Suspect my charge may have Asperger's

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I have been working for this family just under 3 months and strongly suspect my 5yo charge has Asperger's. How do I go about telling the parents this in as tactful and kind a manner as possible?

They are a lovely family and I'm really happy working for them, so of course I don't want to cause them any unnecessary hurt. I thought about broaching the subject with his teacher, but decided against that idea as I don't want to look like I'm going behind the parents backs.

Has anyone here had to handle this situation before? Are there any parents of ASD children who can advise me? I just want to do what's best for my charge and I know early diagnosis means he can be better helped long term.

What medical qualifications do you have? I don't think that its either a teacher's or a nanny's place to suggest that a child has autism. There are many other medical conditions like glue ear that cause social or communication problems. Autism spectrum disorders are diagnosed by a TEAM of QUALIFIED people over several appointments.

I think its perfectly reasonable for a teacher or even a brave nanny to say to an employer that you have concerns about communication skills and that prehaps this needs to be valuated by someone more qualified. (Ie. prehaps speech and language theraphist or audiologist)

However bear in mind that many parents do not like being told that their darling is less than perfect and may will want to shoot the messenger.

I would raise it as a general concern about his development, don't say Aspergers/ASD or any other diagnostic term.

assume you are a nanny so not sure what if any paperwork if any you need to do. as a childminder we do regular assessments on the children as routine so can just highlight areas they are perhaps not reaching targets expected for their age and suggest ways to help. absolutely not up to you to diagnose and I imagine you would cause a lot of upset doing so. sorry I'm not much help sure a nanny will be along soon.

Well I wouldn't raise the subject of apergers at all. I would talk to them about specific concerns regarding his development and let them take the lead on how to handle it. It would be highly inappropriate for you to suggest an actual diagnosis.

What ever you do, don't go to the teacher behind the parents backs. It's likely the teacher is on the case anyway.

I would try and help the child in the specific areas he has difficulties - so if he has sensory difficulties, be understanding, etc.

Put in place strategies which might help him in the home, keeping to routines, preparing well for transitions, avoiding supporting him with parties if he finds them difficult.

I've always believed if everybody was accommodated for sensitively there would be no need for a diagnosis.

My son has asd by the way, mind you it was always me pushing for referals so I didn't need anyone to point it out as it were!

Lunettes is right you can still focus on meeting his specific needs without a diagnosis.

Please don't say you think he nay have autism - you're not qualified to make am assessment. But please raise your concerns by taking about specific examples where you're able to compare his behaviour to other children you've cared for. I'd tread very gently but they will welcome your input if you can share positive experiences.

Lynette rather

yes, I meant to say you cannot come out and say to the parents "I think your child is autistic." It's not your place to diagnose, it's your place to nurture and care for the child. Bringing up concerns about the child's development with the parents would of course be appropriate.

Sorry , hopeless phone autocorrect

Is your concern social and communications skills delay?

I have an ASD son and the diagnosis for a team of professionals takes time. As others say if you can avoid diagnosis terms.

You have no doubt experience of many children and development at this age but it would be helpful to the parents if you could actually define your concerns and use a few examples.

For example:

Is your charge generally very compliant so long as everything is happening in its usual routine?

Does he choose not to interact with others?

Does he become inconsolable if things don't go his way?

If you can get it down to a few concise examples the parents can choose to discuss with the school or GP or just play the waiting game and see if he naturally develops in these areas.

I had a nursery teacher mention to me that DS may have autism, I was shocked, very angry and in complete disbelief that she would even suggest such a thing. A few years later it was me pushing for a referral with his school and he received his ASD dx last year.

I agree with you though about the early intervention, it is very important. I think you should mention some developmental delays/sensory issues you've noticed instead of going straight for the ASD suggestion.

Hi all. Thank you for your replies.

No, I am not medically qualified. I do however have plenty of personal experience of (specifically) Asperger's as a member of my family has it (albeit very mild). Can I just reiterate that it is my concern for the child motivating me to post and ask advice here?

I never had any intention of bluntly stating to the parents "By the way, I think your child is Autistic/has Asperger's" but IF that is the root cause of his behaviour surely an early diagnosis is best? I am in no way saying 'I have observed him for 3 months and this is my diagnosis', only that I strongly suspect he may be on the spectrum.

I am supporting him as best I can in his day-to-day life and have made huge progress with his anxiety issues. The fact he has responded to the techniques I have been using so well add weight to my suspicions.

Mis - Yes to all the points you mention. Plus, he is incredibly anxious, detests going to parties/being in crowds/noisy places, gets disproportionally upset at even the smallest change to his routine, plays the same games obsessively and I could go on. His speech and language abilities are not delayed and he is light years ahead of his peers academically.

His parents ARE concerned about all these things already, but I don't think autism is even on their radar as it doesn't seem to be discussed as openly here (not in the UK). Hence my dilemma.

I wouldn't say anything at all if I were you.

I think you should sit down and ask to chat about strategies to help him cope in situations he finds difficult, maybe ask how he is coping at school. If they raise their concerns maybe gently ask if they feel it's worth chatting to the GP or school SENCO.

I think the family are lucky to have you as a concerned and capable person looking after their child! As you say, you're right about early diagnosis. If you can, as others have suggested, speak with the parents about the specific issues and how you have managed those, then maybe the conversation will at some point turn the way you need it to. If they say they are also concerned, maybe you could then suggest they may want to raise it with the school to see if it's also a problem there? Then hopefully the teachers will flag up the suggestion of ASD.

Thank you Cats, Willow and Scott.

I like that suggestion Scott. I am very lucky in that I have an honest and upfront relationship with both parents, who are absolutely lovely and very approachable. It's because I like them so much that I don't want to hurt them by being tactless, but at the same time want to look after the best interests of their son.

I was thinking of asking for a 3 month review and using the opportunity to express my opinions on the behaviour I find concerning. They might be more open to discussing strategies for dealing with it if we're having a professional meeting rather than a spontaneous discussion after an upsetting day.

I am still up now (it's 3am here), as I can't sleep for worrying about them. His Mummy was on the verge of tears today after his behaviour at a birthday party

I am going to have to be careful not to 'out' myself, but school doesn't start here for another year and as he only attends pre-school sporadically (and is academically super-bright), I don't think his teachers will have picked up on it yet.

Ahh I think if mum has been in tears after a birthday party then now is a good time to talk. You sound lovely and I'm sure the parents will be grateful for your support.

Like I said nothing wrong with putting strategies in place even without a diagnosis.

Op, you sound really lovely, and switched on.
As Catchingmockingbirds, the first time someone (DSs teacher) suggested DS my have aspergers, by saying; "maybe something isn't quite right in his brain" I thought she was an idiot - didn't get what she was on about, and though she was suggesting DS had depression. (He certainly wasn't very happy in her class!) With hindsight, I can look back and see what she was really saying.

I don't know what country you are in, and don't know the route for a diagnosis in that country, but even if you had a diagnosis tomorrow, the parents are still going to have to learn through experience what works for this child, and what doesn't. It may be that you are with the child more hours a day than the parents, and are therefor are able to give them tips and advice on what works and what doesn't so they don't have to go through, or can minimise the trauma of such things as "fun" birthday parties and cinema visits.

I first thought DS has sensory issues (as in sensory processing disorder). I would have described him as highly sensitive, except it sounded very precious. It was a few years before I actually got a diagnosis of autism. I think pointing out that you've noticed the child is sensory sensitive, would be the way to go initially.

Yes the whole diagnosis issue before assessment is often the way to jack everyones anxieties sky high plus it can lead people down a path that might not be correct. Also at his young age it doesnt always mean you would do things drastically differently that any other tailored behaviour management plan for a child who is displaying some difficulties with coping.

Honest and open communication is most definately the way forward and as he isnt your child you will be most valued by his parents if you talk about ideas to move things forward. Perhaps talk to them about some joint recorded observations - agree that you both will keep a note book observing difficult situations - what happened; what happened before what happened after. Record really good days as well as tricky ones. As you probably know the whole basis of observation allows you to see if there is a pattern and from there you can focus in on what are some of the triggers for his difficult experiences. It also helps you identitfy what works well in terms of soothing him and keeping him calm. Hes very young still so no one would rush to diagnose but a log is very helpful if down the line it really is getting to be a problem and the professionals would be glad to have it.

I have some experience of this with a charge. Good observations are vital, plus the analysis of them to point out patterns and areas of concern. The country I was in also has very poor awareness of autism in general, specifically of Aspergers because autism = really really really autistic.

A diagnosis is great but as others have said you need coping strategies and they need to be put in place ASAP, and you don't need a diagnosis for that. That's the angle which IMO is most helpful for parents.

Good luck.

I think your approach needs to be very well thought through here.

I think you really need to do something, if you are concerned because making sure the kid gets the right kind of help comes imo before sparing the parents feeling.

It doesn't have to be as heartless as that :). Tink about your relationship with the parents and how to wrap/ sugar coat the info. Mention behaiour you find concerning. As long as you make clear it's a theory (maybe one of many) and you don't suggest that this is what it definitely is, it might even be useful to put a name to your suspicion. (This depends v much on the parents and your relationship to them and also how much problems the child currently has).

Good luck.