26mo hates playgroup, constant whining and screaming...

[pushyviolinmum]

We've been going to a lovely playgroup since DS (26 months) was 10 months. We go 9-12, four days a week. There is one teacher and lots of engaged parents who do activities with their children, and with other children when the kids are old enough - it is for children from birth up to school age. It is in a quiet suburb, surrounded by leafy gardens, has a big garden, no overstimulating traffic noise or anything. The kids are generally very well-behaved and well looked-after. So it's all kind of ideal...

DS has enjoyed it, and is a kid who likes structure. But last term he began being generally miserable, whiny and shrieky, unsociable, disliking other children, constantly screaming for a breastfeed (we're trying to give up, and have been for ages. It's hard as he's also got severe food allergies and has some kind of sleep disorder). He was fine over Christmas with relatives, loving interacting with grandparents and cousins. But this term he hates playgroup again and just wants to cry and whinge and constantly ask for breastfeeds, which are now down to just before naptime and bedtime. He won't play with other children, wants to spin wheels on tricycles or toy cars, or do his own thing wandering around by himself.

I've spent a lot of time looking up ADOS and MCHAT-R (diagnostic tools for Autism spectrum disorder). I honestly think that when not at playgroup, he pretty clearly isn't autistic. He's bright, chatty, interested in lots of things, happy. But at playgroup he's like a different child. He's miserable.

Is this normal?

Also - he is genereally much more inclined to interact 1:1 and talk about things with the playgroup teacher than with me or other parents. When with me he's basically able to be distracted for about 3 minutes from thoughts of feeding and whinging/getting hysterical about going home for a feed.

If only it were also a day care with 1:1 adult:child ratio I'd leave him there... but it isn't, and I don't think he obviously has the social skills to cope in a daycare situation at the moment.

It is not unusual for autistic children to behave in a neuro-typical fashion or near to while at home but different when the absence of familiarity, routine, structure and control is taken away (like in the playground). However an autistic child can't turn it "on and off" so there would also be signs while at home, maybe not as exaggerated as when out. Asking to breastfeed is a form of him trying to calm down as he is asking for familiarity and comfort (i.e. he is not asking because he is hungry) - spinning wheels is him trying to self-regulate. But again, all children like spinning wheels, however if it happens in a quite obsessive manner then it could be a form of stimming.

How does he score in the M-CHAT? if you are worried about autism, at 26M the signs would be quite apparent. For example, does he point to request and share items of interest (like a plane in the sky)? does he show/give you items of interest? (not to ask for help but just to show you), does he seek praise with eye contact when he does something that he is proud of? etc. deficits in these areas at 26M would be concerning.

Maybe he's just bored? That's a long time to be going to the same place four days a week. I sometimes find that my DD turns into a bit of a nightmare, in sort of the way you describe when she's grown out of, or just got bored of an activity.

We used to go to a music group and she was whiny and clingy and then started running out the door! I decided she was voting with her feet and started doing something else. So now, for instance , I find that she needs to burn off a lot more physical energy than she did when she was a bit younger. So lonnnnnnng visits to the park...

I think that you should give it a break for a few months or go to a different group. Same place, same toys so many times a week might be boring him.

He scores 2 on MCHAT - social referencing, eye contact etc is all there perfectly ok, he just has never brought anything to us to show, and never pointed to something to try to show us. He is generally fairly self-contained a lot of the time, but does enjoy attention from others.

Actually i think it may be sleep related. A lot of the time he has 6-10 wakes per night, and he has tended to hysterically demand a feed at all of those wakes. Things improve hugely when he manages to just stir and either get himself back to sleep or be patted back to sleep, which has happened the last 2 nights. Today's playgroup was absolutely fine for the whole 3 hours. We may have just turned a developmental corner...?

@pushyviolinmum I can see why you are confused, I am confused too. An MCHAT of 2 is a pass, but the fact that he fails in both pointing to share and show/give you items of interest should be noted as concerning as those two question explicitly test what is referred to as "theory of mind" which autistic infants have a very hard time to grasp (they don't grasp the fact that your mind and theirs are two different minds instead thinking that they are the same, that what they see you automatically see and hence there is no need to show you things, as you will see them automatically when they see them). Studies has also shown that infants not pointing to share by 18-24M nearly always means autism, unless there is something else going else. Pointing to share/request is an emergent skill, like crawling and walking, so even if you never show them how to do it they will still do it. However on the flip side, with a score of 2 it means that he is doing things like following a point, following a gaze, social referencing, requesting attention, pretend play, etc - things which would be very rare on a autistic infant. So yes, confusing, and no clear answer there.

I agree, his sleeping pattern does sound a bit extreme, and could be impairing him. While there is some concerns he also has many great positives. See how he progresses in the next few months, they change tremendously from month to month, but I would say that if repetitive behaviour/obsessions increase or if he gets more rigid with change in routine/structure, it could be worth having him assessed by a development paediatrician for peace of mind, only them could properly asses him and get to the bottom of it.

He sounds great, and it could be nothing, it could be just boredom like other posters suggested, but worth keeping an eye on his progress in the months to come!

Neither of my boys liked playgroups at all. They were too structured an both preferred running about and doing their own things.
TBH I'd find going to the same playgroup every morning a bit dull as well, I'd rather be at the park.

I think one of the issues is that your son is still so young. At just turned 2 a lot of normal toddler behaviour can appear autistic and unless the presentation is severe it can be hard to unpick what is going on.

From your posts I do see a number of red flags and I'd keep an eye on his development over the next few months. My DS is autistic and was referred at 2 for assessment due to delayed speech, but the gap between him and his peers didn't widen until he was 3. If his speech hadn't been delayed I don't think he would have been assessed so soon, as he is very affectionate, loves cuddles and gives good eye contact to family members.

It might be worth considering putting him into nursery/preschool for a few hours a week. My DS started at a private nursery at 2 and a half and coped ok as there was a high ratio of staff. I then moved him to a preschool after he turned 3 and that was when everything went downhill very quickly. The ratio increased 1:8 and he couldn't cope in the setting at all. I felt awful putting him through it, but I am glad I did, because we started to get the help and support he needs. Obviously I am not saying this will be the case for your DS, but if he does need support then it is much better to find out as early as possible.

As I said though, just keep an eye on things at the moment. You may well find, as he develops over the next few months, a lot of your concerns will simply disappear. Trust your instincts though, if you feel he needs an assessment then push for it.

Thanks for all these views. After a fabulous day yesterday (and a good night's sleep) we're back to screeching, hysterical non-participation, being fine as soon as we were out the gate, and then being asleep in seconds when we were home.

The "playgroups are boring" comments are revealing because I had been thinking ours was far more interesting than being at home. Obviously I was mostly thinking that in terms of other children being there (DS is an only child). The playgroup itself is in a small house with a big yard full of appropriately-sized play equipment and a big sandpit, a paddock for running round in, a carpentry bench, water tables, a painting/craft area, play house, play shop, music room, room with beds and dolls, etc etc. Parents often organize activities like baking or electronics or sandcastle construction. The children can do whatever they like for 2h 45 minutes and spend the last 15 minutes (while the parents clean up) doing a group activity, which is usually something like dancing to music, or playing What's the Time Mr Wolf in the paddock. So it's not particularly structured, but there's plenty of space, there's a lot to do and the kids are usually pretty well occupied.

Another red flag is that he's very physically cautious and clumsy. He went straight to walking at 13mo from sitting, never bumshuffled or crawled. He can now crawl, but has to be pushed to do any physical activity like attempting to slowly and painfully climb a ladder when kids half his size are nipping up it in 3 seconds. He does it twice and gets demoralized by the other kids pushing him out of the way and goes off to do his own thing instead. Swimming is awful - other little kids will be jumping up and down, running round, splashing lying down on their front, some will be swimming... DS will be either screeching to get out or sitting on the side of the pool watching everyone else.

Seeking praise with eye contact is also something he doesn't really do - possibly because he doesn't do anything he feels proud of. I give him praise for things like climbing a ladder, walking up the stairs, singing a song, or waiting patiently or whatever. But he doesn't have any grasp of doing slightly difficult stuff "like a big boy" - if he wants to do something he will, and if he doesn't want to do it, he will scream blue murder until he gets his way or falls asleep after crying for a couple of hours.

His will is driving me into the ground, given that it's exercised with such impossible-to-ignore screeching.... and is generally only exercised at me, not at anyone else.

Hi @pushyviolinmum, I hope you had a better day today. I know how hard it is when every communication is punctuated with high pitched screaming. DS2 is starting to talk now, so we often get a mumbled incoherent sentence followed by screeching, as he can’t quite work out what to say. I know he can’t help it, but it is so draining.

I just had a thought from your last post, you said that your DS will only do things if he wants to, does that extend into his play? So for example if he was driving cars round a track and you joined iand made one of them crash, would he mind? Would he incorporate the idea into his play and expand it further (i.e. get another car to come to the rescue)?

Also, you said that he is very chatty, but that he doesn’t point to share an interest and I wondered how does he communicate to get his needs met at home? If he wants food say, how does he ask? Verbally, gestures? And, if you ask him a question, will he reply or just ignore you? Can he hold a conversation yet? Is it back and forth or does he tend to talk at you?

Thanks - yes, today was far better, though as it was raining hard everyone was inside so DS was on edge the whole time. Mostly he sat on me, and came looking for me every time I moved more than 2 metres away.

His play is not particularly imaginative, but it's not concerningly unimaginative either. Plastic insects typically go up and down stairs in the doll's house, or drive trucks, the polar bear eats DS's food, etc. He's fine if you add things into the sequences, but doesn't tend to reciprocate, so if cars have a crash he'll enjoy having more crashes but won't extend that to getting a tow truck (though he hasn't seen any TV involving emergency vehicles or rescues, so maybe we need to get into the Octonauts... at the moment he is clearly totally mystified as to why people keep pointing out fire engines - and says "no fire?" as if to say "but why are you telling me about this?").

He communicates in sentences, sometimes sentences with four or five subclauses. He got tenses, moods and pronouns as he started talking. So if he wants a drink it tends to be "I want an oat milk in the blue cup please Mummy, with bubbles in it from the tap water, like we did yesterday. If we put the water in really quickly onto the oat milk then we get better bubbles." [I water down the oat milk as he drinks so much of it. He likes it frothy...].

He replies to questions, though much less fluently than if he has initiated a running commentary about something. He doesn't do conversation yet - but of about 20 kids I've known in the past year and a half who are or have been 2, I only know one 2 year old who does conversation (2y 8 mo, a 4th child, extremely sociable primary-teacher parents) so I'm not sure if that is a red flag or not.

wow, a 26M old saying "I want an oat milk in the blue cup please Mummy, with bubbles in it from the tap water, like we did yesterday. If we put the water in really quickly onto the oat milk then we get better bubbles."??? .... that must be off the scale for being super advanced in speech! a typical 24M is expected to string together 2 or 3 word sentences....

It's a bit ahead for age but we've known other kids doing similar things. The boys have all been like Ds, interested in the structure of language more than communication, and wildly asynchronous in social development vs language The girls have tended to just be really bright and fabulous communicators. It's the asynchrony that is the problem here!

A bit ahead is probably a slight understatement.... he is very advanced in language. Its all a bit of a mystery, please do keep us updated on his progress, he clearly has a very bright future with a mum like you behind him regardless of outcome, he is clearly a very bright boy. Whether there is an underlying issue or not I guess time will tell, no one will be able to tell you in this forum, there is certainly a few red flags as other posters also mentioned, I think a deficit in sharing interests and experiences is certainly the big one. Also, infants love praise, they share experiences through praise, I help in a children's centre and infants as old as 3Y will seek praise for the smallest of things like stacking a few blocks together, pouring water from one cup to another, banging a drum, kicking a ball into the goal, climbing a ladder to the top, etc - they will look up at an adult while clapping and saying "yay" or something similar, waiting for the adult to reciprocate (if you ignore them, some will point to your hands or say "clap" asking you to clap too!). I am not sure if the lack of back-and-forth conversations is a red flag but with such advance language skills you would have expected him doing a bit better there. If your son does fall in the spectrum (and I am not implying that he does) it would certainly be Aspergers. Hans Asperger himself referred to his infant patients as "little professors" because of, among other things, their obsessive interests in numbers and the composition of language with their incredibly large vocabularies and ability to "ramble on" non-stop about favourite subjects (using complex sentence structure) yet they would find it very difficult to keep a simple social conversation going beyond one or two steps.

I agree his language does sound very advanced. Being hyper verbal can be a red flag, particularly if you notice difficulties with conversation as well. Between 2-3 years you wouldn’t expect long conversations, but by 3 children should be able to take 2-3 turns on one topic and if they struggle with this it would be a concern. So for example it is the difference between an adult walking into a room and child saying “I’ve built a tower!” then waiting for a response “You have. It is very tall” child then says “Yes. I’m going to crash it” or adult walks in and child says “I’ve built a tower! I wanted it to be very tall. I think I’ll crash it”. Obviously that is very simplified, but in the latter although it may feel like the child is engaging in social interaction they are actually just commenting/expressing thoughts.

Another thing to look out for is taking things literally, so with a phrase like “It’s raining cats and dogs” an autistic child could well expect cats and dogs to be falling from the sky.

It is really positive that he will let you join in with his play and take your ideas on board. In a typically developing child they will start to copy play and add their own ideas. Again there will be this drive to share. An autistic child might be quite rigid. Some things to look out for would be always choosing the same toys and playing in the same way. Finding it hard to move to other activities and not engaging with adult led play. It is not straightforward though, because there are so many different presentations. Another child might be desperate to join in, but struggle to understand the rules.

Overall what you are looking for is a pattern of behaviour. It will vary person to person, but you should see a pattern. My eldest DS at 2 didn’t like playing with other children and he just wanted to do his own thing. His language was very advanced too. Both red flags, but at the same time he was very social with adults, lots of back and forth conversation by 2.5 years, imaginative play and open to play suggestions. His interaction with peers was just delayed and by the time he had started school he had caught up.

On the other hand my youngest DS didn’t want to play with his peers or adults. He was very much in his own world. He had some language, but didn’t use it functionally. He’d only wanted to play with his animals etc. It became clear that there was a pattern of him struggling with social interaction. At just turned 2 it wasn’t obvious (unless you knew what to look for), most toddlers are still engaged in parallel play, language skills are just emerging etc, but by 3 you could tell he was developing differently.

If you do start seeing a pattern, then don’t take a wait and see approach. Waiting lists are long and regardless of what people say any diagnosis will not just be handed out. Getting the right support in place takes time (often years rather than months) and this is so important as at the end of the day it is what makes the difference.