cm club_ how do you tell a mother you suspect her child has autisum???

[dmo]

i have tried to raise the subject before as i have concerns their is something not quite right, but mum got upset and said x was just shy that he knows his ABC and numbers etc etc
i have never heard x say more than 2 words in 2yrs he will be 3 in may.
after looking around i looked at autisum but dismissed it but then today somebody asked if he was autistic (another cm who has seen him twice a week for 2 yrs) we dissucused what he was like as a baby and she told me about a boy who she had in her care who was autistic and it sounds simier.
we are not doctors so we cant say for sure but how do i tell mum??? or should i tell her at all??

as a mother of a child with very delayed speech and awaiting assessment for ASD I would say:-

1)I would consider it your duty as a professional childcarer to alert the mother to your concerns
2)But DON"T mention the autism word - just that you are concerned for the reasons you have outlined above
3)Speak to your council early year service for advice about handling the situation.
4)A more acceptable way in to discussing the situation might be to suggest that the child has a hearing test - hearing problems can have huge knock on effects on language and behaviour.

I don't agree with waiting till the child starts school - as that could be wasting a further 18 months of that child's life.

bear in mind that if he isn't saying much, he may have some difficulties in understanding what you are saying - so uses photos/gestures etc to reinforce what you are asking/telling him.

the NAS website also has a pretty good advice page for trying to coax kids to communicate.

thanks
feels i bit dumb sticking my head in the sand

Ah dmo I second the idea that the parents should be alerted to your concerns about the child, bearing in mind that we CMs are not HC professionals.

Your network leader or Child Development officer should be able to offer guidance on how best to voice concerns without frightening or alienating the family.

Also that the range of hearing possessed by the child, in my experience, has a great bearing on speech and it's development.

HTH

as a qulified nursery nurse NNEB you re going way beyond your duty in suggesting this, autism is notoriously hrd to diagnose even for a professionl in that disorder- you dont need me to remind you that children develop at all different rates and usually do catch up.

you were ill advised to discuss it with other people and in mentioning to the mum before you ris upsetting her again,your duty is to stimulate and nurture tht childs abilities if you want to be a doctor i suggest you retrain.

I also agree that you should raise your concerns without mentioning autism. I think that as a CM you have the experience of seeing many children's development/behaviour whereas the mother may not have. If the mother is in denial and the child does have some problems then it is best that she starts to face the truth and learn how to help him as much as possible before he starts school.

I think you should be able to start with very gentle/subtle questions to try to establish whether she has any worries etc.

If you were a teacher you would have to raise your concerns about him. Surely a CM is in a similar situation.

I think you should mention someting about say, him not coming when you call him, and is he like this at home, or he doesn't seem interested in your toys, so what toys does he like? Ie raise your concerns in a ubtle way. However I do agree with the poster who said it was important not to waste time about this..........

If you were a teacher you would have to raise your concerns about him. Surely a CM is in a similar situation.

I think you should mention someting about say, him not coming when you call him, and is he like this at home, or he doesn't seem interested in your toys, so what toys does he like? Ie raise your concerns in a ubtle way. However I do agree with the poster who said it was important not to waste time about this..........

as childminders we should raise any concerns we have about a child with the parent.

can you arrange a meeting with his mum - just to chat about his development and behaviour? i would keep it light and definately not mention AUTISM - but you could just mention that he isn't interacting or coming when called - i would suggest a trip to the health visitor about his hearing although i imagine he'd of had a hearing test at 2yrs?

it's a very difficult situation.

i have a friend with a little boy displaying exactly the same symptoms except he can count to 100 and knows all the numbers up to that too and always obsessively plays with the numbers on the fridge etc. i have decided it is none of my business and to not say anything at this point. but i have gone through the process of wondering if it would make any positive differenc eto how she would deal with it if she suspected at an earlier stage but just concluded to keep out of it for the sake of the relationship and just that i dont see how he is at home etc....

You don't suggest that he has autism. If you do you'll get into the realm of stuff you know nothing about (such as eye contact/sense of humour/affection- all of which are pretty much red herrings in terms of autism diagnosis).

You can tell the mother that you have some concerns about his development and advise her to speak to her HV.

When the (evil) nursery raised concerns about ds1 I already had concerns so went straight to the HV. Unfortunately they then followed it up by blaming me for things like ds1's lack of speech (I was 'talking over him' or - 'not talking to him enough' - take your pick they said both- considering he still can't talk aged 9). They were also very rude about ds1 'he's not like other children, look at how far ahead X is compared to him?' and then finished it off by telling me I 'didn't seem to care' (that must have been why I was awake every night and had a stash of autism books borrowed from the library). A lesson in how not to do it. We removed ds1 (not because of what they said- more because when I came to pick him up I found him left in a separate room from the other children sat on a chair alone because apparently 'he likes it there'

Anyway after a break we switched nurseries and ds1 was there whilst going through diagnosis. The nursery manager was very supportive- she achieved this by supporting us through the system rather than telling us what she thought about ds1 (other than to say that he was lovely).

I think that if you have already discussed his speech you probably don't need to say any more. I agree it is a grey area. A nursery (particularly one including a pre-school section) would probably have a SENCO and might bring up a concern about lack of speech, but I certainly don't think a nursery would suggest autism. I think its your duty to make the parents aware of how a child behaves in your care, but suggestion of a diagnosis goes way beyond this.

I think you should bear in mind that although she may have said she doesn't think anything is wrong, she may not be telling you everything - she may aready be talking to the doctor/HV, but not told you about it and this is her right.

I disagree about not mentioning it again Madame Platypus - the 3rd birthday tends to be a "crunch" point - that if a child is just a late talker and will magically acquire a normal level of speech without intervention that usually happens by 3rd birthday.

I disagree with not saying anything actually. I agree with saying to mum that you have concerns and to talk to her HV, and give her reasons why. You aren't an expert, fine but you have experience around children that she may not have. Also particularly if she is a first time parent she really may have no idea.

My nursery in the States helped me through this, I was in a huge state of denial that there was something wrong with my baby and they very gently helped me contact the right people for an assessment etc.

Yes I was devastated but if they hadn't told me they had "concerns" I would have gone a lot longer without doing anything, maybe even to school age and by then it really would have done ds a huge disservice. Time is of the essence here.

I agree with crace. It's helpful if you back it up by saying how lovely the little boy is. Also you can say that waiting lists are long and although lots of children start talking late she might have to wait up to a year for an appointment and she may as well get her name on the waiting list as she can always cancel it if the appointment isn't needed.

If you find it easier to discuss concerns around speech than general development (and I think it's easier to hear as a parent- speech delay far less scary than developmental/autism) it's worth knowing she can self refer to speech and language therapy (you might be able to refer him if she wants that- not sure- nurseries certainly can).

DMO, i had similar prob and child's parents are still ignoring problem, despite me mentioning it to them AND school mentioning it.

I would maybe log your concern(dont know how you would do this as they have right to see it?, but you could just try and rememeber date and add and entry to diary saying you ahd concerns about x and menioend it on y date but no action was taken..at least then you know you cant be seen as doing nothing?..good luck chick

There is a section for concerns in the accident/medication book and I would think about noting it there as well.

when we were on the eyfs intro course we were told of a dept for cm's to ring for info if they had concerns about childs development, esp if the parents didnt accept or help when you addressed it..ring your local child care plus and ask if you have a dept to deal with behaviour/development issues..good luck

DMO - I've had this same problem, but ultimately, if the mother does not want to discuss it then you cannot do anything. Do not mention the A word or any word that would give a diagnosis, as you cannot do that and it will just upset her.

You've told her your concerns. Record your conderns as well, but really, until the mother believes or accepts that their child might have slow development in areas, you can't do anything. It's very frustrating, I know, especially as you sound like you really want to help.

I've been lucky and the parents have really wanted my help, so we're all working together now with speech therapists, my network co-ordinator, the health visitor and the portage scheme and it's working great. But it did take a while for parents to open up to me about their concerns and what was happening from their end.

The best thing you can do now is to record your concerns and any developments and do what you can to encourage development at home with him. At meal times when you're sat with them and have close one-to-one time, start repeating a letter sound, then turn that in to a word. It's worked for me so far. Also, putting simple signs to common words used apparently helps to encourage speech.

I HTH

also if you keep child daily diaries as well as writing in the lovely stuff and practical stuff(poops/meals etc), you could in the middle seomwhre put x had a problem with bla bla today, will see how he manages next time or could you see how he oes this at home and give me any tips..that way they might think theyre helping YOU instead of other way round??

I didn't mean not mention it ever again - I was more thinking give the mother a chance to let what you have said sink in and don't suggest a diagnosis. How long ago was it that you discussed it?

I also think that you have to listen to the mother. A child knowing its ABC's and numbers doesn't mean that there aren't any problems, but it does seem to imply that the child is saying more than a couple of words at home.

How often does this mindee come to you?

I do agree that if there is a problem (could it be a hearing problem?) it is best to pick it up earlier rather than later, preferably before school, but, frustrating though it may be, its up to the mother to make the decision about what to do.

I dunno MadameP- ds1 knew his entire alphabet aged 2 - could approximate most of the sounds and give the correct letter, could count to over twenty (poorly intonated but recognisable approximations of the vowel sounds) and knew things like an equals sign and a trapezium.

He couldn't actually talk though and still can't aged almost 9.

helath professionals tend to wake up when a child reaches 3 and can't talk so you may not have to wait too long for the parents to start moving things along a bit. You have to be quite feisty to get anyone to take you seriously before 3 (which is difficult to do when you're desperately hoping there's nothing wring).

Personally i would mention the things that concern you but not mention what you suspect.

I think when telling the mum about her childs time with you it is reasonable to say that
"he did x and y and ate z but that he still seems to play mostly on his own or finds mixing tricky. Does he have any games he likes to play with others at home?"
Or that
"he isn't talking much - is he chatting more with her?"
It is much kinder to gently draw her attention to the behaviours that concern you.
I would argue that giving her an accurate reflection of his behaviour during his time with you is part of your job.
Guessing at what those behaviours may signify definately isn't.
Apart from anything else there is a good chance that if he does not have ASD you will feel terrible. And if he has she may shoot the messenger.
Tough situation. Good luck

Can I jump in here and make another suggestion? I would say that given your list of concerns there clearly is an issue of some kind here. However, it is possible that it is nothing to do with genetic developmental issues but could be something to do with psychological trauma - eg abuse or perhaps the child does not have a strong bond with mum and so feels unable to connect with others. The others have been spot on to say do not assume or diagnose - those behavioural symptoms could be due to a whole range of potential causes and it is up to a qualified health professional to make that decision. I guess your best bet is to go with the observations approach of making notes and reviewing and I should say that it needs to be a minimum of 4 weeks of observation. That should give you a clearer picture to present to the mother. I do support you in that you are clearly trying to do what's best for this child but also its such a sensitive issue that we do have to tread carefully.