK GOODNESS, but they agree that it's worth getting him checked out. If it's something 'simple' like his hearing then hopefully it can be corrected, if not, they said he may need extra help.

Thank you everyone for your help, I'll go to this SALT clinic as we wouldn't get a GP appointment before then anyway, and go from there! x

The SALT clinic was useful but we're now waiting for further appointments! The therapist referred us for a hearing test and to a talk therapy group, but as we're now on holiday, I won't get to book anything till next week at the earliest. I am so, so much hoping that something helps though - DS2 is now (relatively!) easy to look after, chats away happily, communicates well etc. DS1 still throws a strop at the smallest thing, will never sit down to eat a meal with us, scratches with or without provocation etc...

I've tried asking DP to manage the situation better - by playing with the DC rather than just watching them or at least to remove DS1 if he scratches other children - but he is too lazy doesn't and that doesn't help either!

Feeling sad at the moment in case DS1 never makes any friends. He can be such a sweet, kind little boy but the scratching and aggression obviously put off other children, and who can blame them? He's only 2.5 and I'm already very anxious about him

I'm glad you've made some progress with the SALT.

I don't have twins but I'm guessing seeing DS2 having an easier time playing must exemplify DS1's current struggles. But he is still so very young and a lot of children his age have difficulty playing well with others. If he does have a language delay, the scratching may in part be down to wanting to play, but not being able to instigate it and the scratching means he gets the child's attention. Obviously you don't want it to continue, but things like role playing toys and modelling a way he could engage may help. I also found with my 2 who had communication difficulties responded better with giving them the instruction at the level they could understand so "hands down!" rather than "Don't scratch!"

Thank you @FrayedHem

That's a good suggestion about "hands down", I'll try it! The HV's suggestion was to keep both boys distracted/ entertained, which works to a point, but I can't concentrate on both of them 100% and especially not in a playground if they go in opposite directions!!

Hopefully I'll get some answers soon about whether he has hearing problems/ language delay/ some other issues. DP gets very impatient with him too, which doesn't help; again, he's comparing him (unfavourably) to DS2, so it's good to be reminded that in fact it's still common at his age to not 'play nicely'.

He loves doing tea parties, we will have to try more role playing as he does concentrate more then!