Preschool concerns

[babydust23]

Preschool have completed a Wellcomm assessment on our little one and have said he’s failing his level of development and he’s actually around the age of 6-11 months. They’ve said he has never said a word in preschool, won’t give them eye contact, flaps his hands, gets distracted easily (would rather play when they are trying to communicate with him), has sensory issues (likes to play with peoples hair), doesn’t respond to his name. I understand that these are all red flags for autism. The thing is, he does say words in the house. Granted he doesn’t hold a conversation but if we ask him what items are in the house like ball, banana, apple, etc he can tell us (if he’s in the mood). He will also tell us what something is if we point to them in a book. He also tells us the noises a lot of animals make. He had his 27 month health visitor appointment and I mentioned the autism/delay concerns and they said they didn’t feel he needed to be referred at this point based on what they can see. They were happy with his response, eye contact and level of words. I explained that he was not talking in sentences yet and they said that this is something that would come soon. They did say that I could go ahead with a referral via preschool or self referral if I wanted to.

I am going to go ahead with a referral but u just don’t understand how preschool can say he’s at the level of a 6-11 month old based on how he is with us. She’s adamant there is a delay which is not a shock but she keeps alluding to autism so I don’t know whether I’m just not seeing what she is.

I too would go through with the referral, Afterall it's for an assessment, if your DS doesn't have ASD then he won't get a diagnosis and if he does have it then early intervention is helpful.

Did your HV use the 27 month Ages & Stages? Did they say how he scored? Usually scoring grey in two areas is fairly typical, if it's more grey areas than that or he's scoring black on any areas then he needs a referral.

Did the HV also do the Social & Emotional Ages & Stages. If they are screening for ASD really they should do both together. You haven't said how old your DS is so I'm assuming that's the right age bracket

It might be helpful to do this simple progress checker from Speech & Language UK too.

Has the HV made any referrals at all like to have a hearing test? Usually they do this as Glue Ear can present in a similar way to ASD.

I would also go ahead with the referral. You say you aren't shocked that there's a delay – and from what you describe, it does sound like a speech delay at least. If he suddenly takes a leap forward with his language and no one has any concerns by the time the appointment comes around, you can simply cancel it, no harm done. If he does need a bit of extra support, better to get the ball rolling early, whether it's a 'simple' speech delay, autism, or something else.

I'd also suggest doing the questionnaires @PolaroidPrincess linked to get a sense of how his overall development compares to the average, although do make sure to check the scoring on the regular ASQ. They never expect 6 'yeses' in a section, usually around 4. The way the scoring is constructed, roughly 1 in every 7 or 8 children will score in the grey for a section – that's why it's not uncommon, and not usually a big concern, to have a grey section or two.

Specifically on speech and language, can he use language functionally, to communication his wants, needs, interests, etc., or is he just labelling things? What you describe is labelling objects. Can he tell you he's hungry? That he wants to go out in the garden? That he bumped his knee? Ask where his teddy is?

How much does he understand? A typically developing 27 month old understands most everyday language about their routine, their toys, places they go, people they know, etc. – there are some examples in the ASQ.