Bright child has no friends at preschool

[Tetherless]

My son started at preschool in September, having turned 3 last May (so is still 3). He’d never been to childcare before and we’d had a very isolated existence during covid as all family live abroad and we had to shield for the first lockdown. He struggled a lot settling in initially - wouldn’t sit with other children at meals, cried at drop off etc - but by the end of the first term he was joining in with everything, got on really well with the staff and seemed to me to have made huge progress.

He didn’t play with other kids at all at first but now does to a limited degree (apparently mainly when he can lead the activity). He much prefers talking to the adults. The staff have said that they are concerned with his social communication because he doesn’t have friends yet and have mentioned ASD as something they are thinking about.

DS is and always has been incredibly advanced - he met all milestones early, particularly those relating to communication (babbled with consonants at 4 months, pointing and first words at 8 months, sentences at 13 months). His maths is similarly advanced and he is extremely musical. He can read pretty well (on year 1 books atm). He is incredibly sensitive, imaginative, has a fantastic memory and sense of humour and is creative with a very wide range of interests. Motor skills wise he walked early, could ride a bike before he was 3, draws really well and starting to write. He has no sensory issues, eats and sleeps well and I have never considered him to have any kind of rigidness in terms of approach to routines. He’s generally pretty flexible but will sometimes kick off if he doesn’t get what he wants (which I thought was typical of his age). He is a bit of a stickler for the rules when playing games and that’s one of the things that nursery has cited (in addition to his preference for talking to adults) as “evidence” that he may be on the spectrum.

It has never crossed my mind that he is anything other than a bright but neurotypical child. Quite how bright I’m not sure. I feel that his issues making friends and preferring adults stem from a combination of natural shyness (DH and I both shy, academically high achieving kids), lack of practice due to covid and being used to being with adults, and difficulty engaging with peers whose language and interests are very different from his.

I feel that nursery has totally got it wrong but am conscious of course that they have a lot of experience (though possibly not with a child with this particular combination of circumstances). I feel slightly trapped in a parallel universe where they are seeing a completely different child from the one we see at home. They don’t seem to see his intelligence as a factor in his interactions with peers and seem keen to label him which seems crazy to me.

Should I be concerned? Is there anything I should be saying/doing with them or with him? Do I need to help him more with friendships or will it come with time? I feel slightly at a loss.

Sorry I didn’t mean “what school” I meant which country and I suppose N S E or W. (Though obviously ignore as you’re uncomfortable). It’s quite a serious blurring of medical/educational boundaries. I wonder if that’s happening elsewhere.

If you believe your child may have asd but school don’t can you see a paediatrician without their say so, or are they effectively gate keeping access? What happens if your child isn’t in nursery/school?

[quote 5zeds]So it doesn't seem silly to suggest that the people at the top of the top academically are neurologically different to most other people. I’m sorry but it really does. You could for example say everyone with an IQ between 90 and 110 is “neurologically different” to those with >110 or

@Anglophobia Same: I said earlier in the thread that I strongly suspect that just about everyone I was at Oxford with was neurodivergent (graduated 20 years ago). Huge levels of anxiety, manic episodes, depression, not understanding why people viewed things differently, addiction to exercise, anorexia, substance abuse, irregular social skills. My friend is an adult social worker in Oxford and has lots of uni students in her caseload.

I think 70 is the cut off for learning disability. Autistics who have IQs under 70 (the majority) are/were described as Low Functioning Autistics and above as High Functioning Autistics. Now we have a situation where “function” is used routinely to describe how well you function in society (pass for nt?) so we would say ASD with Learning disability. All aspergics were HF and some autistics were HF, but we no longer distinguish between the two.

That’s interesting @Anglophobia and @BelleTheBananas but absolutely not my experience at all.

In my friendship group no one has suffered with any of those issues.

I also wouldn’t conflate anxiety, eating disorders and depression with ASD (although I am sure there may be a link). It doesn’t surprise me that high academic achievers are also anxious and perfectionist, and those traits can lead to other things. But we all know that correlation is not causation.

Perhaps me and my friends are merely clever and not “gifted” (whatever that means).

Btw I never said DS taught himself to read at 3 - I taught him because he expressed an interest. He has learned in the normal way with phonics.

@Tetherless We're all well over forty, and it's only just being discussed now. I only entertained the idea because of my child being diagnosed, same for one of the others.

Absolutely a link between autistic women and anxiety and eating disorders and perfectionism. Very strong link!

And agree ex Oxbridge myself and v likely autistic - I'd have been very surprised if you'd suggested this to me 10 years ago but makes so much sense. No idea about others I was with but wouldn't be surprised - high number of very clever people with extreme focus on specialised interests!

@BelleTheBananas I graduated, er, sometime before that. One of the thing I feel deep regrets about are some people who clearly had significant issues and whom we just ignored and who now would have a lot more help.

But I've been on various groups for gifted children and there are very, very few of them who are not neurodiverse in one way or another. I thought my child was an exception, as did a couple of other parents, but they've all got a diagnosis of some kind or another by the teenage years.

@5zeds I'm talking about ability in general, not just in terms of those with a diagnosis of autism.

Christopher Gillberg (psychology prof) has been researching the link between anorexia and autism since the early 80s (he initially called it ‘female autism’).

www.spectrumnews.org/news/anorexias-link-to-autism-explained/amp/

@Anglophobia Absolutely the same. My friends aren’t as aware of their ND as me, mainly because they don’t have kids with ND (and don’t work with children). My best friend’s hobby at 3 years old was typing stories on her mum’s electric typewriter and her husband fell into a black hole of Schopenhauerian depression as a kid and had to be put on suicide watch . All of my other friends are in counselling/on anti-depressants

I’m sorry I’m not sure I understand what you’re trying to tell me @Anglophobia ?

Seeing a paediatrician should be arranged through a dr not a teacher. Can I ask what part of the country you are in that this is the route used?

Why ?

The school, or Nursery might spend anything between 15 and 50 hours a
week with that young person, as opposed to 5mins in a Dr's surgery, potentially with a GP who has neither specialised in child development nor has ever met the child before. It makes MUCH more sense for education to be able to refer in as well. I know the Paediatricians prefer school / nursery referrals here, as they are so much more detailed / can give SO much more information.

I wonder if that’s happening elsewhere

I work in one very large local authority, that borders several others, and, in all of them education can refer for further assessment. It is only since reading it on MN I found that some areas can't.

If you believe your child may have asd but school don’t can you see a paediatrician without their say so, or are they effectively gate keeping access?

Well, only in the same way that a GP could say "I don't see any signs so am not referring.
However, parents can still go to the GP
Or the HV. Or the HV's Assistant Practitioner.

What happens if your child isn’t in nursery/school?

They can still go to the GP, or to the HV as alternative routes.
Or, if they are lucky enough to be having Home visiting / portage, they can refer. As can a SaLT if they are lucky enough to be being seen by a SaLT.

Some very helpful posts by @BessieFinknottle

@OutlookStalking

It does depend on area - referall to paed assesment is through school here, not through GP.

And ed psychs arent in and out of shcool. Schools have so little budget they will jave them in for a specific case but even they sre rationed far too much.

EPs don't diagnose ASD as such but are part of a multidisciplinary team, where I am, that does (community Paed, SALT, OT, etc.) so work alongside them to provide their input on a diagnosis.

@BelleTheBananas

As the autism diagnosis has largely been based on the male presentation, many autistic women have slipped through the net, Historically some suffered with anorexia but more recently this cohort have expressed this difference as being transmen. The change in womens bodies can be really frightening and as with anorexia they want to control this change.

A CV paediatrician would ask for info from nursery etc anyway but I suppose primarily there are very different rules and very different legal obligations in the different relationships. For example a paediatrician wouldn’t disclose your child’s diagnosis to school without your permission. These lines are drawn to protect children not to inconvenience. It’s clear reading this thread that there isn’t a clear understanding of professional scope, patient dr confidentiality or even if the condition itself. It was a paediatrician who had been pressured by a senco to share medical information who highlighted this to me.

Sorry terrible typos, I hope you get my drift

@Ohnonevermind

Yes, I teach this cohort. Lots of girls presenting as/identifying as NB/opposite sex. I’ve always assumed it’s due to rules-based adherence to gender roles, sensory issues and discomfort with pubertal bodily changes.

@BelleTheBananas

It’s so hard for them.

For example a paediatrician wouldn’t disclose your child’s diagnosis to school without your permission. These lines are drawn to protect children not to inconvenience. It’s clear reading this thread that there isn’t a clear understanding of professional scope, patient dr confidentiality or even if the condition itself. It was a paediatrician who had been pressured by a senco to share medical information who highlighted this to me.

Really not sure what you are trying to say here.
If the parents gave school permission to refer to the Paediatrician, then obviously the school would be aware this was under investigation.
The parents then have the option - at the Paediatrician appointment - to say who they would like copied into any report.

Why would a SENCO be pressurising a Paediatrician ?
and if they did, why wouldn't the Paediatrician just remind them of patient confidentiality ?

However, what has that got to do with the fact that it makes a lot of sense for professionals who know the dc best, to be able to refer for assessment ?

[quote BelleTheBananas]@Ohnonevermind

Yes, I teach this cohort. Lots of girls presenting as/identifying as NB/opposite sex. I’ve always assumed it’s due to rules-based adherence to gender roles, sensory issues and discomfort with pubertal bodily changes.[/quote]
All of that and also trans is a socially acceptable way of explaining to themselves why they feel different.

I think it’s great that they can refer it to that you can’t go through the GP as was stated up thread. I DO think there’s an issue in smudging boundaries between education and medical data/professionalism (I’d as I said originally teachers shouldn’t be suggesting diagnosis and it’s unusual for a trained Dr who is not a paediatrician to do that). There are people on this thread, some with stated experience who think being high IQ implies autism rather than some autistics have high IQs. Surely when you get people who believe most of oxbridge are autistic you can see how problematic that is?