3 year old possible ASD - but so unsure and confused

[Manyconfusungopinions]

First post, and I am very new to neurodiversity, so apologies in advance if I don't use correct terminology. I am trying to educate myself but accept that I might not get it right. Apologies that this will be a long one.

My 3 year old DS has always been an 'early everything' kind of kid - early walker, early talker, ate brilliantly from 6 months etc, sociable, confident, funny, loves people. Because of this, when he started nursery at 2 and a half I thought he would do brilliantly, fit right in. And at first he did. His first summative assessment was glowing, they commented how advanced he was in all areas, how much fun he seemed to have, etc.

However, since turning 3, things seem to have changed in his behaviour at nursery. He is struggling to deal with frustration aand overwhelm and and has been known to hit or push other children when things don't go his way. He has started toe walking and flapping his hands, and nursery believe he struggles to understand others emotions. They are pushing quite strongly for an ASD diagnosis so that they can claim funding to put in specific measures to support him.

This is where I am feeling out of my depth and confused. Because these things do sound like ASD, but I don't really see them at home. I do see the frustration when things don't go his way or are different from what he expected, but ont see any flapping/stimming. He also doesn't seem to have problems understanding emotions at home, will be concerned if his sister is crying for example, or will describe himself as feeling sad if I have a day in the office so am not around for a bit.

From my point of view, the following are all concurrently true

• Chatty, confident kid with a wide active vocabulary (in 2 languages, we're a bilingual household)
• loves meeting new people, will chat to them freely

-Numerate (can count and apply this to the real world, e.g. correctly counting the number of toys in a box)

• 'literate' in an age appropriate way, knows the alphabet and phonics, recognises common words written down , loves books
• active imagination, engages in imaginative play e.g playing shops, pretending to drive a bus

But also:

• easily frustrated and overwhelmed. This sometimes results in a meltdown, for example if trying to piece a puzzle together and it doesn't immediately work.
• finds it hard to join in with group activities with his peers (toddler classes are usually unsuccessful as he just has no interest in joining in and will just do his own thing)
• toe walks
• sometimes too loving with other children - will try to hug them or hold their hand when they don't want to (I intervene)
• covers his ears if anticipating a loud sound
• cant yet draw anything beyond a scribble, although he can draw letters on his tablet following along with a game
• sensitive to uncomfortable clothing

A health visitor visited the setting to perform an initial assessment aand found minimal concerns, but nursery say things have gotten worse and are still pushing for a diagnosis. I don't know where to turn, or where to start.

I'm not convinced he has ASD, but equally if he does I don't want to ignore it and disadvantage him for starting school next year.

Can anyone comment, or offer me some pointers? Should I go to a GP?

Nursery can't push for a diagnosis @Manyconfusungopinions. They can push for an assessment but if your DS does not have ASD, they won't get a diagnosis.

Do you know what tools the HV used on her visit? Was it the Social & Emotional Ages & Stages?

Nursery seem to have enough evidence to make the referral. I would honestly co-operate as, like I said earlier, if he hadn't got ASD he won't get a diagnosis.

I agree with @ExplodingSmittens , I'd go for the assessment. If he's not got ASD, he won't get that diagnosis, but if he does need a bit of extra support, better to know as soon as possible, and waitlists are very long at the moment.

An experienced nursery worker often has a very good sense of what's in the range of typical child behaviour and what needs looking into – they just see so many children. Your list also suggests some sensory difficulties with noise and clothing and some possible social difficulties (the too affectionate and difficulty joining in, but I think those could still be later end of typical developing, especially if he's just three, rather than almost four).

In the meantime, I'd suggest supporting him with the sensory stuff both at home and nursery – comfiest clothes possible, somewhere quiet he can go if the noise is getting a bit much at nursery (or ear defenders maybe, if he'd wear them?). If he's spending less effort dealing with unpleasant sensations, he might have more capacity left for noticing others' emotions and managing his own.

Even if he does get a diagnosis, of ASD or something else, remember that changes nothing of who he is – he'll still be your wonderful, bright, funny DS.

And that was also quite long...

I think this was what they completed, yes. Thank you so much for your response!

Thank you so much, this was so helpful and also reassuring to read. I'm a massive overthinker at the best of times, and I've got myself in a bit of a spiral.

It's so easy to spiral when it's one of our DC.

I was thinking, when he turned three, did he change rooms at nursery? Move into the bigger, busier, lower-ratio preschool room? If so, maybe that took him beyond what he can cope with.

Thanks for the reply! He's actually always been in the same room. The big piece of info I missed out is that his baby sister was born in the summer, and things at nursery have gotten more difficult since then.

Have you decided if you'd like to pursue an assessment yet or not @Manyconfusungopinions?

I've decided that yes I will but I'm doing it down the 'correct channels'. There's an organisation in my local area that provides guidance for parents in my situation to make sure the assessment is thorough and everything done in the child's best interests, and I'm meeting with them next week. They're an official organisation I should say, so should be helpful.

Go for the assessment OP. And good luck. He is still your same wonderful boy!

there’s any update??

Many @Manyconfusungopinions I'm going through somethibg similar with my son at the mo. Do you mind if your little one ever recieved a diagnosis?

Hello, seems strange to be replying years later!

3 year old is now nearly 6 and in year 1. We never pursued a formal diagnosis, but we liaised with the local SEND offer and parenting groups, and were advised 'watchful waiting'. Essentially, he's coping well enough, let's see how this plays out.

I was very concerned about him starting school, but he's taken to it like a duck to water, thriving, exceeding in all areas. The disregulated behaviour has largely vanished (he still has a strop from time to time, but its noticeably different).

My tentative conclusion is that he is not ND, but was going through a period of anxiety due to a new sibling, plus bored at nursery. However, I haven't ruled anything out, and check in with teachers and the SEND officer to see if anything is happening in class that I wouldn't be aware of at home. His school have no concerns that he could be ND, but it is possible he is just very low support needs. I always bear this in mind.

The biggest change is that he is now sociable with other children, makes friends, engages in imaginative play, which he didn't have much interest in before. I think for him that side of his development just came a bit later

I hope this is helpful. If I were to offer any advice it would be to see what support is out there, get as much knowledge as you can, but know that everything may change.