Should I be worried or am I being Paranoid.

[Arhumuk]

First time Dad here and first time post. My DS has turned 14 month today. The last two months have been very hard for me and the feeling of clinical depression felt very real Ive had to see a therapist due to my anxiety. When my son turned 12 month my wife pointed out that he he rarely responded to his name and this was a n important milestone, furthermore his eye contact was fleeting. I was conviced that he must be autistic and this became a point of contention between my wife and I which has caused immense strain in our marriage. My wofe is a Speech and Language therapist so she was conviced because of her experience our son was not autistic.

Over the last three weeks my sons behaviour has changed almost unrecognisable h=it feels he is actually engaging with us his eye contact is strong just like any other toddler his age. But he still does'nt respond to his name consistently which is a cause of concern to me it has improved i'd say he responds 30 40 percent of the time. The improvement has coincided with the emergence of his teeth as teething went on for a protracted period. But this is my only cause for concern at the moment,..

His positives far out number the negative. This is what he does do.

Walk, Fine motor skills are impressive for example he has a strong pincer grip and can hold key rings with his thumb and forefinger. Can feed himself finger food. Higfive when you ask him.

Babbles and can say Apple , mUMMY Daddy

Engaging with everyone and is aware of his environment.

Has started to display imaginative play making broom broom noises when playing with cars. Pretending a book is a car going brrom brrom with it pushing it on the floor,

Smiles and laughs is response to you smiles, loves peekaboo and incy wincy. He waves and claps

JA evidenced eg reading a book he looks at the book then looks at me smiles and then bak to the book. We were playing with a horse both looking at it then he looked at me smiles then back to the toy horse. There are other examples.

Furthermore he has since two weeks ago handing thing to me like his books a toy.

Lasty he has started pointing at thing. For example at the dinner table the warning for battery running out came up onto the tablet he pointed at it and started winging as if to say get that off. My wife was takingn him in the park and he started to point at the duck in the park. but she is not sure if he looked back at her.

So you see there are a lot of psitive but responding to his name consistently remains an issue particulalrly when he is engaged in an activity. Should I be concerned or give it a little more time before I start panicking. My wife is absolutely convinced he is not Autistic as she has worked with autistic children.

As I said 2 mnths ago I could tell there was something odd about is engagement bt recently compring him to other children his age there is little difference. And I analyse him like a hawk, which has led me to go a bit boonker.

Your advice would be appreciated.

Not in therapy any longer. I felt the anxiety had gone away. I m worried about the struggles he'll face. How has it been for you dealing with autism.

Your last posts really don't seem like your anxiety is under control, and I say this with respect and empathy. I think you need to be thinking more about managing your own anxieties.

Life for me has been ups and downs like it is for anyone. I definitely have struggles that are related to being autistic but for the most part I have decent coping mechanisms in place. I was diagnosed in early adulthood whilst at uni. If I had been diagnosed in childhood I'm sure I would have had a much easier adolescence and start to adulthood because I would have understood myself more, would have learnt coping mechanisms earlier, would have received more support and understanding from other people etc. So early diagnosis would have significantly reduced the problems I faced/face. Apart from struggling with my anxiety (which many non autistic people do, of course!), my MH is fairly ok at the moment in terms of mood etc. I'm happily married to an NT husband and have a DC who is 15 months and a bit delayed in some of her development but I'm trying not to worry about it, as it's too early to tell whether she is autistic or not, and even if she is, well, I am, and I manage ok for the most part! I did very well at school and have a first class degree and work part time in my chosen sector although in a low waged job. I have some very good friends, good family relationships, etc.

@meadowhay thank you that is very re assuring. I've been chatting to my wife talking about it helps.

We'll have to see what happens. We have seen his comprehension is increasing he can point to his nose if I ask him where his nose is but not sure if that's from repetition or he actually understands.

He's still pointing and nursery says he has great imagination and motor skills are excellent. He is a good its just the not responding to name he seems to have regressed in that department and eye contact is also an issue. They also claim is social skills are lacking but he does show interest in other children. They will otherwise he hits his other milestones. He is a I'm hoping if he is diagnosed high functioning.

I worry about bullying and being singled out for being different that would break my heart.

Not trying to put a downer on things but that can happen to anyone, it doesn't just happen to autistic people, and lots of autistic people aren't bullied. He sounds like he's doing great. I don't think not responding to his name is regression, it's probably progression in that he is more independent and being less compliant! My daughter is 15 months, she often doesn't respond to her name because she just doesn't want to

Thanks @meadowhay it's really great to hear the personal experiences from someone on the spectrum.. My wife is a Salt. As I said he had a Salt assessment and I was told not to worry. His nursery keg worker feels that he is only mildly autistic as she feels he is very bright and has great problem solving

Only time will tell. But because he hits most of the milestones physically and in terms of language not terribly behind. 13 words.

I hope he is high functioning. my wife feels he is 100% but she can't make that assesment

Thanks for the update - I would be very interested to see what the private pediatrician has to say. I would very surprised if it turns out to be autism with all the list of positives you have mentioned, while you think they are weak, he does communicate to meet his needs and to share interest through the use of gestures (this would be classified as social communication). I am thinking about the autism diagnostic criteria as described in the DSM-5 (and for example used in the ADOS) and 'not great eye contact' and 'poor attention span or not listening' is not even close for diagnosing autism. A autism diagnosis requires multiple and obvious deficits in social communication together with stereotypical repetitive behavior. If that is met to a sufficient level, it then needs to be impairing the every day life of the child, i.e. the child needs daily support. Would you say that your child needs support day to day? However, I don't want to say that the nursery is incorrect - nurseries are in a privileged position to see so many children and hence be able to compare them and know 'on average' what is normal and what is potentially not quite normal. It could be autism (I would be incredibly surprised), It could be temperament/personality, or it could be something else - a private pediatrician will hopefully be able to shed more light.

On what planet are nursery workers now qualified to suggest a child has "mild autism"? Yes they see a lot of kids and might be able to get an inkling for what's normal/unusual, but not to diagnose.

OP, get your DS referred if you're worried, the waiting list is bloody long.

@aladdinmum thanks for the response. Ill be honest no repetitive behaviour sticks out. He still gestures and looking back coordinated eye contact when pointing is happening but not what I'd say at a rate that is expected in fact seldom.

There are moments when he is really engaged and I think I must have got it wrong like yesterday when I took him to the park he was playing like any other kid. infact I was proud how he tackled the big slide. Climbing the steps a child was coming the other way he smiled at the child and stepped aside let the child pass walked up carefully positioning himself before sliding down.

His key carer at nursery says he is very careful and has a sense of being a cautious when trying out a new physi Al activity ensuring he's secure first before he takes the next step. . Pretend play is still there we had some platic pizza slices he was pretending to eat them. He was mimicing his mother putting on make up.

No repetitive behaviour that sticks out or impairs his life. His understanding is concerning as does not understand simple requests like get me your shoes but my wife asked where was his nose and he responded with pointing at her nose.he has 13 words in his vocab. For example if you show him a banana for example he will call it a nana he will point at ducks and say quack quack. Does he need daily support? no more than any other 20 month old.

Even though he communicates his needs through gestures and points out things of interest, I too am concerned with the infrequency of eye coordination with gestures. There is something definatley not typical about that.

Anyway if he is diagnosed with autism I hope it is very mild as nursery suggests. My wife met up with her friend yesterday in the city. her friend is a nurse and she tried to engage with him with little effect as he seemed more interested in the buses and passing traffic.

On the flip side a friend s of ours who is an Ep ( as you are probably aware eps are involved in the process of diagnoses) , came round last week and sat at our house for 2 hours she didn't know my concerns
At the time whilst my son and her daughter chased each other around the house. I h
called her the next day and expressed my concerns. She was shocked and said she didn't pick up any hint of autism. She said thathe way my son was playing with her daughter would be out of character for an autistic child. And that his problem solving skills were good as she observed how he tried to get on the balance bike she had just bought him as a belated present.

So there we go im stumped myself.

Sorry for the long post but I've been quite stressed.

It will certainly be interesting to see what a pediatrician will think, the concerns you mention are subtle and not 'in your face' making it particularly difficult. If interested Goggle 'sub-clinical autism', the word sub-clinical can be used with many medical disorders. It means that a person has traits associated with a disorder but does not have the disorder, it is rare, and I have only seen a handful of children that have presented in this way - i.e. their parents were concerned about autism, and the children did show signs of autism (that one could not ignore) but through testing they did not meet the diagnosis criteria, not even close. There is many theories on this, including what they describe as a "autism phenotype", but all theoretical. These children are normally bright, articulate and not impaired in any way, but have traits which an observer could describe as atypical.

Thanks if so do they outgrow these traits

Yes, they normally do as they become more self-aware.

Today I showed him how to use a spoon to eat his porridge he did it albeit creating a lot of mess saying yum yum. When going to nursery his uncle asked him for a kiss and he then asked him to give his cousin a kiss without gesturing to go to his cousin. He went and sat next to his cousin on the steps and then tried to interact with him.

I collected him from the nursery and he said bye bye to the nursery manager as we were going she was surprised he also displayed the three point gaze shift as she handed him the painting he did with a smile. She confessed the staff have been talking and some are a bit ot convinced that he is on the spectrum. Had to cancel the pead my wife insists we should see one in the afternoon not the evening as this are the only appointments I was getting. Also when he got home he was using the remote as what could only thing was a car dragging across the wall going brmm brmm.

But the traits are there and just particularly the 2 listening and eye contact.

However if I call him from the top of the stairs he looks at me every time not sure why.

Honestly you seem so anxious and like this is taking over your life. I really don't think it's usual behaviour to be analysing every tiny thing your child does in the way that you are. He might be reacting to your clear anxiety about what he does or doesn't do and that could affect his behaviour, I'm not saying that to try and guilt trip you but what is jumping out at me again and again in your posts is not any difficulty your DS is having but instead your own difficulty with obsessing over his behaviour and it seems to be that is the crux of the issue here. By all means seek a referral if concerned but it's not your job to spend every minute of his life trying to 'diagnose' or 'assess' him as you're not qualified to do that and it could be harmful for both of you

HI @AladdinMum and everyone.

Just an update met the behavioural paediatrician speciality neurology and ASD.

She tested his development and commented that there is variable eye contact and his play is self led does not engage with us as much as she would expect.

However due to the fact that he is developing normally he would not meet the criteria of autism as yet.

She did a series of tests with him testing his problem solving skills which he did well meant for 2-3 years he is 20 months.

Also performed at a 24 month old for Motor skills so advanced for his age. stacked 5 blocks, draw straight line and circles, copies, he also drinks from cups unassisted and can use a spoon to eat. climb and decend stairs, runs. she tested his refelxes perfectly fine.

also language he has 17 words so not classified as delayed.

He is also showing understanding my wife and I asked him to get shoes without gestures he went and got them. asked him to get the ball which he did. and then his toy cat.

Continues to point and it is being coordinated with eye contact but not as regular as one would typically expect. Shows this to me with eye contact again but not as prolific as a typical child. says bye bye and waves at appropriate time and also initiates this gesture when appropriate.

In conclusion the doctor said his condition is not pervasive enough to classify for autism and that if we feel his social abilities do not improve then go for evaluation at 2.5. as before then would be unfair. She said if it is autism then would be very mild.

She said she was optimistic that he is not ASD, but was unwilling to rule it out because of the reduced engagement.

My wife and I discussing this yesterday she is SALT . And she also cant place it as he does not meet the criteria for a typical ASD, but she has mainly worked with teenagers lowest age is 10 so her knowledge for this age is limited. But she too feels there is something atypical there with his social and emotional engagement. Both of have been stressed and snappy with each other but we need each other for support.

We hope things will improve for him and we a grateful for him. It could have been far worse and recognise that whatever it is is mild and should not significantly impede his life.

Thanks for listening.

Should also add he is picking up words fast 1-2 words a day

Not much to say on the subject of 'is he/isn't he autistic' because I don't like to do the whole internet diagnosis thing based on tiny amounts of information. But I do remember very clearly the constant anxiety that hung over DH and me when we were waiting for our son to get diagnosed. Waiting and not knowing is very hard. You do spend a lot of time looking for signs and second-guessing everything and it gets exhausting. Hope it all works out ok, OP.

In terms of your earlier concerns about bullying etc. Our son is ASD and in year 1 at school. It's very early days but I would say that the kids in his class have been extremely accepting of him and don't treat him any differently to any of the other kids. He's genuinely happy at school. I think it's much more normalised in schools now - hopefully the next generation of autistic kids will have an easier time being accepted by their peers than previous generations...

@BatleyTownswomensGuild thanks for your support. These are dogfight times for my wife and I and I appreciate the support I've got from the people on this site. I have tell me was there any a
p
Support needed to get your DS ready for year 1.

@Arhumuk thanks for the update, it sounds generally positive and I agree with what she said and what I mentioned in an earlier post of him not meeting the diagnostic criteria for autism. It is a tough time but at the moment the "wait and see" approach is probably the best way to go until he gets a little older.

@aladdinmum thanks for your response. I wish I could share your optimism his eye contact has got worse. If its not autism I don't know what it is.

@aladdinmum do you have any tips for improving eye contact. Or is it too early for a 20 month old

He is a little young but one technique that is used at this age is to bring objects closer to your face. So for example, if you show him something that he wants, i.e. a toy car (or anything else), he will probably first look at the car while it's in your hand, while he does this move the car towards your face nearly touching your nose, his eyes will normally follow the car towards your face and once his eyes reaches your face he will nearly always be forced to make eye contact for a split second - once he does that give him the car (the idea is that he associates this eye contact with getting the item that he wants). This can be performed multiple times per day with any object that he requests (first show it to him, then move it towards your face).

@aladdinmum thank you I'll practice that.

This morning DS pointed at the apple logo on the laptop in front of his cousin and said apple looked at him then back at the logo as if to show him.

I'm utterly confused.

@Arhumuk that is an excellent example of a 3-point gaze (joint attention).

@aladdinmum yes it's not the first time either but as I've said it's infrequent. Also a couple of days ago there was a noise in the kitchen he looked at the area where the noise came from then Turned to look at my wife and me. I thought that would also be a form of social referencing.